Novel device protects patients, HCPs from COVID-19 during paediatric endoscopy

The novel box-type device Endoshield can help prevent the spread of the novel coronavirus disease (COVID-19) during paediatric endoscopic procedures, according to a Thailand study. This protective barrier is affordable, usable, and is suitable for use both at the left lateral and supine positions.

“Recent knowledge shows that the major routes by which novel COVID-19 spreads are human-to-human transmission, including direct and indirect contact and droplets; airborne transmission is also possible, especially during aerosol generation, such as during gastrointestinal endoscopy (GIE),” the researchers said.

“To prevent and minimize the spread of the disease, we used a simple, affordable, and reusable plastic box as a physical protective barrier for both patients and healthcare providers during aerosol-generating procedures (AGPs), such as GIEs,” they added.

The novel Endoshield was tested on 12 children (median age, 9 years, 66.67 percent boys) who had to undergo emergency or urgent endoscopy amid the COVID-19 outbreak. Eight of the participants had life-threatening GI bleeding that needed an emergency procedure. All patients were screened and stratified according to exposure prior to the AGP, and all were classified as low-risk for COVID-19 and were not tested for the infection. [Clin Endosc 2021;doi:10.5946/ce.2021.082]

The device was used successfully in both the left lateral (n=9) and supine (n=3) surgical positions, with respective procedure durations of 14.15 and 19.59 minutes, respectively. The overall time under endoscopy was 15.39 minutes.

Notably, after completing the GIE, all patients and involved healthcare providers were telemedically followed after 14 days, and none reported having symptoms of COVID-19, pointing to the potential value of the Endoshield as a deterrent for transmission during AGPs.

“The present study revealed the feasibility of a paediatric size box, namely Endoshield, as an adjunct tool with personal protective equipment for endoscopy,” the researchers said. “This is the first innovative device that is suitable for paediatric endoscopy.”

“Even though our study did not prove the efficacy and safety of the box, we did prove that Endoshield is suitable for children of different sizes and different surgical positions and is convenient to use with anaesthetic equipment,” they added.

The Endoshield is made primarily out of transparent acrylic formed into a box that can cover the patient’s head and shoulders. The side walls of the box contain holes that allow the passage of the endoscope and of respiratory support apparatus. A soft plastic sheet was used in conjunction to further impede aerosol spread.

“The benefit of this box is that it not only minimizes disease transmission but also works suitably in the supine position of patients, a feature that no prior studies have mentioned,” the researchers said. “Further large and well-designed studies specific to paediatric patients that focus on the efficacy of the box to prevent transmission are warranted.”