Discontented upon watching news reports about the lack of equipment in hospitals worldwide to treat patients infected with Covid-19, production engineer Marco Aur\u00e9lio Fernandes decided to adapt, for hospital use, three types of masks used by firefighters\/emergency response teams for controlling emergencies involving hazardous chemical leaks.<\/p>\n
\u201cI was in Portugal at the beginning of March when I received a copy of a report broadcast in Italy from a firefighter there, which reported how an engineer helped doctors in his country by adapting a scuba diving mask for hospital use. Since I have three people in my family with serious respiratory problems, my concern is particularly greater regarding this lack of possibilities for hospital care. Because I work with Respiratory Protective Equipment (RPE), I decided to search the market for masks\u2014recognized as safe\u2014that would allow this adaptation, among those we use in chemical, pharmaceutical, and petrochemical industries and by firefighters, so that they could be applied in the treatment of non-invasive oxygen therapy with positive pressure in Covid-19 patients. And the results were positive,\u201d the engineer reports.<\/p>\n
\u201cSince there are several models and brands of masks already approved and certified by various national and international government bodies, I selected those that were the most comfortable, considering that the patient will spend not hours, but days with one of them on their face. Another criterion was a model with a good seal, since faces have very different anatomies. The third differential was greater resistance to cleaning and disinfection procedures,\u201d comments Fernandes. Thus, he arrived at three full-face models and one half-mask.<\/p>\n
One of them has already been approved for use with sophisticated equipment in respiratory and seal (leak) tests. The equipment, called the \u201cPosiChek3 test bench,\u201d features a mechanical lung that breathes (inhaling and exhaling) into the mask, simulating use by a user. \u201cIt\u2019s one of the pieces of equipment I have in my workshop for testing firefighters\u201d self-contained breathing apparatus (SCBA), which must be 100% safe and ready for use. This test complies with the demanding U.S. standard set by the National Fire Protection Association (NFPA),\u201d he assures. This mask has already been submitted for approval by the Brazilian Health Regulatory Agency (Anvisa).<\/p>\n
Marco Aur\u00e9lio explains that in all assemblies, commercially available medical and hospital equipment was integrated into the mask, such as tracheal tubes, oxygen supply connectors, and HMEF filters\u2014which filter up to 99.99% of viruses and bacteria \u2014 and the Positive End-Expiratory Pressure (PEEP) valve, which maintains positive pressure inside the facepiece. \u201cWe performed a leak test, which ensures that the facepiece is airtight and that the virus will not escape through it. I made sure to equip the mask with the same filters used in hospital ICUs to filter and retain 99.99% of viruses and bacteria from the air exhaled by the patient, thereby preventing contamination of medical staff. The respiratory test showed that airflow in the masks we adapted\u2014both during inhalation and exhalation\u2014is restricted as little as possible, providing the patient with a large volume of air,\u201d explains the engineer.<\/p>\n
Patients and doctors<\/strong><\/p>\n The adapted mask can have up to five different assemblies, four of which are for use on patients and one to be used by the clinical staff, who have been heavily affected by a lack of adequate protection. According to the engineer, the full-face mask, for example, makes it possible to treat the patient with increased positive pressure. With the amplified pressure, the reach of oxygen in the patient's inflamed alveoli also increases, aiming to improve the lung surface for gas exchange, which greatly aids in their recovery. Furthermore, as Marco Aur\u00e9lio clarifies, \u201cthe mask has, in addition to the filter at the air intake for its interior, another filter on the patient's air exhalation, which prevents the contamination of the hospital environment and also of doctors and nurses.\u201d.<\/p>\n \u201cAccording to the various doctors I spoke with, if as soon as the patient arrives at the hospital with the onset of respiratory distress, they are placed on a mask that works with positive pressure controlled by a PEEP valve \u2013 with oxygen-enriched air and a filtration system on both the air intake and exhaust \u2013 there is a high chance the patient will not need to be intubated, says Marco Aur\u00e9lio.<\/p>\n The patent has already been applied for at the National Institute of Industrial Property (INPI), as well as the mask's registration with Anvisa. \u201cWe are only waiting for Anvisa's approval so that hospitals can begin using the masks,\u201d he reports.<\/p>\n \u201cI spoke with the manufacturer and the largest distributor in Brazil about the availability of these masks for the market and the distributor. At least 400 masks are available immediately. The problem is the cost, which, including the parts needed for modification, comes to about R$ 1,400.00 each. But we are all committed to lowering prices and seeking donations. It was Decathlon that donated diving masks for the modification carried out by the Italian engineer. Companies in the industry\u2014or those that can purchase these masks and donate them to hospitals\u2014will help save lives,\u201d he suggests.<\/p>\n <\/p>\n