Medical Professionals from Amrita Institute of Medical Sciences (AIMS), Kochi campus, has come up with the hacks for making face-shields, improvements on standard surgical masks and acrylic barriers to prevent virus-containing aerosols from entering the atmosphere during intubation.

Some people who have contracted COVID-19 develop severe pneumonia and must be put on a ventilator. To accomplish this, a ventilation tube has to be fed down the patient’s throat. During intubation, it is common for the patient to expel a large amount of highly infectious aerosol mucus, which permeates the atmosphere. Dr. Sundeep Vijayraghavan of the AIMS, plastic-surgery department has created a three-sided acrylic box to physically separate the intubation team from the patient. Amrita Hospital has already supplied two of these “intubation boxes” to the Government Medical Colleges in Kottayam and Ernakulam.

Other hacks developed by AIMS include face shields/visors that can be used with the currently available PPE Kits at the hospital using easily available materials like baseball cap with a stiff frontal peak, OHP transparency sheet and double sided tape. A variation of this is the face shield using styrofoam strip, OHP transparency sheet, double sided tape and string. Over a 100 of these shields have already been made by AIMS plastic surgery department. A third variation of the shield includes a 3D printed face shield which takes about 2 hours to print. They have also improved upon standard medical-protection gear through processes such as fixing surgical masks to medical professional’s faces with dental putty and other adhesives, thereby creating an airtight seal.

In order to be prepared to face future shortages of N95 and equivalent masks, AIMS doctors have designed several adaptations of face masks which includes a hood designed using polypropylene (PP) surgical wrap material with a front viewing window of a OHP sheet. Another variation is to make a flexible ring out of PLA filament to hold a regular surgical mask tightly against face to give a tight seal. They created a double layer wrap of polypropylene over the loop/ring to add additional protective layers to the mask in addition to the airtight seal. They also took the 3d printable montana mask design and enhanced it with a dental putty (Aquasil, Dentsply Sirona). The kneadable putty is applied along the sides of the mask and the mask is pressed over the face until we get a air tight seal. When the putty hardened, it provided a custom, comfortable airtight seal for any healthcare worker's face.

To avoid the shortages of ventilators available in the emergency department, AIMS doctors have designed and tested inflow and outflow splitters that can be quickly attached to existing ventilators to provide ventilation for two adults simultaneously. This solution can be used only if equal ventilation is needed for both the patients .

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