In April 2020, Dr Robert Urbanowicz and his colleagues Drs Rami Issa and Issam Tanoubi came up with the idea of developing a tool to protect operating room staff from COVID-19 during maneuvers such as intubation. Their engineering background has enabled them to develop, in collaboration with Polytechnique de Montréal and the École de technologie supérieure, a very special box.
In addition to forming a physical barrier between patient and staff, the box creates a negative pressure environment that helps remove aerosols including those generated by patients with COVID-19.
Here is how the box developed by the Maisonneuve-Rosemont Hospital team works:
- The masked patient is lying on the operating table and the box is then set up. The patient's mask is removed, because the box becomes the element of protection.
- A hose on the top of the box is connected to an air suction and a pump sucks the aerosols emitted by the patient's mouth.
- When the patient is asleep, the team can perform the intubation using gloves attached to the openings of the box
- A device calculates the concentration of aerosols in the box and determines when the box can be safely removed. After removal of the box, surgery can proceed as usual.
From innovation to clinical use
The first step in this research project demonstrated that the box, nicknamed the VACCIN Box (VACCum / Intubation), effectively controls the emission of particles into the air, thus protecting personnel in the operating room.
The second stage of the project consists of a comparative study carried out on 60 patients (the box was used in 30 surgeries with patients and 30 other surgeries were performed without the box). Analyzes are in progress to compare the maneuvers performed in the presence of the box compared to those performed without the box. This study will demonstrate, among other things, whether the VACCIN Box does not interfere with the intubation process performed by the anesthesiologist and respiratory therapist.
The results will be analyzed and then compiled into a scientific article which will be submitted for publication. This peer validation step is very important and will possibly lead to extended clinical use.
Much more than protection against aerosols
In addition to protecting personnel during intubation, the box will also save operating time. Indeed, between each surgery for a patient suffering from COVID-19, it takes at least an hour to disinfect and ensure good air quality in the room, which is not the case with the box.
The VACCIN Box could also prove to be a simple and economical alternative to negative pressure surgical rooms.