Correspondence Address: Vivek Tandon Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi India
Source of Support: None, Conflict of Interest: None
Coronavirus disease (COVID-19) has posed immense challenges for healthcare workers, among them are procedures related to suctioning of bodily fluids during surgery or intensive care. These procedures are potentially aerosol-generating and can lead to disease transmission. We have modified the usual suction apparatus in a simple and easy to do manner so that all suctioned material first passes through the 0.1% sodium hypochlorite solution, which is virucidal and decontaminates the suctioned material. This innovation may help in addressing the safety concerns of all healthcare providers working in operation rooms and intensive care units.
Keywords: COVID, modification, prevent COVID transmission, prevention, suction bottle Key Message: This low-cost modification of the suction apparatus can help in decontaminating the suctioned fluids and prevent the spread of transmissible disease like COVID-19.
How to cite this article: Tandon V, Raheja A. Modified Suction Apparatus to Reduce the Transmission Risk of COVID-19 among Healthcare Providers. Neurol India 2020;68:1170-1
Many coronavirus diseases (COVID-19) patients require emergency surgical procedures. A bigger challenge is to treat emergency patients, where mandatory reverse transcription polymerase chain reaction (RT-PCR) testing for COVID-19 cannot be done due to dire urgency before definitive treatment is administered. COVID-19 virus is shed in nasopharyngeal secretions and even viremia has been documented. Theoretical risks of transmission from suctioning infected blood and nasopharyngeal products to healthcare workers cannot be ruled out. The nasal cavity has a higher viral load. Thus neuro-otorhinolaryngology and gastrointestinal procedures can carry higher risks. All possible precautions must be taken for patients where nasopharyngeal approach might be required. Healthcare providers, working on the floor of operation rooms, wards, and intensive care units are particularly at risk because they must frequently empty the suction containers.
We have modified the existing suction bottle caps and have fitted them with a longer inner metallic tube. On this metallic tube, another rubber/silicone tube can be attached which goes up to the bottom of the container [Figure 1] and Video 1]. We partially fill the suction container with a 0.1% freshly prepared sodium hypochlorite solution, which is a known viricidal compound. This way, all the products sucked from the surgical field will pass through the sodium hypochlorite solution which automatically sterilizes them. The drawbacks are minor loss in power of suction and more frequent change of containers is required due to frothing. Two containers joined in tandem can be utilized to avoid early blockage of the suction system.
Figure 1: (a) Original suction bottle cap (b) Modified suction bottle cap with a metallic tube (Arrow) (c) Rubber tube of appropriate length is attached to the inner metallic tube (d) Tube should be long enough to reach the bottom of the container, which is filled with 0.1% sodium hypochlorite solution (e) Suction being used in the neurosurgical procedure (f) Collection of blood and irrigation products in the modified suction container
This low-cost minor modification in the suction system helps in addressing the safety concerns of all healthcare providers working in the operating rooms, intensive care units, and high-dependency units during this COVID-19 pandemic and has the potential to reduce the transmission.
We would like to thank Dr. G.D. Agrawal, the sole proprietor of Surgiwear Company for his contribution to materializing this innovative concept.