IIUM doctor tweaks idea of aerosol boxes, urges engineers help make them in Covid-19 treatment to assist frontliners

Dr Nur Fazira Ramly took to social media to ask for the help of engineers to create these makeshift isolation devices. — Picture via Facebook/Dr Fazira Ramly & Twitter/@niekvanvliet
Dr Nur Fazira Ramly took to social media to ask for the help of engineers to create these makeshift isolation devices. — Picture via Facebook/Dr Fazira Ramly & Twitter/@niekvanvliet

PETALING JAYA, March 26 — A doctor from the International Islamic University of Malaysia (IIUM) has called on engineers nationwide to aid medical frontliners by making a protective intubation device used in Covid-19 treatment.

Dr Nur Fazira Ramly, who works on the frontlines at IIUM, took to her Facebook account on Monday night in an attempt to enlist the help of her fellow countrymen.

“I was thinking of ideas of how to make a device to protect us when we intubate Covid-19 patients. If there are any engineers out there who aren’t working, maybe you could help,” said the post.

Dr Fazira’s design has the same applications of the equipment being used to treat patients who have contracted an infectious virus, such as aerosol boxes and Individual Patient Isolation Systems (Isopods).

This equipment is in short supply during this difficult period, with isopods costing a pretty penny — being priced at around RM30,000 — which is too expensive for most hospitals to purchase in bulk.

Her drawn-up designs for the makeshift intubation device are inspired by Taiwanese anesthesiologist Dr Lai Hsein-yung’s ingenious aerosol box made from transparent acrylic.

Dr Lai’s aerosol box design measurements. — Picture via Facebook/賴賢勇
Dr Lai’s aerosol box design measurements. — Picture via Facebook/賴賢勇

The improvised aerosol box assists physicians to perform endotracheal intubations through the cutout holes on the box.

Dr Lai uploaded onto his Facebook the original illustration file for the invention as well, as he gave approval for medical professionals worldwide to use and improvise on his design.

Dr Fazira took those words to heed as she made additional improvements to the apparatus, applying modifications based on her personal experience of treating patients every day.

She described to would-be volunteers in the comments section of her post that the intubation device is required to fulfill certain criteria to ensure optimal efficiency and safety for doctors.

These criteria include having a flexible and transparent framework to facilitate easy movement for the doctors, be properly sealed to prevent bacteria from escaping and was able to be attached to the hospital bed for easy use.

“The dimensions must be correct. If not, we will have problems with manipulating the laryngoscope and endotracheal tube,” said Dr Fazira in the comments.

“Some of the designs don’t have the right height and some of the armholes are too high, making it difficult to work in it.”

She added that it is preferable for the material used to create the aerosol box to be transparent, water-resistant, reusable and cleanable.

“The idea is to avoid droplet spillage from the patient to the doctor during the procedure. It may involve the aerosolisation of the droplets and doctors are usually in very close proximity to the patient’s mouth,” said Dr Fazira.

“Please help us doctors who are the frontline intubators during this crisis.”

Three days since her first call for help, Dr Fazira said “thank you” yesterday on Facebook to the many Malaysians who have helped her to create aerosol boxes for her hospital over the past three days.

However, Dr Fazira reiterated that hospitals around the country are in dire need of this type of equipment to treat Covid-19 patients and has implored for engineers who have time off work to continue to help.

“In these difficult times, hopefully we can call on the help of engineers to design this type of equipment or any others that doctors desperately need but are out of stock like isopods or powered air-purifier respirators,” said Dr Fazira on Facebook.

“God willing, with all this equipment available, the doctors on the frontlines will be more confident and strong-willed.

“For now, our institution has received donations of aerosol boxes and we are grateful for your help. But, I believe that there are many more out there who need help. So, please keep contributing.”

She added that other medical professionals in the country can contact her if they are in need or looking for such equipment, as social movements like #KitaJagaKita (https://www.kitajaga.us/) have been in contact with her and are eager to help others as well.

Malaysia entered its ninth day of the movement control order (MCO) period, during which movement for non-essential services is restricted.

Yesterday, Prime Minister Tan Sri Muhyiddin Yassin announced that the MCO would be extended for an additional two-week period, until April 14, to curb infection rates in the country. 

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