S0555 A Novel Patient Oxygen Mask Apparatus for Environmental COVID-19 Protection During Upper Endoscopy
Bibliographic record
Abstract
INTRODUCTION: Concerns over COVID-19 aerosol release during upper endoscopy has led to recommendations for negative pressure rooms, prolonged air-settling times and HEPA filtration machines. The resulting procedural inefficiency has led to prolonged patient wait times. Although N-95 masks can protect staff from viral exposure, potential environmental contamination remains an issue for room turnover times. Oxygen procedural masks were originally developed to avoid hypoxemia in patients undergoing bronchoscopy in intensive care units. It has been suggested that these devices be considered for patients undergoing upper GI endoscopy to reduce aerosol release, but to date, no studies have been performed to confirm their effectiveness in protecting the procedure room environment. METHODS: A procedural mask with three self-sealing ports that can accommodate almost any endoscope (Explorer, Intersurgical Berkshire, UK), was attached to a T- piece containing an oxygen inlet (Vyaire, Mettawa, IL) . The expiratory port was connected to a N-95 round anesthesia filter (Flo-Guard, Intersurgical ) to protect the environment from airborne pathogens. The procedural mask was applied to an adult CPR mannequin with elastic straps to ensure a secure fit. A fluorescent powder and mist ( Glo Germ Company, Moab, UT, USA) with particle sizes between 1 and 5um (SARS-COV-2 is 0.7-1.2um) was injected into the trachea of an adult CPR mannequin to simulate a cough. An endoscope was placed into one port of the mask and a suction catheter was placed into another opening to simulate an actual upper endoscopy. The degree of fluorescein staining on paper outside the mask was assessed with ultraviolet light detection in a darkened room. RESULTS: Preliminary results using our cough simulation model without a procedural mask revealed a widespread dissemination of fluorescent droplets, contaminating the surrounding area. The use of a patient procedural mask significantly reduced the aerosol dispersion and contamination surrounding the patient. CONCLUSION: Our preliminary findings provide proof-of-concept support for use of a patient procedural mask apparatus to reduce environmental exposure to cough-generated aerosols and droplet sprays during upper GI endoscopy. While the patient procedure mask provides environmental protection and may reduce the need for prolonged air-settling and HEPA filtration, it should not replace the appropriate use of personal protective equipment by endoscopy staff in case of patient procedural mask dislodgement.Figure 1.: Endoscope insertion into patient procedural mask with oxygen T piece and N-95 expiration filter.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".