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AIR tent for airway management of SARS patients

New Territories, Hong Kong

To the Editor:

The suspected culprit, a coronavirus, of the severe acute respiratory syndrome (SARS) is believed to spread mainly by droplets.¹ Positive airway pressure generated during coughing, tracheal intubation and extubation, and during assisted ventilation may facilitate the dispersion of droplets from infected patients.

We developed the airway intervention and resuscitation tent (AIR tent) to provide an extra layer of barrier between the patient and health care workers (Figure). The "tent" is an assembly of a clear transparent plastic bag mounted on a plastic frame. The anesthesiologist can use the gloves on the cephalic side of the tent while an extra glove on the caudal side can be used by the assistant to provide cricoid pressure and pass instruments. An airtight seal around the glove is produced by screwing two plastic rings over the plastic sheet with the glove first mounted on the inner ring. The inner and outer rings are cut from the top and the lid of a plastic container respectively. A rubber seal, fashioned from a feeding bottle tit and fixed by an adhesive dressing at the top of the tent, provides a conduit for bronchoscopy. The plastic frame and rings can be disinfected with sodium hypochlorite solution. Other parts are disposable. The AIR Tent is inexpensive to construct (plastic frame: US$ 15; gloves + plastic bag: US$ 1.5) and is easy to put together (setting-up time < 5 minutes). We believe the AIR Tent is suitable for use in operating rooms and other parts of the hospital where resuscitation takes place.

View larger version (126K): [in this window] [in a new window]   FIGURE AIR tent covering the head and the upper part of the chest of a manikin on an operating table.

Reference

1 Li TS, Buckley TA, Yap FH, Sung JJ, Joynt GM. Severe acute respiratory syndrome (SARS): infection control (Letter). Lancet 2003; 361: 1386.

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