Impact of aerosol box use during cardiopulmonary arrest: A multicenter, randomized trial

Many patients diagnosed with Coronavirus Disease 2019, or COVID-19, suffer from severe illness requiring intensive medical care. Patients suffering from cardiac arrest require aerosol-generating medical procedures (AGMPs) that spread virus throughout the air. When healthcare providers perform these procedures, they are at risk of becoming infected with COVID-19. During the pandemic, a new device called an aerosol box was invented to protect healthcare providers while they perform AGMPs. This device is placed over top of the patient's head while they are lying on a stretcher, shielding the doctor's face from viruses in the air. Unfortunately, there is limited published research describing how well the aerosol box works to protect healthcare providers, and whether or not use of the box impacts patient care. Our study will use a plastic manikin head and chest as a patient. Teams of physicians, nurses and respiratory therapists will work together to care for this simulated patient. We will use a special fluorescent powder to mimic COVID-19 particles. When the teams perform their tasks, the powder will be spread throughout the air, just like viral particles would in a real setting. We will then use a particle counter to detect particles in the air, and a camera and UV light to detect where the powder has spread on surfaces. Half of the teams will use the aerosol box, and the other half will not, which will allow us to determine if it is effective at preventing spread. By seeing where the powder has spread, we will also determine how risky it is for healthcare providers to care for patients in cardiac arrest. Concomitantly, we will measure how long it takes for providers to complete important tasks required to save the patient. This is important because it will help hospitals decide if aerosol boxes should be routinely used when caring for COVID-19 patients. Our study will also help hospitals develop rules to reduce healthcare provider risk during the COVID-19 pandemic.