There’s an old cliché that roughly translates to “an urgent need is the driving force behind most new inventions.”
X-rays are taken in small rooms where the patient and the technicians breath and, occasionally, cough and sneeze. Not a big problem in the pre-coronavirus world.
But nowadays, the simple act of breathing in a small, enclosed space can be dangerous to everyone nearby.
“The big problem we now have when an x-ray machine is inside a room,” said Timothy J. Mosher, M.D., chair of Penn State Hershey Medical Center’s Department of Radiology, “is that the mode of transmission [of the coronavirus] is the aerosolized particles that are in the air.”
“So you have to wait about 90 minutes for these particles to get exchanged by the building’s ventilation system,” Mosher said. “It really slows down your ability to effectively image a large number of patients.”
Faced with the challenge of how to give lots of chest x-rays quickly and safely to suspected COVID-19 patients, HMC medical, technological, and facilities employees put their heads together to solve the problem.
“We were looking at some interior rooms, but they were going to require major renovations,” Mosher said. “Then we thought about sort of a boardwalk photo booth, where a patient would just stand inside a small box where we’d be able to change the air really quickly.”
“And then,” said Mosher, “somebody said ‘why don’t we just shoot through a window?'”
An unused interior hallway that opened onto a parking lot at HMC’s 35 Hope Drive building, the removal of the exit door, a sheet of plexiglass sitting in a stockroom, and a pair of walkie-talkies were all it took to give HMC a drive-thru x-ray window.
The door was removed and a pre-measured plexiglass panel was installed and sealed in the doorway. “We have somebody in the facilities department whose whole job is to make things out of plexiglass,” Mosher said. “So when the facilities crew came over there, they basically had it up and running in about two hours.”
Now, patients needing chest x-rays walk into a privacy enclosure outdoors, face the doorway, and are x-rayed through the plexiglass. The next patient can be x-rayed as soon as the machine is reset.
The solution led to one more problem: Patients and staff outside and x-ray techs inside couldn’t hear each other through the walls and plexiglass. Two walkie-talkies were borrowed from HMC Security, and employees operate them on either side of the wall.
Mosher added that many employees in HMC’s facilities department—the unseen folks who keep buildings and their systems running every day—have also been working hard to convert rooms to negative air pressure rooms which are used to isolate patients with COVID-19.
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