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Comment
. 2020 Oct;67(10):1478-1480.
doi: 10.1007/s12630-020-01720-6. Epub 2020 May 21.

A simple negative-pressure protective barrier for extubation of COVID-19 patients

Orlando Hung  1 , David Hung  2 , Christopher Hung  3 , Ronald Stewart  2
Affiliations
Comment

A simple negative-pressure protective barrier for extubation of COVID-19 patients

Orlando Hung et al. Can J Anaesth. 2020 Oct.
No abstract available

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Figures

FIGURE
FIGURE
A) One side of a clear plastic bag is split along the seam and the bag is then placed over the intubated patient’s head and chest, forming a “tent”. B) A hole is cut in the “apex” of the tent to accommodate the endotracheal tube (ETT) for connection to the filter and ventilator. C) The bag is then sealed around the ETT with an elastic band (arrow) prior to being reconnected to the circuit; the tape securing the ETT can be loosened through the plastic “tent”. D) During tracheal extubation, a continuous suction is applied at the filter connector (arrow). The insert shows the suction tubing connected to the filter using a three-dimensional (3D) printed tapered connector. The 3D printer STL file is available from the co-author (chris.r.hung@gmail.com). E) During tracheal extubation, the plastic cover is slowly lifted from the patient’s head and neck, and combined with the continuous suction, creates a negative pressure within the “tent.” Following removal of the tent, a tightly fitted mask with filter can be quickly applied to the patient’s face. F) Small aerosol droplets projected during coughing are illustrated visibly suspended in the environment and are being removed by the suction at the tip of the ETT within the negative-pressure “tent.” These processes can also be seen in a video available at https://youtu.be/CxDD2YY70VI. The video shows the steps involved in building the negative-pressure tent as well as the extubation procedure. In addition to serving as a barrier to contain the large droplets, it also shows that this tent has the potential to remove the smaller aerosol droplets (< 5 µm) using suction applied through the ETT
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