Hospital carpenter creates a lifesaving device.
Typically, Wayne Zahratka is a fixer.
Usually, it’s cabinets, doors and tables that get caught in the crossfire of activity at Baylor St. Luke’s Medical Center, where he has worked as the in-house carpenter for 30 years. He’s always busy, said Zahratka, because “stuff is always breaking.”
But the coronavirus pandemic created a unique situation: Rather than fix, the doctors needed him to create.
In less than a month, Zahratka, 57, developed and built a plastic box to protect St. Luke’s health care workers and patients during the intubation process. It’s a simple solution that could save an unknown number of lives.
When a patient is no longer able to breathe on her own, a respiratory therapist aided by nurses and other health care workers will insert a plastic breathing tube in the patient’s throat and into her lungs. The tube is attached to a ventilator. This intubation process has become more dangerous because of how COVID-19 is spread from person to person. An illtimed sneeze or cough can spread infectious respiratory droplets as far as 13 feet, according to some studies.
Zahratka’s intubation box started as a sketch on a piece of paper, he said. And at first, there were a lot of “I wants.” He asked what the doctors wanted, took notes and a mental inventory of what materials he had available in the hospital’s carpentry shop.
“They wanted wheels; they wanted it to come up and down and a negative air machine hooked up to it — a whole wish list,” he said.
Not every wish was granted, but the box itself is a solution to a contagion issue and will likely be tweaked and reused in the future for other procedures, said Dr. Christoper Howard, medical director of respiratory therapy at Baylor St. Luke’s.
The 2-foot-tall box has three sides and a top, and the patient’s head and chest area fit through the open side. A drape is placed over that side, and a negative air machine hose draws air out of the box, while also purifying it. There are two 6inch arm holes for the doctor to perform the intubation process.
Zahratka was the first to test the box’s capabilities — first with a fake sneeze (water in a spray bottle) and next with smoke to be sucked out through the air machine’s hose.
“We had a lot of ‘what ifs,’ ” he said. “One of the changes they wanted to make was ‘What if I need another hand in there? There’s only two holes.’ So I cut another hatch in it, and everyone was happy with that.”
Hospital staff realized they needed an option for multiple hands when mannequin tests began last week, and Zahratka added a removable panel.
The boxes are simple. Most importantly, he said, they are easy to clean — otherwise, doctors and nurses wouldn’t use them.
“At first, some were talking about a drape that you put across the front like a screen that can be used for multiple patients. But you can’t have something that can’t be cleaned or thrown away,” he said. “Everything here is plastic and stainless steel; it’s all sealed up and can be wiped down, cleaned up, sterilized and ready for the next person.”
In March, Zahratka started building sneeze guards for the emergency department’s front desk, security desk and the triage area, leaving a surplus of plastic material. Ten boxes have been constructed from the leftover material.
As treatment and containment of the new coronavirus continues, Howard believes there will be many necessary changes made to normal operating procedures. The solutions forged now during crisis times will help shape what future ERs and operating rooms will look like.
“So many of even the smallest innovations are making a big impact and will stay with us long beyond coronavirus,” Howard said. “(Health care workers) are in there every day, potentially exposing themselves, and no one is talking about how difficult or challenging it is — they’re all asking ‘How do we make this better?’ ”
Houston Methodist has built a similar intubation box called the Houston Methodist Aerosol Container, which is based off a prototype created by a Taiwanese physician. Boxes are being used to protect workers and patients at Memorial Hermann facilities and HCA Houston Healthcare hospitals.
More than 9,000 U.S. health care workers tested positive for COVID-19 as of April 9, according to the Centers for Disease Control and Prevention. The median age for the infected workers was 42 years, and 73 percent of reported cases were women.