A Multipurpose Droplet and Aerosol Mitigating Enclosure to Protect Health Care Professionals from Infectious Diseases

The SARS-Cov-2 crisis has prompted a call to mitigate risks to health care workers (HCWs), especially during endotracheal intubation (ETI) and other aerosol-generating procedures (AGPs). During ETI HCWs are in close proximity to the patient’s airway subjecting them to potential splash exposure to secretions, droplets, and aerosols which may contain potential pathogens. ETI is known to present a distinctly higher risk of transmission of acute respiratory infection to health care workers in patients with coronavirus relative to other medical procedures. ETI in itself can be frightening for many providers. Now that it is potentially deadly, the procedural stress is deeply magnified. Other procedures associated with aerosolization and respiratory droplets include bag-mask ventilation, high-flow oxygen delivery, non-invasive ventilation, bronchoscopy, nebulizer therapy, cardiopulmonary resuscitation, and procedures that are likely to induce coughing such as tracheal extubation. Although HCW’s are instructed to don appropriate personal protective equipment during these procedures, there is still a risk of harmful exposure to microscopic pathogens. Droplet particles (> 5μm) generally have a ballistic trajectory, whereas aerosols (≤ 5μm) are capable of being suspended in air. During this current SARS-Cov-2 crisis, operators are rapidly innovating ad-hoc barriers in order to mitigate droplet and aerosol exposure, particularly during tracheal intubation. Recently, a simple Plexiglas enclosure has been shown to prevent droplet splatter on operators, monitors, and the floor during a simulated endotracheal intubation experiment. This preliminary data suggests that simple and practical procedural enclosures can provide an additional degree of protection to HCWs from exposure during ETI, tracheal extubation, and other AGPs, potentially decreasing infectious risk. They will also be invaluable in decreasing HCW stress. The current pandemic has  spawned a myriad of these enclosures. Unfortunately, virtually all of them are bulky, single-purpose oriented, require cleaning, and are not capable of scaling to national or international needs. Olifant Medical has developed a procedural hood that is lightweight, disposable, foldable, and capable of being produced, shipped, and stored in large quantities. During the COVID-19 crisis military HCW’s are facing risks similar to their civilian counterparts. However, in the deployed setting HCW attrition (by any cause) is much more difficult to manage. HCW force protection is particularly relevant in the multi-domain operational environment, where long distances and airspace denial will limit the ability to replace stricken personnel. Infected military HCW can also serve as vectors, infecting others, and further diminish readiness. Olifant Medical seeks to align its new technology with Air Force and DoD needs, adding yet another layer of protection for medics and to military readiness.