In the face of the COVID-19 pandemic, the Snitz Creek Cabinet Shop at 2020 Cornwall Road has modified some of their woodworking equipment to create hard plastic boxes that will protect healthcare workers as they intubate or extubate patients.

The intubation shield or box is relatively new, and is used to protect doctors or paramedics as they introduce breathing tubes into patients unable to breathe on their own, as part of the procedure performed when connecting patients to ventilators.

As the medical personnel lean in closely to do the job, they are inundated with respiratory emissions of the sick, increasing their own chances of contracting the airborne disease.

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Also called an aerosol box, the contraption is the brainchild of Dr. Hsien Yung Lai, an anesthesiologist in Taiwan, who developed the concept in response to the COVID-19 crisis. (Mennonite Christian Hospital)

Masks and plastic face shields help to reduce that possibility, but a Plexiglass barrier is even better.

Dean Zook, one of the owners of Snitz Creek, said the company is donating the plastic protective shields, which would normally cost a few hundred dollars, to hospitals free of charge.

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“It seems like, since we were allowed to work, if we could do something helpful, that’s what we wanted to do,” Zook said. “It also seemed like an interesting project.”

Zook said he had not heard of the intubation shields before the United States representative of the Italian company, Biesse, told him about the potential for Snitz Creek to make them, using computerized code.

The shields had first been used in France, Zook said.

“Over the weekend, [the representative] sent me an email saying they have the code available if we wanted to use it,” Zook said, adding that Snitz Creek has used Biesse-made equipment for some time and their primary equipment, a computerized router, operates from code.

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“Making things out of plastic isn’t our main business, but our machines are certainly capable of making these shields,” Zook said.

Dr. Steven L. Sivak, chief medical officer and president of Einstein Physicians Philadelphia, learned of Snitz Creek producing the shields from a friend and emailed Sharon Zook to ask for three of the boxes for the hospital.

“We were extremely grateful to get them,” Sivak said Tuesday morning.

Sivak knew that the Einstein facility was already using three intubation shields, and spoke with the Chief of Anesthesiology to find out if more would be needed.

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That physician suggested getting three more to use during extubation (the act of removing the breathing tube).

Ventilator tubes are removed from a patient either when the patient is able to breathe on their own or if death has occurred.

Late last week, the Einstein Healthcare Network had 140 patients suffering from COVID-19, and 40 of those patients remained on ventilators, Sivak said.

“These shields are clear barriers so they can see exactly what they’re doing,” Sivak said. “[Healthcare professionals] are at risk of getting sprayed when the tube is taken out.”

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An airborne virus can travel in two forms, Sivak said; either in droplets when a person sneezes or coughs, or in aerosol form, which can happen during intubation or extubation.

The aerosol particles are much smaller than droplets and can also travel much farther than droplets, Sivak said.

The shields can also help to protect staff standing nearby, Sivak added.

The intubation shields resemble fish tanks with one side missing and with holes for hands to go through, said Snitz Creek manager Sharon Zook.

An intubation shield in the making at Snitz Creek Cabinet Shop.

“It’s kind of a new gizmo for COVID-19 patients,” she said. “We don’t really have a name for them yet, but as soon as the doctors see them, they know what they are.”

For now, Snitz Creek is donating the units.

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If the company becomes inundated with orders, the cabinet company may reach out to philanthropic organizations for help so that the hospitals won’t have to pay for the shields.

Sharon Zook said this is the first time Snitz Creek is working with plastic for medical needs. After receiving the code, the Snitz Creek owners checked into the availability of the supplies they would need to construct the shields.

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Plexiglass, a brand name of acrylic sheets, and special tools were needed. Plexiglass is flying off the shelves, Zook was told, and when the current supply is gone, no one is sure if they’ll be able to find more.

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“These are big pieces of equipment, about 15 feet in one direction,” Sharon Zook said. “Typically, we’re cutting wood to make cabinets, but the size of the equipment is different and router bits had to be changed to fit into the machine.

“The assembly is a bit difficult because the adhesive is different than what we use with wood, so there’s a learning curve,” Sharon Zook said.

A Philadelphia company had been making the shields but had to close down the plant so it could be sanitized, according to Zook.

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“Putting the shield over the patient is another way of handling the [contagious] situation,” Sharon Zook said. “We reached out to area hospitals in case someone was in need.”

When the shield is placed over the patient, the physician can reach in underneath to complete the intubation or extubation.

“I’m not sure we’re going to find a big demand,” said Dean Zook. “But within a few hours, we can make more if we need to.”

The information for the intubation shields has been listed on a statewide resource, Dean Zook said, and they’ll be ready to help.

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Read all of LebTown’s COVID-19 coverage here.

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