A space suit modification for the COVID-19 era

Background

Space suits have been adopted widely in orthopaedics to protect both surgeons and patients. Since COVID-19, their use has been described and recommended in aerosol generating procedures (AGPs)¹. However, there are concerns that negative pressure created by the hood fan allows entrainment of aerosolised coronavirus² into the breathing space.

We have modified a commercially available powered air respirator, Jetstream^® (JSP Ltd Oxford, England) (Fig 1), to make it compatible with the Stryker^® T4 hood (Stryker Corporation^®, Kalamazoo, USA). This has the benefit of eliminating the negative pressure effect and introducing a High Efficiency Particulate Air (HEPA) filter that draws in air from the filter at waist level and into the helmet. This is then expelled below neck level and into the gown.

Figure 1.

A commercially available powered air respirator, Jetstream^®

Technique

The Stryker T4 surgical hood has two metal discs on the bottom edge of the visor as shown in Figure 2. With solvent free glue, we attach two corresponding button magnets to the Jetstream^® helmet (Fig 3). This creates a sound interface between the hood and head unit (Fig 4).

Figure 2.

Stryker^® T4 surgical hood, metal discs visible on lower edge of the visor

Figure 3.

Jetstream^® head unit, corresponding magnets attached on lower edge of visor

Figure 4.

Jetstream^® head unit with Stryker T4 surgical hood

Discussion

This modification creates a safe environment for clinicians when AGPs are performed and is not solely for orthopaedic procedures.

Disclaimer

To ensure safe use, Jetstream^® helmets should be serviced as per manufacturer guidelines.