Abstract
Poor access to basic personal protective equipment (PPE) is the primary reason for a high proportion of healthcare workers being infected with the 2019-nCoV virus worldwide (1). Intubating a COVID-19 patient is considered an extremely high-risk procedure for the healthcare workers in an emergency room or ICU. Current guidelines recommend a negative pressure room for the aerosol-generating procedures. However, the number of such rooms is limited in low- and middle-income countries. Clinicians rely on personal protective equipment (PPE) to protect themselves from airborne transmission especially during the aerosol-generating procedures. To help the healthcare professionals with an extra line of protection and free range of motion during resuscitation of COVID-19 patients, we have started to use a modified aerosol box in the pediatric emergency department. Our design is based on an open-source original plan presented by Dr. Hsien Yung Lai from Taiwan (2). The fluorescent dye experiment conducted by Robert Canelli and colleagues have suggested that the transparent aerosol box provides additional protection during the endotracheal intubation; however, the restricted hand movement during the procedure was its main limitation (3). We have found that a design based on a light frame and a flexible transparent plastic cover enclosing it could facilitate greater hand movement and enhance the efficacy of the procedure.

Key words: airborne, covid-19, healthcare, personal protective equipment.