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. 2021 May-Jun;42(3):102888.
doi: 10.1016/j.amjoto.2020.102888. Epub 2021 Jan 4.

The FEES box: A novel barrier to contain particles during aerosol-generating procedures

Michelle G Ganann  1 , Merertu Kitila  2 , Ravi Patel  3 , Christopher D Brook  4 , Jessica M Pisegna  5
Affiliations

The FEES box: A novel barrier to contain particles during aerosol-generating procedures

Michelle G Ganann et al. Am J Otolaryngol. 2021 May-Jun.

Abstract

Purpose: Due to the COVID-19 pandemic, aerosol-generating procedures (AGPs) such as flexible endoscopic evaluation of swallowing (FEES) have been deemed high-risk and in some cases restricted, indicating the need for additional personal protective equipment. The aim of this study was to erect and study a protective barrier for FEES.

Materials and methods: A PVC cube was constructed to fit over a patient while allowing for upright endoscopy. A plastic drape was fitted over the cube, and the protective barrier was subsequently named the "FEES Box." Three different particulate-generating tasks were carried out: sneezing, coughing, and spraying water from an atomizer bottle. Each task was completed within and without the FEES Box, and particulate was measured with a particle counter. The average particles/L detected during the three tasks, and baseline measurements, were statistically compared.

Results: Without the FEES Box in place, the sneezing and spraying tasks resulted in a statistically significant increase in particles above baseline (p < 0.001 and p = 0.004, respectively); coughing particulate never reached levels significantly higher than baseline (p = 0.230). With use of the FEES Box, there was no statistically significant increase in particles above baseline in any of the three tasks.

Conclusion: The FEES Box effectively contained particles generated during sneezes and an atomizer spray. It would also likely mitigate coughing particulate, but coughing did not generate a significant increase in particles above baseline. Further research is warranted to test the efficacy of the FEES Box in containing particulate matter during a complete FEES procedure.

Keywords: Aerosols; COVID-19; FEES; Particulate; Speech-Language Pathology.

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Conflict of interest statement

All authors declare they have no financial, consultant, institutional, or other relationships that may lead to a bias or conflict of interest.

Figures

Fig. 1
Fig. 1
PCE-PCO 1 particle counter.
Fig. 2
Fig. 2
FEES Box set up on clinic chair for experimental design.
Fig. 3
Fig. 3
A, Participant set-up without FEES Box. B, Participant set-up with FEES Box.
Fig. 4
Fig. 4
A, FEES Box frame. B, Various hook attachments for different bed and chair types. C, FEES Box frame with cover and hook, next to FEES cart on hospital unit.
Fig. 5
Fig. 5
The mean particle count during simulated sneezing with and without the FEES box. ** Indicates a statistically significant difference from baseline at the 5% level. Error bars represent a 95% confidence interval.
Fig. 6
Fig. 6
The mean particle counts during simulated coughing with and without the FEES box. There was no statistically significant difference in either condition from baseline at the 5% level. Error bars represent a 95% confidence interval.
Fig. 7
Fig. 7
The mean particle counts during simulated coughing with and without the FEES box. ** Indicates a statistically significant difference from baseline at the 5% level. Error bars represent a 95% confidence interval.
See this image and copyright information in PMC

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