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Innovative Tent-like Shield (DART) Offers Increased Protection for Healthcare Workers when Interacting with COVID-19 Patients

Droplet and aerosol Reducing Tent (DART) developed by a research team from National University Singapore (NUS) offers extensive protection to healthcare workers against viruses and other pathogens, in efforts to combat the COVID-19 global health crisis.

The DART, like its name, is a tent-like shield device designed by a cross disciplinary team from NUS to protect healthcare workers who are combatting COVID-19 at the frontlines. This inventive device is the brainchild of the team led by Professor Freddy Boey, NUS Deputy President (Innovation & Enterprise), and Associate Professor Yen Ching-Chiuan, the Co-Director of the Keio-NUS CUTE Center.

This project features collaborative efforts from multiple departments, including the NUS department of Biomedical Engineering, the Keio-NUS CUTE Center, NUS Division of Industrial Design, the NUS Faculty of Engineering and the Department of Anaesthesia, National University Hospital (NUH).

DART was conceptualised and effectiveness was verified in a short timeframe of less than 2 months as a result of close collaborative efforts. It can effectively lower the risk of direct transmission of the coronavirus from patients to healthcare workers, who increasingly face constant exposure to the novel coronavirus among other pathogens during droplet and aerosol generating processes such as suctioning, intubation and extubation on COVID-19 patients. Additionally, DART can also reduce the risk of indirect transmission from contaminated objects in the immediate surroundings in a hospital setting.

COVID-19, being highly infectious, has considerably increased the exigency for controlled intubation and extubation – the insertion or removal respectively of a plastic tube into the windpipe of patients to keep the airway open and as a means for the delivery of some medicines, to minimise the transmission risk to healthcare workers.

It was apparent from the outbreak of Severe Acute Respiratory Syndrome (SARS) in Singapore in 2003 that healthcare workers who conducted intubation and extubation among other procedures, who came into contact with the droplets and aerosols from SARS patients had a higher risk of being infected. Similarly, in this COVID-19 outbreak, healthcare workers such as anaesthesiologists, operating theatre staff, intensive care unit staff and first responders who need to be in close contact with COVID-19 patients to perform a range of medical procedures are facing a much higher risk of being infected by the coronavirus as compared to other non-frontline healthcare workers.

Protecting our frontline healthcare workers is essential and as Dr Khoo, a Consultant at NUH Department of Anaesthesia puts it: “Healthcare workers caring for patients run the risk of being exposed to known, suspected, or even asymptomatic COVID-19 patients. The DART serves as an additional physical barrier to infection and provides enhanced protection for healthcare staff at a time when they need it the most, giving us greater peace of mind and enabling care to continue safely for both patients and healthcare workers in the hospitals.”

DART is a lightweight and movable tent-like shield that is convenient to set up around or remove from the patient’s head for intubation or after extubation. Among DART’s notable features are clear polycarbonate panels, 3D printed nylon joints and Delrin inserts, which are chosen for their ideal durability and ability to be sterilized via autoclaving and 70 percent alcohol solutions. These features ensure a longer product lifespan and a reduced risk of cross-contamination.

DART also features arm access ports at its back and side panels, snap-on flanges which permit the fitting of disposable sleeves or diaphragms depending on the choice of the healthcare workers, hence greatly reducing the traditionally high risk of contamination associated with arm ports.

Furthermore, the main aspect of DART – the High Efficiency Particulate Air (HEPA) filter conducts air within the device, resulting in the generation of negative pressure that decreases the effusion of exhaled droplets and aerosols from within the DART. Pilot tests have already ascertained the effectiveness of the HEPA filter at limiting the spread of infectious viral particles from the patient, thus giving a peace of mind to healthcare workers in close contact with COVID-19 patients.

At present, 25 prototypes have been generated and the research team is testing them in various public and private hospitals in Singapore. Based on the evaluations of this device, the team will improve and finetune DART before presenting it in collaboration with Temasek Foundation as a medical aid not only to Singapore hospitals but also hospitals in the neighbouring countries.

Since the start of the global health crisis, NUS has been taking active steps in tackling this novel coronavirus from different angles and sectors ranging from creating fast COVID-19 detection test kits, to case connections and vaccine and public health model development. The creation of DART is just one approach among many others in the national and global fight against the COVID-19 pandemic. [APBN]