Bronchoscopy in children with COVID-19: A case series

Area of Science:

• Pulmonology
• Infectious Disease Control
• Medical Device Innovation

Background:

• The COVID-19 pandemic created significant challenges for respiratory teams, particularly concerning aerosol-generating procedures like bronchoscopy.
• Bronchoscopy poses a high risk of transmission for respiratory viruses due to aerosolized particles and environmental contamination.
• Protecting healthcare workers during aerosol-generating procedures is critical, especially when personal protective equipment is limited.

Observation:

• Modified full-face snorkel masks were utilized for pediatric bronchoscopy in four children with confirmed COVID-19.
• These masks were implemented during a peak pandemic period when filtering facepiece respirators were in short supply.
• Each snorkel mask was adapted with an O-ring, adapter, and heat and moisture exchanger filter.

Findings:

• No COVID-19 infections were reported among the bronchoscopy team members using the modified snorkel masks.
• This contrasts with a hospital-wide staff COVID-19 prevalence rate exceeding 13.5% during the same period.
• The modified snorkel masks proved to be a safe alternative for aerosol-generating procedures.

Implications:

• Modified full-face snorkel masks offer a viable and safe alternative for performing emergency bronchoscopies on COVID-19 infected or status-unknown patients.
• This approach enhances patient and healthcare worker safety during respiratory procedures in pandemic situations.
• The findings support the adaptability of medical equipment to maintain essential clinical services under resource constraints.