Much like a biohazard hood; 2 principles are used
- negative pressure (pulling bad stuff away from you)
- directionality shielding (a clear shield protects your face while you work; and all other 3 sides are shielded)
In the most extreme situations a complete seal is formed. This doesn't work for emergent airways; we need something we can set on top of a patient in seconds; and get to work. It needs to be cheap, lightweight, and idiot proof. We need visability. We need to protect everyone in the room; and give the intubator the best visable window and flexibility to work.
Here is model one; the fastest and cheapest solution I could build in 5 minutes with stuff from a hardware store:
- set of 6x 1/2" PVC pipes; cut to 23.5" length [$4]
- 4x 3-way and curved standard fittings at junctions [$4]
- 72x72" clear vinlyl sheet (AKA a shower curtain) [retail $2]
I tried working under the slack of the front pieces; works; but particles preferentially go out into the user.
A few hours later; I have printed a few C clamps; that can snap on and off to hold the sheet to the frame in tension.
Next step will be arm holes; which ability to grip to the arm and allow some range while maintaining some element of seal. After that; I'll show you a vacuum port I've designed; where you can link up suction from the wall port in parallel to generate a negative pressure in the space.
I 3D printed a mold and cast silicone into it form a 2" hole in side a 6" reinforced sleeve; fits my arm (170lb 5'11" male) and my wife (100lb 5'2" female) with minimal tension. When mated to the sheet adds minimal weight and allows for a user to insert/remove arms. Also; if you leave slack in the sheet facing the end use your can move around about 1 foot in all cardinal directions without issue. I used ecoflex 35 extrafast by Smooth-On -- sets in 5 minutes. Adds a lot of weight but if you want to go overboard and make it airtight-ish here is how ya do it on the cheap.
***I ended up scrapping this silicone idea; adds time, cost and weight; while adding very little value***
VIDEO SHOWING ASSEMBLY/USE/DISASSEMBLY OF VERSION 1
I have updated the C clips to be easier to snap on and off. And I have decided against the silicone arm holes; rather cutting flaps as shown below. You can also perforate the plastic and then punch through when needed.
I've also stopped putting clips over the top; as its nice to have slack in the vertical direction during use. Watching a few other ICU and ED docs use it that was the most common wall struck during intubations (on an intentionally difficult maniquin).
Also, I bought a new/clean shower curtain and visability is MUCH improved (water stains from the old curtain made it blurry in the first version. Target sells this one for $2! I bought a cart full.
Today I experimented with overhand arms; 6" long on the top braces; adds neglicible weight; but changes how the sheet folds over. The main benefit is that you have more working room; no need for the sheet to go down to the mid-chest; in fact it enables chest compressions this way to shorten the arms along the pt's sides.
It also makes it easier for a 2nd or 3rd user to enter from the side. I cut quick circles and X's with a blade; took seconds, and works just as well as a careful loop. In a pinch it lets a second user in.
I think it's worth adding the overhang; since the roof is what more user hit; and just choke up on the clips in the back of the unit. Make it more of a trapazoid.
Went and got more supplies; as we are gonna roll this out in our system at each site. I found cheaper parts too. Junctions are $0.65 and 10 feet PVC pipes were $1.69 for a 10 foot slat; I also got a PVC cutter for $15; worth every penny, cuts em like butter. I made 6 more units in 30 minutes; and got buckets to hold/clean em.
Mold ArmHole v3.24.20
WARNING: Your Design Medical and it’s Owner Justin Henneman make no guarantee whatsoever that these devices will function perfectly (or even at all). These items were developed because people are dying & the health of our nation including our medical personal are at stake. Everything you do is at your own peril (welcome to life); but doing nothing to help is probably just as risky. Try not to sue me for helping once the dust settles; at least I can sleep at night knowing I tried.