Internal medicine chief resident, Dean Kellogg III, M.D., has been utilizing his spare time to build and distribute aerosolization boxes—large acrylic boxes that fit over a patient while they’re being intubated. The box helps to reduce the spread of COVID-19 to health care staff.

“Before this, in my spare time I’ve built furniture and cabinets, so this is a similar skill set,” Dr. Kellogg said. “On weekends when we have off, it’s kind of a fun hobby, so I get enjoyment out of it too. It’s definitely more meaningful than a normal project because protecting physicians is an important role.”

The construction of the boxes is a family affair, with Dr. Kellogg and his wife building the boxes in their garage, and his father-in-law obtaining the materials with a donation from a medical nonprofit organization, where he sits on the board.

Dr. Kellogg and his family began this project because his wife, Allison Kellogg, M.D., an obstetrician and gynecologist at Methodist Hospital Stone Oak, was concerned about his increased risk of exposure to COVID-19 when he begins his pulmonary/critical care fellowship in July.

Dr. Allison Kellogg found the design plans for the aerosolization boxes online. The boxes, designed by a Taiwanese physician, have gained interest due to a recent study published in the New England Journal of Medicine, which illustrated the boxes’ efficacy.

The acrylic boxes are enclosed on all sides except one, which allows it to fit over the patient’s head and shoulders while they lie on their back. They feature two holes positioned above the patient’s head where health care providers can insert their arms to perform the intubation.

demonstration of intubation box on patient
From left to right: Antonio Anzueto, M.D., professor of medicine; Laura Mendez; and Varun Goyal, M.D., assistant professor of anesthesiology.

The Kellogg’s have distributed 15 of their boxes to hospitals throughout San Antonio, including University Hospital, the Audie L. Murphy VA Hospital, Methodist Hospital and Methodist Hospital Stone Oak.

“We have used them with several patients, and we are very impressed and very happy with them,” said Antonio Anzueto, M.D., professor of medicine in the Division of Pulmonary Diseases, who uses the boxes at the VA hospital. He has found them to be very effective for his patients and staff.

“It makes us all feel safer, but also it is better for the patients because they can receive proper medical care without anyone on the staff being concerned for their own safety, so this is a win-win situation for both the patient and the provider.”

The process of intubation involves inserting a tube into a patient’s airways to help them breathe, often causing patients to cough with health care providers in close proximity, said Dr. Anzueto.

“Out of all the procedures that increase the risk of aerosolization and dissemination of the virus, it would be endotracheal intubation,” he said.

Even though providers already wear protective gowns, gloves and masks, Dr. Anzueto believes the acrylic boxes are doing even more to protect health care providers.

“Having the box gives an extra layer of protection because during the intubation, if patients happen to cough, all that material is going to sit within the box,” said Dr. Anzueto. “So that not only protects the individual doing the intubation, it also protects the rest of the staff inside the room. The whole team that will intubate will be protected and patient care won’t be compromised.”