Authors (including presenting author) :
Lung PY(1), Au SY(1), Fong KM(1), Yeung CH(1), Wong HMR(1), Tsang YN(1), Ng WYG(1), Lam CL(1)
Affiliation :
(1) Intensive Care Unit, Queen Elizabeth Hospital
Introduction :
Novel coronavirus 2019 (COVID-19) is a pandemics that hit the world.The safety of frontline healthcare workers raised our concern.To manage COVID-19 patients with a chest drain system,that is commonly used for pneumothorax,a few modifications were made to the system as to minimize the potential risk of viral transmission.It was a prove-of-concept trial and supported by the results of the polymerase chain reaction (PCR) of COVID-19 from swabs of various parts of the system.
Objectives :
Our objective is to focus on the safety of healthcare workers and protect them from the COVID viral spread from the system.Due to limited literatures,we invented and made three modifications on the chest drain system in our unit,so that it can be a reference for other units.
Methodology :
The chest drain system used in our unit, like most others' is Atrium Ocean. The modifications were listed below. 1)0.05% aqueous-based Chlorhexidine Gluconate solution in water seal chamber We suggested the use of 0.05% aqueous-based Chlorhexidine Gluconate solution,that is proved to be effective against COVID-19,to replace water in water seal chamber. 2)Water column in the suction control chamber Five milliliters of sterile water were added to suction chamber to water seal it so that excessive gas could not escape the system through the suction control port. 3)Bacterial viral filter (BVF) at the suction port A BVF,with filtration efficiency rate of >99.9999%,is connected to the suction port after we first disconnected the suction control stopcock in system.An adapter from Cook Airway Exchange or a segment of endotracheal tube is used to connect in-between. The above modified system was connected to one of our COVID-19 patients,several swabs were taken and tested by PCR of COVID-19. Four parts were swabbed for comparison. For part 1:the inside of drain tubing which connected to patient 2:1mL of fluid from water seal chamber was aspirated 3:pre-filter-the tubing inside before connecting BVF 4:post-filter-the surface of the BVF
Result & Outcome :
The result showed that SARS-CoV2 RT-PCR gene was found positive at part1 but were all negative at 2-4. Safety in workplace environment is of prerequisite.Preventing the viral spread of COVID to healthcare workers is main consideration.The modification of the system could potentially prevent the spread of COVID.It can be a reference to all other units.
