JOHOR BAHRU, 8 Apr. 2020 – The Faculty of Engineering, Universiti Teknologi Malaysia (UTM) has been producing protection devices known as Aerosol Box or “Intubation Box” to protect healthcare workers from infections while handling COVID-19 patients. Those devices were distributed nationally to hospitals and medical centres.

The project leader, Dr. Wong Tuck Whye, said that the main intention of him and his teammate in creating this device was to ensure the safety of medical front liners who are working in the ‘hot zones’ to treat the sick ones.

“While we as civilians are staying in the comfort of our home throughout the Movement Control Order (MCO) issued by the government, others such as doctors, nurses, and medical officers are at the front line risking their lives battling with COVID-19 pandemic.

“In this critical situation, their safety is of utmost importance. For that, voices have been raised on the increasing demand for Aerosol Boxes in hospitals,” said Dr. Wong through a phone call interview with a representative from Office of Corporate Affairs, UTM recently.

In providing the local healthcare workers with this facility, Dr. Wong has collaborated with a group of medical doctors which consists of Dr. Maryam Sumaiya Ahmad Termizi, Dr. Rashdan Rahmat, Dr. Ahmad Zakimi Abdullah, Dr. Noorhayati Ngatimin, and Dr. Kareen Chong from Emergency and Trauma Department of Hospital Sultan Ismail (HSI), Johor.

This project is also coordinated by Pharmacy Department staff from HSI which are Noor Ratna Naharuddin, Siti Rosnah Suradi, and Madam Chong Siew Ling. Through this collaboration, Dr. Wong and his team have improvised the original design of the Aerosol Box by adding a rim to the arm insertion slots so that gloves can be attached if necessary.

“For extra safety features, the box was constructed without any sharp edges. Like folds of origami box, an acrylic sheet was cut into 2D structure frame of the box.

“The folding edges were heated at a glass-transition temperature of the material which is soft enough to fold the sides into the desired shape and eliminate the sharp edges. This is an important feature for ease of sterilization,” said Dr. Wong.

According to Dr. Wong, the first two units of fabricated Aerosol Box were delivered to HSI on March 28, 2020 where professional feedback was received to consider the ergonomic aspect in its design that caters to the differences in height of the end-users.

“Together with Daniel Lim Yeong Ching from TTMC Sdn. Bhd. and Farah Hidayah Jamaludin, Doctor of Philosophy (PhD) candidate, we designed more ergonomic and user-friendly Aerosol Box by modifying the 90° edge at the user side into a slanting plane with an approximate angle of 18.45°.

“This is to improve the vision side of the users who have various heights. The level of the hand insertion hole is also a crucial aspect to consider in designing an ergonomic Aerosol Box. Based on the feedback, we have uplifted the holes by two centimeters,” said Dr. Wong.

Meanwhile, Dr. Ahmad Zakimi Abdullah from Emergency and Trauma Department of HSI has explained that an intubation procedure is performed using a rapid sequence intubation technique (RSI).

“For a COVID-19 patient, the intubation procedure is performed in an Aerosol Box with video laryngoscopy to prevent virus infections toward the healthcare workers from the possible occurrence of aerosol generated from the COVID-19 patient’s airway.

“The glove used is a long of  L-size which fits on the acrylic ring hand insertion hole. It seals well to avoid the exposure of aerosol effects from the patient and will be replaced upon completion of the procedure. I figured the Aerosol Box is easy and safe to be used for the intubation procedure,” he said.

Besides Dr. Ahmad Zakimi, a Cardiothoracic Anesthesiologist Consultant from Hospital Sultanah Aminah of Johor Bahru (HSAJB), Dr. Mohd Khairul Anwar Abdul Rahim also approached Dr. Wong and stated his interests toward the Aerosol Box.

As facilitated by Centre for Community and Industry Network (CCIN-UTM), the improvised design of Aerosol Boxes was delivered on April 1, 2020 in a batch of 10 units (sponsored by TTMC Sdn. Bhd.) while another 17 units were delivered on April 4th, 2020 (sponsored by Pertubuhan Pendidikan Rumah Ngaji Negeri Johor,  a Non-Governmental Organization (NGO) religious group).

29 units of the Aerosol Box were successfully distributed to nine hospitals in Johor, coordinated by Public Relations Officer of Hospital Sultan Ismail.

“Beyond that, Rumah Ngaji and our team also have raised a fund for another sponsorship with 41 units of Aerosol Box which tentatively be delivered by April 10, 2020.

“Among the destinations for the distribution of the Aerosol Boxes are HSAJB (four units), Kumpulan Perubatan Johor (KPJ), a private hospital in Pasir Gudang (one unit), Gleneagles Hospital Johor (one unit), Hospital Selayang, Selangor (five units), Hospital Tuanku Ja’afar, Negeri Sembilan (15 units), Hospital Pekan, Pahang (five units), and Hospital Tengku Ampuan Afzan, Pahang (10 units)” said Dr. Wong in elaborating his future plans.

The equipment was first designed by Dr. Hsien Yung Lai, an Anesthetist at Mennonite Christian Hospital, Taiwan who generously shared the design through online for others’ benefit.