Discussion
This device provides a means to help to reduce viral transmission and provide ENT staff with additional protection. It likely reduces the chance of aerosol spread and contamination of the clinic room. It is simple, reproducible and easy to make with available resources in every department.
Some limitations of this paper are that the device may be uncomfortable for some patients but it was well tolerated by the authors and patients in clinic to date. Some hospitals may not have theatre/emergency departments and thus, may have require special ordering to get all kit pieces needed. These items should be on ordering lists as they are all standard pieces on emergency trolleys – apart from the CPAP harness. Further, assembly of the device and verifying the seal will mean procedures take\souts more time and may not be appropriate in some emergency settings. Lastly, humidification in a closed circuit may present an issue where demisting agents are not available – the authors suggest gently pressing the lens of the endoscope on a clear area of the inferior turbinate to clear large debris or eliminate misting.
Areas for future research would include the impact using this device has on clinic times. A pre-made supply of the most common mask sizes could be created to minimise delay in clinics. Further, would be looking into its practicality in emergency settings. Most impactful of all would be to test if the patient wearing this mask reduces or prevents aerosolization completely.