>> In hospitals and emergency response situations,
patients sometimes need to be isolated in order
to protect other patients and their health-care providers
from airborne infectious diseases.
Hospitals generally do this
by placing a patient in an isolation room.
These airborne infection isolation rooms are expensive
to construct, typically costing $30,000 more
than the traditional patient room.
It's important to note that not all hospitals have these rooms,
and many places that do will often not have enough rooms
to fill potential needs during an epidemic.
>> We at NIOSH know that it's important to be able
to isolate potentially infectious patients,
especially those that might be infectious
with an airborne contagious disease.
However, we also understand that it's not realistic
or even economical to think that every hospital is going
to have enough airborne infection isolation rooms
to handle the kind of capacity
that might be required during an epidemic.
The ventilated headboard met our criteria of being inexpensive.
It was easy to erect, and it was pretty much universal
in its application, meaning we could send it to any hospital
that might need that kind of surge capacity
in airborne infection isolation, and they would be able to use it
and get an expected result.
The ventilated headboard is unique in terms of the science
and the scientific protocol
that went behind testing the performance of this solution.
First, we started out using a qualitative smoke,
and through that, we can watch the smoke
and see what the airflow patterns are within the hood
and whether the smoke stays contained
within the hood itself.
As you can see here, as the smoke starts to come out,
is it's a nice, gentle airflow back into the hood.
We release these microscopic beads
into the air using a medical nebulizer.
We then activate the nebulizers,
and you'll see the fog that's coming out of the nebulizer.
But what you'll also notice is
that the fog dissipates very quickly
within just a couple of inches.
At that point, the water has evaporated,
and the only thing left are the beads.
You can't see them in the picture, but they're there,
and they're floating around the room now.
What we can do to see those beads, though,
is to use what we call an aerosol spectrometer,
and we can tune that spectrometer in to focus only
at the size of those beads.
And by doing so, we can do measurements of how many
of the beads escape into various sampling positions of the room.
So the real science is when we took the study to the field,
and we went to four different Midwestern hospitals
and tested the ventilated headboard.
And when we did that -- you can see a graph here
that shows the setup.
The two red dots,
that represents two different nebulizers.
We put one on each side of the manikin's cheek,
and that was our source.
That's where the small beads that I talked about earlier.
Each of the yellow circles you see here are spots
where an aerosol spectrometer was placed,
and they would do measurements of the aerosol concentration,
specifically looking at that 2 micron size that I talked about.
But in each case, you see geometric mean reduction ratios
of 0.99 or greater.
In fact, at the center position, the control worked so well
that when we put the ventilated headboard in place,
we couldn't even find one of the little microscopic beads
to measure there under the control on scenario.
So that's why our geometric mean reduction ratio was one.
So by controlling at the source, capturing at the source,
removing at the source, we're not allowing the germs to float
around and expose people through the air
or through contact surfaces.
So, as we saw, the ventilated headboard worked so well
within the hospital environment.
One of the actual migrations or the ideas that came to mind,
then, was to take this concept
into the emergency medical shelter type environment.
And with just a few modifications, we were able
to adapt the hoods for that kind of environment.
We have a ducted system here, so now all of the exhaust is going
into the headboard, but then it goes into a single duct system
to a single HEPA fan for final cleaning.
All right.
The fan system, in addition to the fact
that it's capturing the source here at its generation point,
it's also cleaning the room air as a whole.
So we have local source control, but we continue
to have the benefit of the room dilution filtration.
One of the things we can also do
to augment the canopy hoods is you can add a second layer
of containment.
So if we were to take a pop-up tent, like a picnic tent,
and add a side wall kit to it,
we would then have the tent inside the tent would be
under negative pressure, and it adds a second layer
of containment for this zone.
So there are several components that make
up the ventilated headboard.
The canopy is an important component for a couple reasons.
One, it's what allows us to use such a low velocity of airflow
to control the contaminants, and that way,
we're not bothering our patient.
It also protects that low-velocity airflow
from being disrupted from air currents from an HVAC system
or people or equipment that might be moving by
and causing air drafts.
It's fairly easy to replace a canopy were it
to get soiled or torn.
It has retainer clips here along the perimeter
and in the back and along the slides.
You remove those clips, cut out a new piece of plastic,
put the clips back in place, and it's good to go.
The canopy retracts so that the health-care worker still has
access to the patient's head for health-care activities.
And in doing so, it covers part of the filter that's behind it.
And by doing that, it allows the velocity through the remainder
of the filer to increase and go through faster.
This allows there to be still a certain level of protection
for the health-care worker even when the canopy is
in a retracted position.
The prefilters that you see here,
these are standard sizes just like you would find
at almost any home improvement store.
The purpose here is a little bit of precleaning
for the HEPA filter as a prefilter,
but the most important function for them is they distribute
that low-velocity airflow across this full dimension.
If we didn't have this filter in place, the majority
of the airflow would just go right into the center,
and then it wouldn't be that nice, even flow of air
into the entire canopy surface.
It has a lightweight extruded aluminum frame plus lightweight
panels to create the filter box for the ventilated headboard.
The height of the frame is easily adjusted using a simple
T-handle wrench, and we can adjust to various bed heights
or cot heights, depending on what you're using.
At the bottom and rear of the hood,
you can see the tapered duct takeoff leaving
from the ventilated headboard.
At the end of the tapered takeoff is a quick-connect
fitting, which allows you to connect
to either a single duct system or to a multi-duct system,
such as we have set up in this room.
>> Adequate patient isolation is critical to reduce exposure
and transmission of infectious diseases to protect visitors,
other patients, and the workers who take care of them.
Whenever a hospital determines the need
for surge airborne infection isolation, the solution needs
to be affordable, safe, and scientifically proven.
We believe the technology you see here meets these
requirements and helps isolate infectious patients while
protecting the health-care workers that care for them.