Emergency doctor, brother develop safer devices for intubating COVID-19 patients

When Dr. Hsien Young Li, an anesthesiologist in Taiwan, released his design for a polycarbonate intubation box for anyone to freely use, Dr. Lou Ciamillo and his brother George Ciamillo went to work designing a similar model that was even more effective.

The original model was essentially box with armholes and a relief cut out for the patient’s chest.

“The point of it was basically to capture any aerosolized secretions from the patient during intubation in the box and thereby shielding the health care providers from the aerosolization during the procedure of intubation,” Lou Ciamillo said.

Ciamillo, who works predominantly with COVID-19 patients in the Emergency Department at Augusta University Health, said there were several issues with the original design, not the least of which was “when you’re done with the intubation, you lift the box off the patient and all you’re really doing is letting a plume of vapor go off into the room.”

The brothers went through four prototypes before they had one they felt was effective enough. The final design includes a negative pressure valve to remove the vapor from the box, is taller to allow for using a hyperangulated stylette, a flat top to make it easier to clean, and handles for easy removal. It also has two viewing windows and drapes surrounding the device across the user’s arms and the patient’s chest to further contain the vapor. The box can be wiped cleaned with a purple top Sani-Cloth germicidal disposable wipe inside and out.

“It’s very intuitive to use; it’s rapidly deployed; it’s easily cleaned,” Ciamillo said. “Essentially we have several layers now that are what we call barrier layers. We’re not making guarantees that there’s no way you can be exposed to aerosolized virus because that would be crazy, but it’s essentially another barrier.”

The box adds another level of protection for health care workers, in addition to the masks, goggles and gowns they already wear when caring for COVID-19 patients.

The Ciamillos donated six of their boxes to Augusta University and one to the Veterans Administration Hospital, where Lou Ciamillo also works part-time.

With the equipment George Ciamillo has at his shop, the brothers have the capacity to produce up to 100 intubation boxes per week and plan to make them available for sale to other hospitals. Producing these boxes will help George Ciamillo and his employees, as well.

“This whole thing was born out of (George’s) desire just to see if he could do something to help me, and then when it turned out there was a need for it, I think he was more interested in potentially not having to lay anybody off who’s working to make these,” Lou Ciamillo said.

The shop, MGW Limited, has been in business for more than 30 years. Begun by their father Louis Ciamillo Sr., MGW produces specialized firearms components and sighting systems, aftermarket shifters for Camaros, Corvettes and Mustangs and custom parts.