Intubation Box

 The Intubation Box is an inexpensive and reusable protective device originally designed by Dr Hsien Yung Lai in Taiwan, to protect healthcare providers when intubating Covid-19 patients.

We, ER doctors and designers, have taken his gracious design and altered it for the American body habitus.

The Intubation Box works by sitting over the head and shoulders of a Covid-19 patient as they are intubated by a healthcare provider. The acrylic box acts as a protective shield between the patient and medical provider, with the intent of reducing the healthcare provider's exposure to Coronavirus (COVID-19).

After each intubation, the box can be cleaned with a bleach or alcohol solution. Ie. Sani-Cloth wipes.

Make Your Own Intubation Box

This website aims to provide everyone information to make as many Intubation Boxes as possible. We are doing our very best to produce intubation boxes daily, but more help means more resources for hospitals across the country. CLICK HERE TO DOWNLOAD PLANS(PDF).   Your local signage, furniture, fabrication shop should be able to take the plan and make them.  Click here to download cut files in DWG, DXF, and 3DM (Rhino5 & Rhino6)

Make your own open source intubation box design plan

Current References

• Canelli, R., Connor, C. W., Gonzalez, M., Nozari, A. & Ortega, R. Barrier Enclosure during Endotracheal Intubation. N. Engl. J. Med. (2020) doi:10.1056/NEJMc2007589
• Nissim L, Reeser B. Medical image of the month: an “intubation box” to protect healthcare professionals. Southwest J Pulm Crit Care. 2020;20(5):173-4. doi: https://doi.org/10.13175/swjpcc030-20 PDF
• Brewster, D. J. et al. Consensus statement: Safe Airway Society principles of airway management and tracheal intubation specific to the COVID-19 adult patient group. Med. J. Aust. 212, 1 (2020)

Provider Resources and Tips

Please share this information with your fellow providers and staff who will be using the intubation box with you. We have been using them here in Arizona for about three weeks now and I have personally used them about 15 times as of writing this.  I would suggest once you a box to do a dry run with your staff so you can feel comfortable having your hands through two holes while intubating.(example)  I have found that staff is able to easily bag the patient if they just stand a foot or so farther down the bed and reach up the front of the box(example), additionally if using the Glidescope I've been tilting the patient's head about 45deg to the right so when getting that very rigid stylet out of the ET tube there is a bit extra room for whoever is pulling it out.  Lastly, using a bougie can be a little tricky, I have found that if you have someone hand it to you from the front and have them place the end curled forward and into the top right far corner of the box(away from you), you should have enough room to maneuver the bougie for usage(example).  Same with tube replacement, just angle the bougie out the front right side of the box for exchange.  One other consideration is while intubating or doing a tube exchange, place a yankauer in the box on the bed coming in from the front and just let it run, the negative pressure from it is better than nothing. Please see below for Glidescope video of one of our boxes.

Acknowledgement

This effort is made possible with help, design, and fabrication by Urban Plough, Ortho Spine Partners, and charitable donations.

Special thank you to:

• Tuft & Needle who built and donated over 60 Intubation Boxes to Phoenix local hospitals!
• Flex Seal who donated material and funds to cover 125 boxes!
• Dr Brandon Lawrence for joining the Intubation Box team early on and all his help!

ABC15 Arizona was gracious enough to cover us in a news article. Big thanks to them for the exposure!

Disclaimer

This is a NON FDA approved device. This is for use by medical professionals only and at your own risk.

The Intubation Box has been created due to the COVID-19 pandemic with best practices in mind.  This design is based off of Dr Yung-Lai's Aerosol Box and is licensed under Creative Commons Attribution-NonCommercial 4.0 International License

This not for profit effort is being ran by the medical nonprofit Anodyne International.

Intubation Boxes Delivered to Hospitals

We have delivered multiple boxes to local hospitals in Arizona. Additionally units started shipping country wide on 3/31. Click here to see a full list of hospitals that have received donated Intubation Boxes.