PPE Challenges Submitted

Challenge 1: PPE Mask Fitting

Is there an app which you can use to determine which faces will be compliant with a PPE Mask that is airtight.  There was a team in Singapore that used the camera to measure size and depth of wounds, then worked out what dressings time use based on the colours.  Could this technology not be repurposed for this?

Update:  See Challenge 8

Challenge 2: UltraViolet Technology

Is there any data on using UV light technology and COVID-19?

Update:  UV light solutions have been used by a range of healthcare, pharmaceutical, food, public transport organisations, offices, laboratories and clean rooms to help improve cleanliness and infection control, reducing the chance of cross contamination.   These are commercially available and we can put interested parties in touch with suppliers.

Challenge 3: Rapid sanitising technology for ambulances

It can take up to 45 minutes to clean ambulances once they have transported a patient suspected of having COVID-19.  Some ambulance cleaning centres can also be some distance away from their base or hospitals – adding strain and delay on an already busy and pressurised service as the vehicles cannot be used until cleaning is completed. Funding available.

Update:  We have received a novel idea for smart coatings/long term viral protection for PPE which fits this call.  An application was submitted to this funding call, which was unsuccessful.  Another funding call has been identified for the company.

Challenge 4: Non user friendly kit

The mask provided fits too tight and after 20 min. I need to ease it off, breath then put it on. I feel so hot and sweaty under the wrap around plastic apron. Need to keep changing these items after every patient encounter is exhausting.

SOLUTIONS: breathable aprons we can wear all day, user friendly masks that can fit snugly and without causing pressure erythema

Update: The team were in favour of finding a solution for this challenge as it is something that is affecting all healthcare workers.  One solution discussed was designing draw strings that have visual indicators of pressure but this would also need to consider any leaks on the masks for example.  One point raised was also of dehydration which can contribute to levels of exhaustion, so one of our team is looking at how to incorporate rehydration into guidance.

The Graphics and Design team is looking into updating guidance on rehydration as a short term measure, whilst our engineering teams explore the feasibility of getting something out quickly. We have also received a potential solution from a company for PPE Facial Protector/Seal which we are currently evaluating. 

Also see Challenges 8, 13, 15 and Solutions 11, 12, 20, 30.

Challenge 5: Venous Ulcers in Community

The community based nursing care of venous ulcers has fallen apart.  We need to provide video for patients to self care.  We need simple information for patients and carers to look after the legs.

Update:  The University of Leeds School of Design and the community team at the Leeds Teaching Hospitals have worked together to develop some electronic documents to support patients in their homes. These have also been reviewed by patients with venous leg ulcers.

They will be disseminated initially through the Leeds community network, and there are plans to conduct an audit to get some pilot data.

Challenge 6: Lack of tests

We go out only on urgent calls now, but without masks unless COVID is confirmed, but as community workers it is unlikely that COVID would have been tested for, so could we take out a test, say like a pregnancy test stick that changes colour if COVID-19 is present?   We could pop it through the letter box, and the patient could breathe onto it, and their family member hold it up at the window so we can see the colour change…

Update:  This has been passed onto our diagnostic colleagues, as diagnostics is outside our remit.

Challenge 7: Use of Ozone

Would it be possible to use commercial ozone generators to sterilise disposable PPE (masks especially) making them reusable?

Update:   Nice thought but not practical. There are also potential regulatory issues and we are waiting for MHRA guidance on the use of new/existing devices to sterilise PPE.

Challenge 8: Fit checking

We have moved from fit testing to fit checking – is there an objective way to check that the PPE mask fit is safe when using fit checking?

Update:  A study has been launched to investigate the utility of thermal imaging as a tool to investigate the fit of protective masks. Work has been undertaken to reproduce previous studies (Harber et al., 2015 & Roberge et al., 2011), which utilised thermal imaging to visualise leaks associated with FFP2/N95 protective masks. Early results have shown that thermal imaging can identify some large leaks, but this has required additional imaging processing and not all leaks were detected. Additional tests are now being undertaken using a small ‘cheap’ phone thermal camera module.

Challenge 9: Laminal Flow

Does theatre laminal flow, in Trauma and Orthopaedics, protect or further endanger the health care workers? Especially in the areas outside of theatres where the flow of air travels via the vents on the walls.

Update:   Nobody knows the answer to this. Various hypotheses, but no evidence.  Some work is being done on airflow modelling and advising relevant bodies.

Challenge 10: Virus Detecting Surgical Gloves and/or PPE Kit

I was thinking a face mask and gloves that change colour once infected with the virus or other bacteria. Maybe molecular reactors or sensors built within the device.

Update:  Whilst this is a brilliant idea, it would take time to translate it for this current pandemic. There was also the suggestion of using end of life indicators on products (e.g. time of use etc).   There is still interest to develop this for the future and submitter is discussing with their organisation.  If this is of interest, please contact us and we will support this collaboration.

Challenge 11: Patient and Healthcare Worker Hood

Patient hood: This will use a simple plastic hood and negative pressure to reduce room air viral load for attending healthcare worker.

Healthcare worker hood:  This will use a plastic helmet positively pressured with “clean air” to prevent the user from inhaling viral load from patients.

The company required validation of clinical relevance / need and some design input to make sure it all fits / works in practise.

Update:  The clinical need/relevance is there for a product like this, however there were concerns around how well the patients with multiple co-morbidities would tolerate this. Some work would be required to work out what levels of viral load are deemed acceptable.  The healthcare worker hood was also a good idea, however there are a couple of other companies that have developed similar concepts that are closer to market, but even then, they require regulatory approvals which will take some time.  

Challenge 12: Scrubbers to reduce viral load

This company is looking at “scrubbers” to reduce viral load in room air / vent air.  They are assuming that the majority of COVID-19 is exhaled from patients within water based liquid droplet.

They wanted to know where to get the mass / aerosol size of most relevance to trap.

Update:  It was suggested that the company read through this publication for your aerosol size query. We have had similar queries and they all seem to be working on the assumption of Sub 5 micron COVID -19 particles remaining suspended in the air for up to 3 hours in non-ventilated wards.  

Download publication here

Challenge 13: Disposable apron that can be removed with minimal risk of infection spread

‘Sessional’ PPE can be used in some high-risk areas, such as ICU; a ‘base layer’ is worn (usually a long-sleeved gown, with under gloves) and an outer layer is added between patients (usually an apron or another gown with a second pair of gloves). The outer layer can be changed between patients whilst other protective elements, such as a face mask or eye protection, can remain.

This removal can be a simple procedure if the PPE is pulled off forwards but re-tying an apron again behind the head can potentially contaminate the back, head and any visor, mask or PAPR (Purified Air Powered Respirators). When the remaining PPE is later removed, this poses a risk of further contamination.

We are looking for a disposable apron that negates the need for retying around the back and behind the neck to minimise infection risk. potential ideas include an apron with a detachable front so that the front section of the apron can be pulled away.

Update:  Surgical MIC contacted the company that submitted Solution 24 and they are now working together with the academic/clinical team based in Manchester on a solution.

Challenge 14: Protective covering

This is to do with a low-tech / low cost / high scalability idea that I have which will be of use to community health in the battle against Covid-19 and may, subject to rigorous testing, be of value in healthcare settings as well.

Update:   Signposted to NIHR Community Healthcare MedTech and In Vitro Diagnostics Co-operative as they have community health expertise.

Challenge 15: Hydration while wearing PPE

Staff are not taking breaks because concerned about shortage of PPE kit, and time taken.  Consequence: they get dehydrated.

Potential opportunity: something allowing staff to drink in PPE, safely. Any idea if such exists?–eg a modified camelback, with one way valve in or around a PPE mask so that staff can safely drink on the floor between breaks.

Update:   The main challenge is how to get the tube inside the protective items. We would need to consider mark variability on types depending upon clinical settings. There could be scope for a 3D printed gasket which provides an inlet for the silicon drinking tube and seals tightly around it. Does this mean the advantage of hydration might be outweighed by the risk of compromised PPE? The team also wanted to find out what type of PPE was considered standard at the Nightingale Hospital.

Here is an interesting study on the relationship between hydration and cognitive function.

Challenge 16: Reducing the extent of micro-droplets through the use of modified Aerosol Box and Vacuum

Endotracheal intubation is an aerosol generating procedure. We have seen the use of Aerosol box described by Lai, Hsien Yung.   This is to reduce the splash and direct cough from the patient onto the face of the proceduralist.  Is there a way to modify the box?

Update:   Design concepts are currently being reviewed by critical care team.

Challenge 17: PPE - gown idea & PAPR mask prototype

Lack of PPE is currently a significant issue all over NHS at the moment .
I have a potential solution for PPE gowns, which makes use of existing material in theatres which are discarded.  The material is used for packing & sterilising sets we use in theatre. It has 2 layers, both of which are water impermeable. They are of the right size for a gown and currently they get discarded.  I have spoken to our chief of surgery who is now trying to save this material to look at the potential to make them into gowns.

Second idea is a prototype for a PAPR, mask made from existing material available on the NHS And I need help in developing this to make cheaper & effective PAPR (personal air purified respirator) which will be immensely useful as a re usable mask , in ITU, theatres & covid / isolation wards and in operating theatres. Currently the ones made by companies sell at £1500 pounds. I think it can be produced for less than a £100 & my prototype has been made with recycled material and a £10 pound portable fan.

I think both these ideas will make a significant difference to our current fight and future ones against a new era of microbes.

Update:   Feedback – There would be infection control issues using the material if it is exposed during the case. Some of the theatre staff doubt that gowns can be made with any less than 3 separate sheets that are used for standard trays. Making this into a cost effective gown would be challenging.
Also, how standardised are the materials used across different hospitals? The material in the photograph looks very different to the paper-based stuff used in other hospitals. 

This might not fly with waste reduction issues around contaminated gowns?
Potential applications for Global Surgery and limited resources if we can get over the infection control bit.  The NHS is moving away from the initial burst of homemade PPE. There are also a couple of PAPR that are being evaluated so this market is getting crowded.

The other concept might be OK in terms of waste reduction, but how do they intend to scale it?

Challenge 18: Reusable PPE

Can aprons and gowns be made of copper fabric?  The lasts the least amount of time on copper and copper fabric already exists. The gowns/aprons/ gloves would be reusable.

Update:   This is not a viable option as one would also need to consider other blood/body fluids.

Challenge 19: Face masks and eye protection for female staff

I am offering to help with the spare time I have (currently 3 hours per week) in trying to help achieve a better design of specific types of PPE that NHS staff need, with the aim of eventually being manufactured and used on the frontline.

Update:  Currently being assessed.

Challenge 20: Vascular Visors

We are desperately in need of getting a visor which accommodates vascular loops to allow cardiac, plastic and vascular surgery.  This is a major problem

Update:  NDA in progress to facilitate delivery of visors.

Challenge 21: Decreased Voice

Communication and difficult duffing technique leading to often unsterilised procedure.  Use separate cover for shoes which will help easy removal.  More zips for easy fitting.

Update:  Referred to design company.

Challenge 22: Novel Idea for PAPR

This novel concept overcomes 99% of the problems associated with PAPR fitting, donning and doffing.  Additional details are subject to confidentiality agreement.

Update:  We have put the innovator in touch with the Royce Institute who are leading a piece of work on PAPR.  However, the innovator is also looking for outside partnerships, only if it seems worth while to go to a “proof of concept stage”.