Negative pressure face shield for flexible laryngoscopy in the COVID‐19 era

Henry T Hoffman; Robert M Miller; Jarrett E Walsh; Helen R Stegall; Daniel J Diekema

doi:10.1002/lio2.437

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Negative pressure face shield for flexible laryngoscopy in the COVID‐19 era

Journal article

Open access

Peer reviewed

Negative pressure face shield for flexible laryngoscopy in the COVID‐19 era

Henry T Hoffman, Robert M Miller, Jarrett E Walsh, Helen R Stegall and Daniel J Diekema

Laryngoscope investigative otolaryngology, Vol.5(4), pp.718-726

08/2020

DOI: 10.1002/lio2.437

PMCID: PMC7444791

PMID: 32864444

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Abstract

Objective Introduce novel methods and materials to limit microdroplet spread when performing transnasal aerosol generating procedures in the COVID‐19 era. Methods Prototypes of a negative pressure face shield (NPFS) were tested then used clinically to create a suction‐clearing negative pressure microenvironment with controlled access to the nose and mouth. Air pressure measurements within prototypes were followed by prospective evaluation of 30 consecutive patients treated with the device assessed through questionnaires and monitoring oximetry. Results The NPFS is a transparent acrylic barrier with two anterior instrumentation ports and a side port to which continuous suction is applied. It is positioned on a stand and employs a disposable antimicrobial wrap to secure an enclosure around the head. This assembly was successfully used to complete transnasal laryngoscopy in all 30 patients studied. Tolerance of the design was excellent, with postprocedure questionnaire identifying no shortness of breath (27/30), no claustrophobia (27/30), no pain (29/30), and no significant changes in pulse oximetry. Conclusion Diagnostic laryngoscopy was successfully performed in a negative pressure microenvironment created to limit dispersion of aerosols. Further application of the NPFS device is targeted for use with transnasal laryngeal laser and biopsy procedures to be followed by additional modification to enable intranasal and intraoral procedures in a similar protected environment. Level of Evidence Level 2b (Cohort Study).

laryngoscopyaerosol generating procedure

laryngoscopy

diagnostic flexible

COVID‐19

Details

Title: Subtitle: Negative pressure face shield for flexible laryngoscopy in the COVID‐19 era
Creators: Henry T Hoffman - University of Iowa Hospitals and Clinics
Robert M Miller - University of Iowa Hospitals and Clinics
Jarrett E Walsh - University of Iowa Hospitals and Clinics
Helen R Stegall - University of Iowa Hospitals and Clinics
Daniel J Diekema - University of Iowa Hospitals and Clinics
Resource Type: Journal article
Publication Details: Laryngoscope investigative otolaryngology, Vol.5(4), pp.718-726
DOI: 10.1002/lio2.437
PMID: 32864444
PMCID: PMC7444791
NLM abbreviation: Laryngoscope Investig Otolaryngol
ISSN: 2378-8038
eISSN: 2378-8038
Publisher: John Wiley & Sons, Inc; Hoboken, USA
Number of pages: 9
Grant note: Institute for Clinical and Translational Science (NIH and CTSA) (UL1TR002537) University of Iowa Department of Otolaryngology
Language: English
Date published: 08/2020
Academic Unit: Infectious Diseases; Pathology; Radiation Oncology; Otolaryngology; Internal Medicine
Record Identifier: 9984001248002771

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