Abstract
The supply of Personal Protective Equipment (PPE) in hospitals to keep the Health Care Professionals (HCP) safe taking care of patients may be limited, especially during the outbreak of a new disease. In particular, the face and body protective equipment is critical to prevent the wearer from exposure to pathogenic biological airborne particulates. This situation has been now observed worldwide during the onset of the COVID-19 pandemic. As concern over shortages of PPE at hospitals grows, we share with the public and makers’ community the Pressure Optimized PowEred Respirator (PROPER) equipment, made out of COTS components. It is functionally equivalent to a Powered Air Purifying Respirator (PAPR). PROPER, a hood-based system which uses open source and easily accessible components is low-cost, relatively passive in terms of energy consumption and mechanisms, and easy and fast to 3D print, build and assemble. We have adapted our experience on building clean room environments and qualifying the bioburden of space instruments to this solution, which is in essence a miniaturized, personal, wearable cleanroom. PROPER would be able to offer better protection than an N95 respirator mask, mainly because it is insensitive to seal fit and it shields the eyes as well. The PROPER SMS fabric is designed for single-use and not intended for reuse, as they may start to tear and fail but the rest of the parts can be disinfected and reused. We provide a set of guidelines to build a low-cost 3D printed solution for an effective PAPR system and describe the procedures to validate it to comply with the biosafety level 3 requirements. We have validated the prototype of PROPER unit for air flow, ISO class cleanliness level, oxygen and carbon-dioxide gas concentrations during exhalation, and present here these results for illustration. We demonstrate that the area inside the hood is more than 200 times cleaner than the external ambient without the operator and more than 175 times with the operator and in an aerosol exposed environment. We also include the procedure to clean and disinfect the equipment for reuse. PROPER may be a useful addition to provide protection to HCPs against the SARS-CoV-2 virus or other potential future viral diseases that are transmitted aerially.
Highlights
The supply of Personal Protective Equipment (PPE) in hospitals to keep the Health Care Professionals (HCP) safe taking care of patients may be limited, especially during the outbreak of a new disease
Since these masks must fit around the nose and mouth to make a perfect seal for effective filtration, a Powered Air Purifying Respirator (PAPR) system is the first choice for protection against aerosols and the production of these specialized respiratory hoods are in demand [3]
The Food and Drug Administration (FDA) has recommended conservation strategies during this time period and issued Emergency Use Authorizations (EUAs) [7] to authorize respirators and other types of personal protective equipment, including all Centers for Disease Control and Prevention (CDC)’s National Institute for Occupational Safety and Health (NIOSH) approved particulate-filtering air purifying respirators (APRs) such as the facepiece respirators, elastomeric APRs, powered air purifying respirators, expired NIOSHapproved filtering facepiece respirators [2,8,9], and respirators that have been decontaminated pursuant to the terms and conditions of an authorized decontamination system [10]
Summary
The supply of Personal Protective Equipment (PPE) in hospitals to keep the Health Care Professionals (HCP) safe taking care of patients may be limited, especially during the outbreak of a new disease. Many hospitals are facing rapidly dwindling supplies of essential safety equipment such as respirators This equipment is very important for the usual care of patients with COVID-19 as they prevent the wearer from exposure to pathogenic biological airborne particulates and from contact with contaminated surfaces. Patients in Intensive Care Unit (ICU) requiring respiratory support or life-saving procedures such as endotracheal intubation for mechanical ventilation and other procedures that cause a spray of aerosols carrying SARS-CoV-2 virus These aerosols, unlike droplets, can suspend in the air for a longer duration and can be inhaled by the HCPs or others in the room since these particles are tiny enough to pass through surgical masks. Non-NIOSH-approved disposable filtering facepiece respirators are permitted for use as well
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