Aerosol boxes are potentially deadly for patients and hospital staff

A medical innovation designed to protect healthcare workers from contracting COVID-19 while intubating patients could actually be deadly.

Known as “Aerosol boxes”, these clear plastic cases are meant to shield medical staff from infectious droplets while inserting a breathing tube into patients, and they’ve been rolled out to hospitals around the world.

But a group of Melbourne doctors have found that the boxes are largely untested. When they undertook the tests themselves, what they found was alarming.

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In a study, published in the science journal Anaesthesia, the researchers found the aerosol boxes often rip protective gear when medical staff put their arms through the holes.

The see-through box also slowed down doctors, with the plastic walls getting in the way of intubating patients effectively.

Doctors spent up to three minutes intubating patients using the box, compared with less than one minute without it.

That could be the difference between life and death for seriously ill patients who desperately need air flow, according to researchers.

Researchers examined two types of boxes and simulated 24 intubation procedures.

Mannequins were used in place of patients in the study.

They found a “concerning” amount of damage to personal protective equipment, as medical gowns got stuck in the arm holes, tearing the fabric and exposing skin to infected patients.

Cabrini Hospital’s deputy ICU director David Brewster was involved in the research and was concerned about the findings.

“Realistically, they (aerosol boxes) shouldn’t be used now,” he told The Age.

“The problem is this equipment is not well researched, or hasn’t been shown to be beneficial.”

The newly invented aerosol boxes have received plenty of glowing media coverage, but Aussie doctors began to feel sceptical after they realised there was no evidence to prove that the invention was beneficial.

Dr Jonathan Begley, lead author of the study, was particularly concerned that “manufacturers around the world have been stating that they’d been distributing hundreds”, despite no research behind it.

“Even in an unusual situation like a pandemic it is important that any device is properly evaluated prior to being used clinically,” he said.

A Taiwanese anaesthetist invented the boxes earlier this year, in response to the coronavirus pandemic.

“They’re doing it from a good place, where they’re genuinely trying to help,” Associate Professor Brewster said.

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