MSU – Mount Sinai Hospital – University Health Network Academic Medical Organization
Development of a Novel Hood Shield to Enhance PPE Security and minimize COVID-19 transmission to front-line health care workers performing high-risk procedures.
Our group has designed a novel hood PPE intended to be worn along with an N95 mask and instead of a face shield to cover the head, neck and upper torso of health care professionals who are performing high-risk procedures for COVID 19 contamination such as endotracheal intubation and other aerosol-generating medical procedures. We have designed the hood prototypes in collaboration with a local Ontario-based engineering company (Lake Harbour Co. Ltd. Markham, ON, Canada). The hood is compatible with AAMI level 3 protection standards and is made of Spunboud Meltblown Spunbound (SMS) fabric with a polyethylene terephthalate front window for visibility. Following a period of time for the design, we performed a prospective randomized test in a high-fidelity simulation laboratory on 40 front-line health care professionals at the University Health Network. Using a high-fidelity mannequin we simulated an episode of cough during endotracheal intubation procedures in a simulated patient with COVID-19 pneumonia. The study was REB approved and written informed consent was obtained from every subject. Participants were randomized to either a) A control group wearing standard UHN PPE or b) Enhanced PPE with the protective hood. The simulated cough episode was performed in a standardized fashion using a GloGerm Mist Kit (Marlatek Inc, Brockville, ON, Canada) and ultraviolet light was used in a dark room to evaluate surrogate contamination before and after doffing procedures. A blinded assessor determined all primary and secondary outcomes. We found that the use of enhanced PPE with the hood decreased residual contamination of the upper body from 90% to 40% of health care professionals. It also decreased the number of body areas affected by contamination and the number of discrete contamination “spots”. Using multiple questions on an 11-point numeric rating scale, we determined that the hood provided similar visibility, ease of breathing, ability to communicate and ease to perform the intubation tasks compared to standard PPE with only slightly lower thermal comfort. These findings suggest that enhanced PPE with this novel hood may provide superior protection to health care professionals from contamination with airborne droplets during aerosol-generating medical procedures. Further research may include testing these hoods in the clinical setting and evaluating for feasibility of mass production and distribution.
Methods of Risk Reduction and Mitigation
Primary Project Lead for Contact
Anahi Perlas, MD, FRCPC