What’s with the box?

April 21, 2020

This is the story of a box.

In Taiwan, anesthesiologist Dr. Lai Hsien-yung wanted protection. When putting a patient on a ventilator, he had to first intubate them which releases nebulized saliva and phlegm all over the room. He asked a local plastic company to make him a box. Missing two walls, it can be placed over a patient with two holes that he could put his arm through. He could do the delicate procedure, clean the box, and go on to the next patient. A photo of him spread over social media across the world.

The aerosol box is now in high demand. As more and more health workers are called on to intubate seriously ill patients, hospitals have been looking to build their own. Many have just copied and pasted the exact original design. While a brilliant MacGyver'd solution, there were issues to address. How can store a big box let alone 20? How can we sterilize the internal corners? How can my hands remain flexible within? What do we do for difficult airways? There had to be an improvement possible. Working with doctors, nurses, and respiratory therapists, UCSF and SFGH we built a box that can help. It can be flat-packed and shipped. It puzzle pieces together. It can be taken apart for storage or bleach baths. It has flexible vinyl sheeting so health workers can move their hands in a delicate procedure. It's resized to be more ergonomic. And yet, it is simply a box. In this epidemic, exposure is a major component of health and safety. High risk moments need high guarantee of safety.

Tomorrow, we are putting on the finishing touches for requests in the prototype. Take out the viral filter port. Add another 3 inches to the height. Remove the horizontal slits for hand entry. Halve the number of zip-tie attachment points. After final approval, we are looking at ramping up to make in the hundreds over the next few weeks.

Health workers are keeping us safe.

We can at least provide a box.