Currently, many countries including Malaysia is hit by the Coronavirus Disease 2019 (COVID-19) pandemic. As of 26th March 2020, Malaysia has 2,031 positive COVID-19 cases with a death toll of 24. During this critical time, the emergency department and several observation wards in Teluk Intan Hospital has been closed recently due to a large number of medical workers being tested positive for COVID-19. With Teluk Intan Hospital being the public hospital with the highest number of positive infection amongst staff (39 medical staffs), there are others such as Putrajaya Hospital, Raja Perempuan Zainab Hospital, Tengku Ampuan Rahimah Hospital and Selayang Hospital, which have recorded a few positive cases as well. The concerning addition of positive cases among medical staffs may lead to a shortage of healthcare personnel that can work be on duty during the pandemic.
One of the main reasons how medical staffs could get infected might be due to the close contact with infected patients while examining and administering breathing support machine to the patients. This close contact risks medical staffs of being infected with the Coronavirus. An increasing number of positive infections among the staffs will eventually lead to the closure of healthcare department and the hospital for sanitization works. Such occurrence would hinder treatment for patients and also increase additional workload to other hospitals to cover for the closure of another hospital.
Intubation is a process to secure breathing for patients with severe breathing difficulty. There has been evidence that show that aerosolization can occur during the intubation process. This is concerning as it could be a risk towards medical staffs in getting infected when treating patients.
To reduce the infection risk, an innovative protective box named ‘Aerosol box’ is able to help physicians to perform endotracheal intubations safely on infected patients. This box was created by Lai Hsien-yung, an anesthesiologist with the Mennonite Christian Hospital in Hualien, Taiwan. The ‘Aerosol box’ acts as a barrier between the doctor and infected patient.
The box was designed using a clear acrylic material to ease operation for healthcare personnel when administering the support breathing machine on infected patients. One side of the box has two holes for healthcare personnel to insert and maneuver their hands while examining the patient. On the opposite side from where the holes are located, a plastic sheet is used to cover the area which can accommodate different dimensions of the patient’s body.
Responding to the arising needs by medical frontline doctors to overcome this pandemic challenges, the researchers from Centre for Innovation in Medical Engineering (CIME), Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya have taken an initiative to fabricate six intubation protective boxes. These boxes were provided urgently to frontline healthcare personnel at University Malaya Medical Centre (UMMC) upon receiving request for it.
These boxes have been delivered to Dr. Khairul Azri at the Emergency Department on 25th March 2020 at 10.30 PM. The initiative work was headed by Prof. Ir. Dr. Fatimah Ibrahim, Ir. Dr. Mas Sahidayana Mokhtar, Prof. Dr. Sajaratulnisah Othman and Prof. Dr. Tan Maw Pin, who are a group of CIME researchers. Additionally, CIME has collaborated with Dr. William Yap from Selayang Hospital and Dr. Izhar Abd Aziz from 3D Gens Sdn. Bhd.
CIME has also pledge to deliver these protective boxes to Sungai Buloh, Klang, Shah Alam, Melaka and other hospitals. The top management of Universiti Malaya has supported this project and has given seed funding under the innovate UM fund. This fund accelerates the project in improvising the current intubation protective box to incorporate more safety and ergonomic features.
CIME would like to acknowledge to all the contributors from CIME, Universiti Malaya and public who funded the fabrication of the intubation protective box.
In response to donations of the Real-time Polymerase Chain Reaction RT-PCR COVID-19 test kits from a reputed supplier in Singapore, RT-PCR COVID-19 diagnostic kits for which a total of 250,000 tests are targeted. CIME has assisted in obtaining the Medical Device Authority (MDA) exemption to bring in these tests for non-commercial use. CIME’s assistance in obtaining immediate MDA exemption can aid the country’s fight against this pandemic.
The COVID-19 test kits will help ease the burden of laboratories who are regularly running out of reagents to conduct tests. It will also save lab technicians’ time as these kits allow them to do tests without the hassle of replicating new components every time. A grateful thank you to Prof. Ir. Fatimah Ibrahim and Prof. Tan Maw Pin from CIME, UM, Dato’ Prof. Dr. Adeeba Kamarulzaman, Dean, Faculty of Medicine, UM, Encik Ahmad Shariff (CEO of MDA) and Madam Ir. Sasikala Devi Thangavelu (Director for Policy, Code and Standard Division of MDA) for their cooperation and support in obtaining MDA approval within a day.
By Prof. Ir. Dr. Fatimah Ibrahim
Director, Universiti Malaya Centre for innovation and Commercialisation (UMCIC) and
Founder and Advisor, Centre for Innovation in Medical Engineering (CIME)