PMC

Tent screw(Tent screw, Neobiotech, Seoul, Korea). A. Lateral view. B. Occlusal View. Tent screw has a hole for the cover screw.

Modifications and installation of the trap—(A) the opening of the tent door is sewn open; (B) clips are used to attach the body of the trap to the tent; (C) a rain-proof cover is added to the collection bag; (D) eyelets are sewn into the back of the collection bag; (E) the collection bag is suspended using guy ropes attached to the tent; (F) a footprint that extends under the trap is added.

Example setup of the novel drape ‘tent’. The assembled drape ‘tent’ that was used for the paediatric patient has been recreated for illustrative purposes with the second author in place of the patient. (a) The CE marked sterile polyethylene drape (intubation drape shield with endotracheal tube access (product reference: VED5010A); Vital Care Industries) is attached to the lens cap of the standard sterile microscope drape (Glass Lens Micro-Kover (product reference: 09-GL902); Advance Medical Designs). The drape ‘tent’ is then extended to cover the entire surgical field. (b) The drape ‘tent’ is supported by an ‘L’ support (black arrow) at the head of the patient. During the mastoid surgery described in this case report, this ‘L’ support was covered in a sterile camera drape with ring applicator (product reference: 202-02; Delta Surgical).

A) One side of a clear plastic bag is split along the seam and the bag is then placed over the intubated patient’s head and chest, forming a “tent”. B) A hole is cut in the “apex” of the tent to accommodate the endotracheal tube (ETT) for connection to the filter and ventilator. C) The bag is then sealed around the ETT with an elastic band (arrow) prior to being reconnected to the circuit; the tape securing the ETT can be loosened through the plastic “tent”. D) During tracheal extubation, a continuous suction is applied at the filter connector (arrow). The insert shows the suction tubing connected to the filter using a three-dimensional (3D) printed tapered connector. The 3D printer STL file is available from the co-author (chris.r.hung@gmail.com). E) During tracheal extubation, the plastic cover is slowly lifted from the patient’s head and neck, and combined with the continuous suction, creates a negative pressure within the “tent.” Following removal of the tent, a tightly fitted mask with filter can be quickly applied to the patient’s face. F) Small aerosol droplets projected during coughing are illustrated visibly suspended in the environment and are being removed by the suction at the tip of the ETT within the negative-pressure “tent.” These processes can also be seen in a video available at https://youtu.be/CxDD2YY70VI. The video shows the steps involved in building the negative-pressure tent as well as the extubation procedure. In addition to serving as a barrier to contain the large droplets, it also shows that this tent has the potential to remove the smaller aerosol droplets (< 5 µm) using suction applied through the ETT