Introduction: COVID-19 Shield - Used to Protect Workers While Obtaining Swabs for PCR Test
New and improved version at https://www.instructables.com/id/COVID-BLOCK. Hangs in doorway.
This project was created out of the necessity to protect healthcare workers from getting snot, sputum and spit in the their face when collecting nasal and throat swabs from suspect patients. There are shortages of protective face masks, and once contaminated with fluids, they should be replaced. By putting a barrier between you and the fluid spewing patients, you can save your PPE. You should still wear eye protection, an N-95 (yeah, I know, they said you don't need to) and full PPE when testing suspect patients. Gloves too!
I'm sure you will suggest excellent improvements. As you can see, I have low craft skills. I tested a few variations when making it so I used a lot of tape. I think you can make it in 45 minutes.
The idea is the patient is on the opposite side of the screen. You have to have your tubes and swabs on the patient's side. You insert your gloved hands into the shield's gloves. You might have to adjust your chair, or get a stool, or adjust your patient's chair or the table height to make it comfortable. You insert the nasal swab into the nostril, about 1/2 the distance from their nose to their ear (yes, pretty far, it isn't comfortable) and give it a little gentle twirl. To get a throat swab, you will need decent lighting. You want to get a good sample. I think some of the patients who re-test positive after a negative test had a false negative on account of inadequate sampling, or maybe for some other reason. In any case, be sure to touch way back there. Then you insert the swabs into the tubes that came with your kit. It is a good idea to label the tubes and kit before your patient is positioned in the sampling spot.
I spent some time trying to secure the gloves so they wouldn't come out when I pulled out my sweaty hands. The trick is to use one hand to hold the fingertips of the the opposite hand's glove. You then pull that hand out about 1/2 way. Then you use that hand to paw at the other hand and extract that glove. The cardboard is too flimsy to really secure the rings against pulling out when you move your hands quickly.
The gloves were big for my hands, but I could get it to work. Swabbing isn't really a precision maneuver.
After the patient moves away, be sure to spray off the patient's side with a fine mist of diluted bleach solution for a minute. I suggest using 2100 ppm bleach. A great little calculator can be found at https://www.publichealthontario.ca/en/health-topic... You will need the concentration of your bleach, it is usually 6%, but double check it. You have to make up fresh bleach every day. The CDC says to use 4 teaspoons of unexpired bleach per quart of water, or 1/3 cup per gallon of water. Be sure to spray the entire glove. You could use a backpack type sprayer to be efficient, and your free hand could use a picker upper type tool to manipulate the glove so it gets saturated. After a minute you can wipe off the solution or let it dry. Eventually, the curtain will get cloudy. The gloves should last a long time.
You should use gloves to pick up the tubed swabs and place them in a clean bag. Wash your hands.
Supplies
Lowes: clear vinyl shower liner $6.98, (1072792 WH 5G PEVA Shower Liner) long gloves $13.48 (625394 TEKK LONG CUFF NITRILE Glove), JoAnn’s fabric - tri-fold poster board ~ $5, duct tape, Two 5 inch embroidery rings ~ $3 each.
You need an exacto knife or box cutter to cut the cardboard.
The critical item is the long nitrile gloves. They have a 5 inch opening that fits perfectly into the 5 inch embroidery rings.
Step 1: Cut Out the Holes and Viewing Window
Trace two 4 inch circles on the cardboard. Cut out the circles. I discovered that you need something under the cardboard to avoid cutting the hotel's carpet. I used the hotel's folder as a template to trace out the viewing window.
Step 2: Embroidery Hoops
Open up your embroidery loops and insert the opening of the glove into the inner hoop. Flip over the ends of the glove. Adjust the screw on the outer hoop so you can fit it over the glove and inner loop. Tighten it gently so it is snug.
On my second iteration I put a strip of duct tape between the two hoops perpendicular to the hoop so I could tape that strip to the cardboard. I did that so it would be easier to extract my hands. It didn't work that well, so I think it is optional. If you hold the tips of the fingers of the opposite hand while extracting you hand, the glove stays in place. If anyone has any ideas here, please share your successes.
Attachments
Step 3: Duct Tape Clear Shower Liner on the Patient's Side of the Cardboard.
I draped the shower liner over the patient's side of the cardboard and extended over the top to make a little roof. I taped it so the "walls" couldn't extend past 90 degrees. I used a lot of duct tape. I put the top of the shower curtain as the "roof". I probably should have made the bottom of the curtain the roof since it doesn't have holes. This was an awkward procedure and was the most time consuming part. I didn't tape up the bottom, I figure if the table is the right size, it could provide a barrier for the lower body. You could cut that part off if you are setting it on a counter.
Step 4: Cut the Holes in the Curtain for the Gloves, Insert the Gloves.
I used the knife to gently slice a pie shape into the curtain right over the 4 inch circles. I taped the little flaps, on one of the holes, but didn't on the other. I don't think it matter. I then inserted the hand ends through the holes until the hoops were as close to the cardboard as they would go.
Step 5: Goofy Me Modeling
I don't think it can be used as a standing shield in its current configuration. Plywood would be nice. You could put it on wheels. You could use a version of it for drive by testing. You could just tape up clear plastic sheeting over your door and cut 4 inch holes for your gloves. You could cut a couple of holes to accommodate patients of different heights and tape a flap over them when you don't need them. You would need a sprayer in PPE on the other side to bleach it between patients. If your door was to the outside, clean up would be easier and patients would be less likely to share pathogens.
Don't forget to bleach after every patient.
Stay safe all!
Identify
Isolate
Flatten the curve
Protect our elders and everybody else too.
P.S. Keep tuned for version 2.0 I've ordered some gloves that vets use to do internal obstetric exams on cows. I plan on testing a curtain hanging in a doorway with the embroidery hoop outer loop glue gunned on.
Here it is, version 2.0...
