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Endoscopy during the Covid-19 pandemic: simple construction of a single-use, disposable face shield using inexpensive and readily available materials
Alexandros Skamnelos1, Alberto Murino1, Nikolaos Lazaridis1, Lloyd Cunado1, Edward J. Despott1
1 Royal Free Unit for Endoscopy, The Royal Free Hospital and University College London (UCL)
Institute for Liver and Digestive Health, Hampstead, London, United Kingdom
Alexandros Skamnelos MD
Alberto Murino MD
Nikolaos Lazaridis MD PhD
Lloyd Cunado
Edward J. Despott MD FRCP FEBGH FASGE MD(Res)
Corresponding author: Edward J. Despott, MD, FRCP, FASGE The Royal Free Hospital and University College London (UCL) Institute for Liver and Digestive Health, Pond Street, Hampstead, London NW3 2QG, United Kingdom Fax: +44-20-74315261 email: [email protected]
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Endoscopy during the Covid-19 pandemic: simple construction of a single-use, disposable face shield using inexpensive and readily available materials
Alexandros Skamnelos1, Alberto Murino1, Nikolaos Lazaridis1, Lloyd Cunado1, Edward J. Despott1
1Royal Free Unit for Endoscopy, The Royal Free Hospital and University College London (UCL) Institute for Liver and Digestive Health, London, United Kingdom
To date, the Covid-19 pandemic has infected over 1.5 million people globally,
despite all efforts to control its transmission and wide-reaching negative
consequences. Personal protective equipment (PPE), so vital to the protection
of medical staff on the frontline, is universally in short supply, regardless of
production step-up in attempt to meet the ever-increasing international
demand.
A critical component of PPE, especially required for endoscopy, is the face
shield (visor), which is designed to reduce the risk of exposure to
potentially infective droplets through splashing [1-8]. Unfortunately,
during the Covid-19 pandemic face-shields are particularly in very short
supply.
Text
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Although most commercially available face shields are designed for single
use, the global shortage has driven frontline healthcare professionals to
resort to reusing these, after attempted “cleansing” with disinfecting
wipes.
Given the international shortage/unavailability and in attempt to mitigate
the risks associated with the reuse of face shields designed for single use,
we have developed a very easy and quick method of constructing
disposable, single-use face shields with simple, inexpensive and readily
available materials.
Simple face shield materials:
For the construction of an effective, single-use, disposable face shield, we
sourced inexpensive, simple, and readily available materials online. These
consisted of (1) an A4 generic acetate sheet (produced for overhead
projectors) (eg, Hartwii Inkjet OHP Film), (2) a strip of self-adhesive stiff
foam (eg, Kompriband Foam Sealing Tape), (3) a 2.0 cm-wide elastic band
(eg, Elastic Band-2.0cm x 40m roll), (4) a piece of generic, soft packaging
foam (eg, HMF 1458-30 Cubed Foam, 30mm), and (5) Cyanoacrylate glue
(super-glue) (eg, Everbuild HV20 Superglue, 20g) (Table 1). By using these
items as described in the following 3-step sequence and as demonstrated
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in our short video, each individual disposable face-shield would only cost
around £1.57 ($1.95 USD) or even less (Figs. 1 and 2).
Simple face shield stepwise construction
Step 1: Affixing the strip of self-adhesive stiff foam to the A4 acetate
sheet.
The backing paper is peeled off the back of the self-adhesive stiff foam,
which is affixed to the top of the lengthwise side of the A4 acetate sheet
(Figs. 1A and 2B).
Step 2: Affixing the elastic band to the A4 acetate sheet (approximately
32cm long, one size fits all) (Fig. 3).
Using a couple of drops of cyanoacrylate glue (super-glue), affix the ends
of the elastic band to the A4 acetate sheet, beneath the ends of the self-
adhesive strip of stiff foam (Figs. 1B and 2C).
Step 3: Affixing the piece of packaging foam to the stiff foam strip and A4
acetate sheet.
Using a line of cyanoacrylate glue (super-glue), affix the piece of packaging
foam to the strip of stiff foam (Figs. 1C and 2D).
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After waiting briefly for the glue to rapidly dry, the simple face shield is
ready to be worn (Figs. 2E and 4). This stepwise construction of the face
shield is clearly demonstrated in our video (Video 1).
This short instructive video demonstrates the construction of a single-use,
disposable face shield using simple, inexpensive, and readily available
materials when purpose-built, commercially prepared face shields are
unavailable or in short supply.
References:
1. Repici A, Maselli R, Colombo M, et al. Coronavirus (COVID-19)
outbreak: what the department of endoscopy should know.
Gastrointest Endosc. Epub 2020 Mar 14.
2. American College of Gastroenterology Joint GI Society. Message on
COVID 19. Available at: https://gi.org/2020/03/15/joint-gi-society-
message-on-covid-19/.
3. British Society of Gastroenterology. Endoscopy activity and COVID-
19: BSG and JAG guidance. Available at:
https://www.bsg.org.uk/covid-19-advice/endoscopy-activity-and-
covid-19-bsg-and-jag-guidance/.
4. WHO. Coronavirus disease (COVID-2019) situation reports.
Situation report – 77, 2020. Available at:
https://www.who.int/docs/default-
source/coronaviruse/situation-reports/20200406-sitrep-77-covid-
19.pdf?sfvrsn=21d1e632_2 .
5. European Centre for Disease Prevention and Control. Download
today’s data on the geographic distribution of COVID-19 cases
worldwide. Available at:
https://www.ecdc.europa.eu/en/publications-data/download-
todays-data-geographic-distribution-covid-19-cases-worldwide.
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6. Gu J, Han B, Wang J. COVID-19: Gastrointestinal manifestations and
potential fecal-oral transmission. Gastroenterology. Epub 2020
Mar 3.
7. Chiu PWY, Ng SC, Inoue H. Practice of endoscopy during COVID-19
pandemic: position statements of the Asian Pacific Society for
Digestive Endoscopy (APSDE-COVID statements). Gut. Epub 2020
Apr 2.
8. Johnston ER, Habib-Bein N, Dueker JM, et al. Risk of bacterial
exposure to the endoscopist's face during endoscopy. Gastrointest
Endosc 2019;89:818-24.
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Table 1. Materials required with examples of their manufacturers, all
sourced online over the internet.
Material Example of manufacturer A4 generic acetate sheet (produced for over-head projectors) Hartwii Inkjet OHP Film
Strip of self-adhesive stiff foam Kompriband Foam Sealing Tape
32cm long x 2.0cm wide elastic band Generic Tailoring Elastic Band roll (2.0cm x 40m)
A piece of generic soft packaging foam-30mm x 30mm x 20mm HMF 1458-30 Cubed Foam, 30mm
1 small bottle of 20g cyanoacrylate glue (super-glue) Everbuild HV20 Superglue, 20g
Text
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Endoscopy during the Covid-19 pandemic: simple construction of a single-use, disposable face-shield using inexpensive and readily available materials
Video legend:
Stepwise demonstration on the construction of a face shield using simple, inexpensive,
readily available materials when purpose-built, commercially prepared face shields are
unavailable or in short supply
Figure 1
A, Affixing a self-adhesive stiff foam strip to the A4 acetate sheet. B, Affixing the ends of the 32cm x 2cm elastic band to the stiff foam strip and A4 acetate sheet with cyanoacrylate glue. C, Affixing the piece of packaging foam to the stiff foam strip and acetate sheet with cyanoacrylate glue.
Figure 2
A, Schematic stepwise construction of the face-shield: materials needed. B, Affixing a self-adhesive stiff foam strip to the A4 acetate sheet. C, Affixing the ends of the elastic band to the stiff foam strip and A4 acetate sheet with cyanoacrylate glue. D, Affixing the piece of packaging foam to the stiff foam strip and A4 acetate sheet with cyanoacrylate glue. E, Fully constructed simple inexpensive face shield.
Figure 3
Elastic band (2cm wide and approximately 32cm long, one size fits all).
Figure 4
Simply constructed, inexpensive face shield, ready for use
Legends
Figure 1 Click here to access/download;Figure;figure 1.tif
figure 2 Click here to access/download;Figure;figure 2.tif
figure 3 Click here to access/download;Figure;figure 3.tif
figure 4 Click here to access/download;Figure;figure 4.tif
Link to video:
https://asge.sharefile.com/d-s97a4287ac3e48c28
Video
Click here to access/downloadVideo customized with template
face shield video for GIE - revised version.mp4
* We will use email addresses only for questions related to this article ** Type of relationship may include: full-time or part-time employee, independent contractor, consultant, research or other grant recipient, paid speaker
or teacher, membership on advisory committee or review panels, ownership interest (product royalty/licensing fees, owning stocks, shares, etc.), relationship of a spouse or partner, or any other financial relationship.
VideoGIE Journal CME Conflict of Interest: Disclosure and Attestation
Lead Author: Edward J. Despott
Article:
Endoscopy during the Covid-19 pandemic: Simple construction
of a single-use, disposable face-shield using inexpensive and
readily available materials
Date: 07-04-2020
The purpose of this form is to identify all potential conflicts of interests that arise from financial relationships between any author for this article and any commercial or proprietary entity that produces healthcare-related products and/or services relevant to the content of the article. This includes any financial relationship within the last twelve months, as well as known financial relationships of authors’ spouse or partner. The lead author is responsible for submitting the disclosures of all listed authors, and must sign this form at the bottom. Additional forms may be submitted if the number of authors exceeds the space provided.
Lead Author: Edward J. Despott Email Address*: [email protected]
No financial relationships with a commercial entity producing health-care related products and/or services relevant to this article.
Company Type of Relationship** Content Area (if applicable) Aquilant Medical Research support N/A
Fujifilm Research support N/A
Olympus Education support N/A
Pentax Medical Education support N/A
Author: Alexandros Skamnelos Email Address*: [email protected]
No financial relationships with a commercial entity producing health-care related products and/or services relevant to this article.
Company Type of Relationship** Content Area (if applicable)
Author: Alberto Murino Email Address*: [email protected]
No financial relationships with a commercial entity producing health-care related products and/or services relevant to this article.
Company Type of Relationship** Content Area (if applicable) Aquilant Medical Research support N/A
Fujifilm Research support N/A
Olympus Education support N/A
Pentax Medical Education support N/A
Author: Nikolaos Lazaridis Email Address*: [email protected]
No financial relationships with a commercial entity producing health-care related products and/or services relevant to this article.
Company Type of Relationship** Content Area (if applicable)
Conflict of Interest
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* We will use email addresses only for questions related to this article ** Type of relationship may include: full-time or part-time employee, independent contractor, consultant, research or other grant recipient, paid speaker
or teacher, membership on advisory committee or review panels, ownership interest (product royalty/licensing fees, owning stocks, shares, etc.), relationship of a spouse or partner, or any other financial relationship.
Author: Lloyd Cunado Email Address*: [email protected]
No financial relationships with a commercial entity producing health-care related products and/or services relevant to this article.
Company Type of Relationship** Content Area (if applicable)
As corresponding author of this article, I attest that I have received disclosure information from all
participating authors as listed above and acknowledge that I am responsible for verifying the accuracy of and
reporting completely the information provided to me. Financial relationships relevant to this article can be
researched at https://www.cms.gov/openpayments/. I understand that typing my name below serves as an
electronic signature for the purposes of this form.
Dr Edward J. Despott Type Name (Electronic Signature)
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