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Negative-pressure box under continuous suction for shielding against aerosols produced by patients with COVID-19 during abdominal ultrasound-guided intervention
Corresponding author at: Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki, Kita, Kagawa 761-0793, Japan.
American Institute of Ultrasound in Medicine Guidelines for cleaning and preparing external- and internal-use ultrasound transducers and equipment between patients as well as safe handling and use of ultrasound coupling gel.
]. Additionally, ultrasound examinations should be postponed to prioritize urgent procedures involving percutaneoushepato-biliary drainage and ablation of hepatocellular carcinoma. However, novel means for shielding against patient-generated aerosols remain undeveloped. A negative-pressure room should be prepared to turn off aerosol circulation when performing interventions for patients with COVID-19. However, such facilities are uncommon in ultrasonography units. We herein describe the use of a negative-pressure box under continuous suction for shielding against COVID-19 during ultrasound interventions (Fig. 1A) (Video S1).
Fig. 1A. Overview image showing the shield for the patient during urgent abdominal ultrasound-guided interventions. The patient's upper body is almost completely shielded by the box. B. Prepared materials, consisting of a transparent vinyl bag (60 × 45 × 22 cm, 90 Liter capacity), kitchen rack (21 × 19 × 44 cm), and binder clips.
The prepared materials included a transparent vinyl bag, kitchen rack, and binder clips (Fig. 1B). Written informed consent was obtained. First, the box was created by clipping the bag inside the rack. Next, a suction tube was inserted into the openside of the box, resulting in a negative-pressure box. An oxygen-insufflated nasal tube was simultaneously inserted into the upper side of the box to maintain patient respiration (Fig. 2A). After the right arm was raised outside the box via a suitable hole, the openside was wrapped with a clean disposable cloth on the mid-body. The upper body was almost completely shielded by the box (Fig. 2B).
Fig. 2A. Continuous aerosol suction is performed via a suction tube (white arrows) inserted into the open side of the box, resulting in negative pressure-box. B. An oxygen-insufflated nasal tube (green arrows) inserted into the upper side of the box helps to maintain patient respiration.
Guidelines for cleaning and preparing external- and internal-use ultrasound transducers and equipment between patients as well as safe handling and use of ultrasound coupling gel.
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