CIHR funds UCalgary study to prevent COVID spread during critical medical procedures

COVID-19 can cause severe illness. In Canada, about 48,400 people have been hospitalized during this pandemic. The sickest often require aerosol-generating medical procedures like intubation that spread virus through the air, and place health-care providers at high risk for infection.

A new device, called an aerosol box, has been engineered to protect health-care providers. Dr. Adam Cheng, MD, a paediatric emergency doctor at the Cumming School of Medicine (CSM) and member of the Alberta Children’s Hospital Research Institute (ACHRI), has been awarded a CIHR operating grant to evaluate the device for clinical settings and provide guidelines for its use. Cheng is one of two UCalgary scholars to receive CIHR operating grants for COVID-19 Research Gaps and Priorities.

The grants were made public by Patty Hajdu, Canada’s minister of health, announcing an investment of approximately $25.2 million in 52 research projects to further improve our understanding of COVID-19 and tackle persistent evidence gaps linked to this disease.    

“This study is important because it will help hospitals decide if aerosol boxes should be routinely used for airway management of COVID-19 patients,” says Cheng, adding that this will be the first multi-site study of this device in Canada. The research will also lead to practice guidelines and training materials that can be used by hospitals to teach their resuscitation teams if they choose to adopt it into practice.

"Dr. Cheng’s study addresses an area of critical importance for patients and health-care providers,” says Dr. William Ghali, vice-president (research). “We look forward to the outcomes of this research and are grateful to CIHR for their support.”

Cheng and his research team will evaluate the effectiveness of the aerosol box during three critical medical procedures: bag-valve-mask ventilation, laryngeal mask airway insertion, and endotracheal intubation, commonly required for critically ill COVID-19 patients.

“We’re going to set up a simulated patient for the study and we’ll create a model using GloGerm powder that illuminates under ultraviolet light to visualize spread that occurs during the airway procedure,” says Dr. Jeffrey Lin, MD, PhD, co-investigator on the study. “When the team performs the aerosol-generating medical procedure, the powder will be spread throughout the air just like a virus. We will use a camera and ultraviolet light to see where the power has spread — both on participants and in the environment.”

The team will also be assessed for how long it takes to complete each procedure. Ideally, the device will be highly effective at preventing provider contamination without adversely impacting the time to complete the airway procedure. 

Approximately 60 teams of respiratory therapists, nurses and emergency doctors at three Canadian hospitals — The Hospital for Sick Children in Toronto, Sainte-Justine in Montreal, and the Alberta Children’s Hospital in Calgary — will participate in the study over six months.

“I’m very excited about this research,” says Cheng, “Our long-term goal is to provide evidence to enhance health-care provider safety during airway management while delivering high-quality care.”

Cheng oversees a program of simulation-based research focused on improving outcomes from critical illness. He co-founded the INSPIRE network, an international research simulation collaborative with over 250 institutions that has fostered the global dissemination of simulation-based research. He was awarded the 2020 Researcher of the Year by the Society for Simulation in Healthcare, the world’s largest interprofessional health-care society.