Simulation-Based Rapid Development and Implementation of a Novel Barrier Enclosure for Use in COVID-19 Patients: The SplashGuard CG

Background. The current COVID-19 pandemic has resulted in over 54,800,000 SARS-CoV-2 infections worldwide with a mortality rate of around 2.5%. As observed in other airborne viral infections such as influenza and SARS-CoV-1, healthcare workers are at high risk for infection when performing aerosol-g...

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Main Authors: Tine François, Laurence Tabone, Arielle Levy, Laurence Alix Seguin, Taher Touré, Carl Eric Aubin, Philippe Jouvet
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Critical Care Research and Practice
Online Access:http://dx.doi.org/10.1155/2020/3842506
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author Tine François
Laurence Tabone
Arielle Levy
Laurence Alix Seguin
Taher Touré
Carl Eric Aubin
Philippe Jouvet
author_facet Tine François
Laurence Tabone
Arielle Levy
Laurence Alix Seguin
Taher Touré
Carl Eric Aubin
Philippe Jouvet
author_sort Tine François
collection DOAJ
description Background. The current COVID-19 pandemic has resulted in over 54,800,000 SARS-CoV-2 infections worldwide with a mortality rate of around 2.5%. As observed in other airborne viral infections such as influenza and SARS-CoV-1, healthcare workers are at high risk for infection when performing aerosol-generating medical procedures (AGMP). Additionally, the threats of a global shortage of standard personal protective equipment (PPE) prompted many healthcare workers to explore alternative protective enclosures, such as the “aerosol box” invented by a Taiwanese anesthetist. Our study includes the design process of a protective barrier enclosure and its subsequent clinical implementation in the management of critically ill adults and children infected with SARS-CoV-2. Methods and Results. The barrier enclosure was designed for use in our tertiary care facility and named “SplashGuard CG” (CG for Care Givers). The device has been adapted using a multi- and interdisciplinary approach, with collaboration between physicians, respiratory therapists, nurses, and biomechanical engineers. Computer-aided design and simulation sessions throughout the entire process facilitated the rapid and safe implementation of the SplashGuard CG in different settings (intensive care unit, emergency department, and the operating room) during AGMPs such as bag-valve-mask ventilation, nasopharyngeal suctioning, intubation and extubation, and noninvasive ventilation. Indications for use and anticipatory precautions were communicated to all healthcare workers using the SplashGuard CG. The entire process was completed within one month. Conclusion. The rapid design, development, and clinical implementation of a new barrier enclosure, the “SplashGuard CG,” was feasible in this time of crisis thanks to close collaboration between medical and engineering teams and the use of recurring simulation sessions to test and improve the initial prototypes. Following this accelerated process, it is necessary to maintain team skills, monitor any undesirable effects, and evaluate and continuously improve this new device.
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spelling doaj-art-2e0250fd323a44378fc0286c1432f2d02025-08-20T03:55:07ZengWileyCritical Care Research and Practice2090-13052090-13132020-01-01202010.1155/2020/38425063842506Simulation-Based Rapid Development and Implementation of a Novel Barrier Enclosure for Use in COVID-19 Patients: The SplashGuard CGTine François0Laurence Tabone1Arielle Levy2Laurence Alix Seguin3Taher Touré4Carl Eric Aubin5Philippe Jouvet6Department of Pediatrics, Pediatric Intensive Care Unit, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, CanadaDepartment of Pediatrics, Pediatric Intensive Care Unit, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, CanadaDepartment of Emergency Medicine, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, CanadaDepartment of Emergency Medicine, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, CanadaDepartment of Anesthesia, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, CanadaDepartment of Mechanical Engineering, Polytechnique Montréal, Montréal, CanadaDepartment of Pediatrics, Pediatric Intensive Care Unit, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, CanadaBackground. The current COVID-19 pandemic has resulted in over 54,800,000 SARS-CoV-2 infections worldwide with a mortality rate of around 2.5%. As observed in other airborne viral infections such as influenza and SARS-CoV-1, healthcare workers are at high risk for infection when performing aerosol-generating medical procedures (AGMP). Additionally, the threats of a global shortage of standard personal protective equipment (PPE) prompted many healthcare workers to explore alternative protective enclosures, such as the “aerosol box” invented by a Taiwanese anesthetist. Our study includes the design process of a protective barrier enclosure and its subsequent clinical implementation in the management of critically ill adults and children infected with SARS-CoV-2. Methods and Results. The barrier enclosure was designed for use in our tertiary care facility and named “SplashGuard CG” (CG for Care Givers). The device has been adapted using a multi- and interdisciplinary approach, with collaboration between physicians, respiratory therapists, nurses, and biomechanical engineers. Computer-aided design and simulation sessions throughout the entire process facilitated the rapid and safe implementation of the SplashGuard CG in different settings (intensive care unit, emergency department, and the operating room) during AGMPs such as bag-valve-mask ventilation, nasopharyngeal suctioning, intubation and extubation, and noninvasive ventilation. Indications for use and anticipatory precautions were communicated to all healthcare workers using the SplashGuard CG. The entire process was completed within one month. Conclusion. The rapid design, development, and clinical implementation of a new barrier enclosure, the “SplashGuard CG,” was feasible in this time of crisis thanks to close collaboration between medical and engineering teams and the use of recurring simulation sessions to test and improve the initial prototypes. Following this accelerated process, it is necessary to maintain team skills, monitor any undesirable effects, and evaluate and continuously improve this new device.http://dx.doi.org/10.1155/2020/3842506
spellingShingle Tine François
Laurence Tabone
Arielle Levy
Laurence Alix Seguin
Taher Touré
Carl Eric Aubin
Philippe Jouvet
Simulation-Based Rapid Development and Implementation of a Novel Barrier Enclosure for Use in COVID-19 Patients: The SplashGuard CG
Critical Care Research and Practice
title Simulation-Based Rapid Development and Implementation of a Novel Barrier Enclosure for Use in COVID-19 Patients: The SplashGuard CG
title_full Simulation-Based Rapid Development and Implementation of a Novel Barrier Enclosure for Use in COVID-19 Patients: The SplashGuard CG
title_fullStr Simulation-Based Rapid Development and Implementation of a Novel Barrier Enclosure for Use in COVID-19 Patients: The SplashGuard CG
title_full_unstemmed Simulation-Based Rapid Development and Implementation of a Novel Barrier Enclosure for Use in COVID-19 Patients: The SplashGuard CG
title_short Simulation-Based Rapid Development and Implementation of a Novel Barrier Enclosure for Use in COVID-19 Patients: The SplashGuard CG
title_sort simulation based rapid development and implementation of a novel barrier enclosure for use in covid 19 patients the splashguard cg
url http://dx.doi.org/10.1155/2020/3842506
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