Local doctor calls on dad to help build intubation boxes

There are community heroes busy donating their time and effort toward creating personal protective equipment (PPE) to help fight the spread of COVID-19 among health care workers. They are making face masks, gowns, face shields and anything else that can help. Gary Domier of Perham may not have picked up a needle and thread, but he did put his handyman skills to work by building three intubation boxes to protect the staff at Tri-County Health Care.

There has been widespread coverage of the importance of ventilators to help treat the most severe COVID-19 patients. To use the ventilator, health care workers need to intubate the patient, which requires putting a breathing tube down the throat.

During this procedure, the virus is often aerosolized which puts everyone around the area at risk of infection. It is one of the highest risk procedures for treating COVID-19 and that is where the protection of the intubation box comes into play. The box fits over the patient and has a pair of holes where the health care worker can put their arms through to safely perform the intubation process. A clear piece of plastic is draped over the patient so if the virus is airborne in the process, it is concealed within the box.

“The intubation box is a barrier between health care workers and the patient so we’re protected from this aerosolizing virus being exposed to us,” said Rachel Redig, M.D. , and Emergency Department Director, and Trauma and Stroke Director at Tri-County Health Care. “This will be used for anyone who is having respiratory distress where they can’t breathe or breathe well enough and needs the assistance of a ventilator. It gives us a very important extra level of protection.”

Dr. Redig, like many Emergency Room providers around the country, has been diligently researching ways to limit the spread of the virus in the health care facility. She has tapped into a network of ER providers who share tips and tricks on social media. The idea to create these intubation boxes came from a hospital in Chicago, Ill.

There has been a rush to acquire PPE and purchasing pre-made intubation boxes was not an option. Fortunately, Dr. Redig knew someone who would be up to the challenge of creating them.

Domier, who is Dr. Redig’s father, usually spends his time woodworking but knew he could build these boxes. The two of them found plans for the boxes online, modified as needed, and Domier started his new project.

The walls are constructed of plexiglass and the frame is comprised of PVC. He spent a day learning the best way to put the boxes together. After the first one was completed, it was brought to TCHC where experts examined it and made notes of any adjustments that would maximize the effectiveness of the box.

Domier finished up the next two in a day, sealed them with caulk and they were ready for use.

“It seems like most of the equipment is being sent to the east and west coasts so we have a shortage up here,” Domier said. “In the end it’s a good feeling to be able to do something like this.”

“We have had several talks about health care workers being exposed day in and day out and the worries about our health,” Dr. Redig, also a Perham resident, said. “I can’t imagine what that is like as a parent, but I think he was thrilled to be able to contribute and provide that extra protection.”

There has not been a need for intubation boxes at TCHC in the past, but Dr. Redig has already received positive feedback about using them as an additional protective measure.

The boxes have been used a couple of times, although not with any COVID-19 patients, and have yielded good results and success.

The boxes Domier built have also had health care personnel outside of TCHC inquire about how to construct their own. After the boxes were built, Dr. Redig posted pictures of them on Facebook, and health care facilities from around the area reached out for the plans.

“These boxes are not a new device, but they haven’t been routinely used anywhere. But with COVID-19 coming, it’s a desperate need for procedures where we are exposed to getting the virus,” Dr. Redig said. “We are using it on all patients we have needed to intubate. It has been used with good success and our health care staff are thrilled to have another measure of protection.”

TCHC has been seeing an outpouring of community support in the form of donations of PPE. You can continue to drop off donations on the table located outside the front entrance of the Wadena Clinic. They continue to request manufactured N95 masks.

Additional needs include:

• Sealed bottles of hand sanitizer
• Safety glasses
• Used scrubs
• Clear plastic face shields
• Safety goggles
• Cloth face masks

Editor’s note: This column first appeared in Tri- County Health Care’s Tri Living Well blog at TCHC.org/blog.