Local health care workers focus on equipment, innovation in fight against COVID-19

To help maintain supplies of personal protective equipment, or PPE, many hospitals have begun seeking innovative approaches to engineering their own solutions to the challenges posed by the spreading coronavirus.

In an effort to help find solutions, a team of engineers at Southeast Missouri State University used 3D printers to produce and deliver about 100 face shields to SoutheastHEALTH over the weekend, with more to follow to other facilities over the next few weeks.

Dr. Kyu-Sik Park sported one of the university-printed face shields in a photo shared in a Sunday night Facebook post by SoutheastHEALTH, along with a photo showing stacks of similar face shields.

The hospital's post thanked "local heroes" Brad Deken, chairman and professor in the Department of Engineering and Technology at the university, and his team for "laser printing, cutting and assembling face shields" for SoutheastHEALTH physicians.

"Eager to help during this crisis," the post continued, "Dr. Deken located open source face shield patterns and, working with a small group of volunteers, produced the shields."

Deken commented on the post later Sunday night extending credit for the effort to his fellow department staff members and employees across the university.

"By the way, we are running low on both transparency sheets (used as the actual shield) and 1/8 inch thick sheets of plastic (used to make the frame)," Deken stated in a comment. "We can make 30 frames with each 18"x32" sheet. If anyone knows of a good source right now of either of these, please let us know!"

A stack of Southeast Missouri State University-printed face shields for health care workers is seen.Photo courtesy of SoutheastHEALTH

Intubation box/ extubation tent

Last week, Saint Francis Healthcare System shared photos of one of its most recent innovations to provide care for COVID-19 patients -- an intubation box and extubation tent.

Saint Francis COVID Care Unit hospitalist Schaun Flaim said the intubation box's purpose is to decrease a physician's direct exposure to aerosolized respiratory air, which occurs when putting a breathing tube in a patient.

The idea was adapted using videos from Italy, then traveled through a chain of chief medical officials and hospital directors resulting in physicians receiving a prototype to test "within days," according to Flaim.

Aside from intubation, Flaim explained patients cough during extubation, which also aerosolizes the virus and puts health care workers at-risk of exposure. To reduce the risks, after talking with various clinical staff, the idea of a "tent" came into conversation.

"All it took was a phone call to Facilities, and we had an extubation tent," Flaim stated. "This is nothing high-tech, it is all pretty basic, but it better protects the staff caring for COVID-19 patients."

Mark Culberson, director of Facilities Management at Saint Francis, stated his department has also helped devise containment barriers throughout the facility and directed routes for patient transportation

Rodney Brown, one of the nursing directors at Saint Francis, stated dedicated pathways have been made for COVID-19 patients, including dedicated elevators. Flaim also detailed other modern, practical solutions being developed and implemented in the COVID Care Unit.

"One thing that Rodney [Brown] came up with yesterday was extremely helpful for communicating with each other," Flaim stated. "It is extremely difficult to talk through the windows in the COVID Care Unit. Anytime staff needed to discuss care, additional staff had to come into the room, utilizing valuable PPE and putting additional people at-risk for exposure. Now, the patient call light rings to one central phone, and we are able to have those conversations without bringing others into the room."

On the front lines

Flaim also shared his perspectives as a hospitalist working on the COVID Care Unit at Saint Francis.

"It has been stressful, this new paradigm of infection control that none of us has seen in our lifetime; however, the number of people who stepped up to think outside of normal, American healthcare and provide innovative care has been astounding," Flaim stated. "Our COVID Care Unit started as an email of ideas that would be helpful to keep everyone safe. Three days later, an entire area of the Medical Center was converted to care for COVID patients. An incredible amount of work has been done by all."

When asked about what the coronavirus outbreak has been like for health care workers, Chad Garner, director of Emergency and Trauma Services at Saint Francis, acknowledged the stress of being on the front lines of the fight but expressed a larger concern over PPE.

"The only thing that we've dealt with like this was Ebola. But the sheer numbers of COVID patients have made this a pandemic," Garner stated. "It is stressful to be on the front lines taking care of these patients, but we are doing so willingly. Right now, we are struggling to make sure our front-line staff are protected with appropriate PPE. This is why we have asked for volunteers to make masks for our patients. We want to conserve PPE for those caring for these patients."

"We appreciate the incredible amount of work and thought that has gone into making this possible," Flaim stated. "No idea to keep our staff safe has been turned down."