Though treating patients in the hospital always requires clinicians to wear personal protective equipment (PPE), we know treating patients with infectious diseases like COVID-19 requires an extra level of precaution. As the COVID-19 virus is transmitted via respiratory droplets, anesthesiologists, in particular, must be vigilant while performing Aerosol Generating Medical Procedures (AGMPs) such as intubations. This heightened demand for safety led Cleveland Clinic cardiothoracic anesthesiologist, Sergio Bustamante, MD, to a simple protection idea. His solution, the CT Airway Bag, is a large fully disposable, non-sterile, transparent plastic bag with four circular openings, two at the top of the head and one on each side for the caregiver’s arms and instruments. The openings at the head have plastic arm sleeves with an elastic band to further protect the caregiver. Each side hole can be accessed through a sealed zip bag, intended to be opened only when needed. The bag creates a “cavity” to surround the head, neck, and upper chest of a patient to provide caregiver protection during AGMPs.
Dr. Bustamante presented this idea in April, shortly after the start of the pandemic, and has since gone through multiple design iterations. The bag was designed with laparoscopic surgery in mind, where access to cavities is done through port valves and openings. In his design research, Dr. Bustamante saw that other barrier methods, such as “Aerosol Boxes” were unwieldy and restricted hand movement due to their plastic cube designs. The flexible material for the bag mitigates this issue.
Dr. Bustamante’s early designs were made possible by the Polymer Core in Lerner Research Institute and with plastic rings 3D printed by think[box] at Case Western Reserve University. Around 100 prototypes were put together by Innovation Manager Ryan Nowicki and a group of volunteers, with adhesive, plastic arm sleeves and plastic zipper storage bags. Nowicki took the design to Parker Hannifin, who is developing improved manufacturing processes to streamline production. The team behind the CT Airway bag has filed a provisional patent and is working on an application for Emergency Use Authorization through the FDA. Dr. Bustamante has created training materials for the bag, which are stocked in COVID-19 operating rooms across the enterprise. Quickly bringing this solution to caregivers and external clinicians whose specialty puts them at increased risk is a priority for the team. We thank Dr. Bustamante and all those involved with the project for helping to ensure the safety and security of the frontline.