Singapore, 16 April 2020
An idea born during a break in the surgical intensive care unit tea room in the midst of COVID-19 situation has led a team of Singapore General Hospital (SGH) anaesthesiologists to swiftly develop a foldable swab screen system that can help double the number of tests performed without putting healthcare workers at increased risk of COVID-19 infection.
The team partnered The Biofactory, a local biomedical incubator, to come up with the first prototype within one week in March 2020. They took another week to produce the system, which they called “Swab Assurance For Everyone” or SG SAFE in short, using industrial grade chemical resistant materials. The systems are now being used at SGH’s emergency department and extended facility to assess patients for COVID-19.
Wearing just an N95 mask, the healthcare worker steps into the U-shaped transparent booth and sticks his hands into a pair of biosafety level 3 gloves built into the panel to take swabs from the patient who is standing or seated on the other side. The booth is then disinfected, and ready for the next patient. The entire process takes about two-and-a-half minutes.
A swab test typically takes close to five minutes as the healthcare worker needs to don a full personal protective equipment (PPE) comprising disposable gown, N95 mask, protective goggles, face shield, and gloves in the correct order. Once done, he removes and discards the gloves, disposable gown, and possibly the soiled face shield, and changes to a new set before swabbing the next patient. In between each steps, he has to clean his hands using handrub.
“As the demand for swab tests increases, we see the need for a faster and more efficient way of doing it while ensuring that the safety of healthcare workers is not compromised and being prudent with the use of PPE. The SG SAFE system is designed by healthcare workers for healthcare workers involved in the high-risk task,” said Dr Hairil Rizal Abdullah, Senior Consultant, Department of Anaesthesiology, SGH, who mentored the team in the development of the system.
Weighing 25kg and measuring 1m x 1m x 2m, the SG SAFE system can be easily set up by two people in almost any location within 10 minutes.
In wards and clinics where SG SAFE is not available or cannot be placed due to space constraints, healthcare workers can bring in the SG SHIELD. As the name implies, it is a shield which blocks healthcare workers from droplet deposition that patients may cough out during throat swabs.
Conceptualised by a multidisciplinary team of doctors from SGH Departments of Otolaryngology – Head & Neck Surgery, and Urology, as well as clinical innovation engineers from Medical Technology Office (MTO), SingHealth, they drew inspiration for the design by observing a throat swab procedure simulation.
“We watched how the doctors move their hands, their body posture and the positioning of the patient. We also received valuable advice from other clinicians such as Infectious Diseases Physicians on the ideal size of the shield and put it through robust testing,” said Dr Siti Radhziah Sudirman, Consultant, Department of Otorhinolaryngology – Head & Neck Surgery, SGH. Dr Siti is the clinical team lead for the project.
To be used with full PPE, the single-use SG SHIELD, which measures 21cm x 34.5cm x 0.3cm, is made of polycarbonate and comes with slots for a tongue depressor and swab stick. It is light weight, easy to handle and can be readily assembled by the patient’s bedside. The team is already working on the second version of SG SHIELD which will allow healthcare workers to also perform nose swab.