With cake collar material, a three-hole punch, a scrapbooking paper trimmer, and the drive to protect those on the front lines of health care, a team from The University of Texas Health Science Center at Houston (UTHealth) has designed a face shield that can be used by thousands of providers in the Texas Medical Center.
This past week, thousands of injection-molded headpieces began arriving at UTHealth, along with polymer sheeting that will be used to create the medical-quality face shields. This shipment is the culmination of just a few weeks of trial and error to create low-cost, highly functional personal protection equipment (PPE) for health care providers at Harris Health Lyndon B. Johnson (LBJ) Hospital, Memorial Hermann, UT Physicians, and other health care facilities across the Houston region.
“I am so grateful that we are able to do something to protect ourselves and our colleagues,” said George W. Williams II, MD, associate professor of anesthesiology at McGovern Medical School at UTHealth and medical co-director of the surgical intensive care unit at Harris Health LBJ. “We don’t have to be worried about our own health. This allows us to focus on our patients and just be the best health care providers we can be.”
In response to a global shortage of PPE and in preparation for more COVID-19 cases in Houston, Williams set out on March 27 to design face armor for those in combat with the virus. He thought 3D printing might be the answer. Barbara Stoll, MD, dean of McGovern Medical School at UTHealth, and Michael Blackburn, PhD, executive vice president and chief academic officer at UTHealth, quickly put Williams in contact with David Volk, PhD, associate professor in the medical school’s Center for Translational Cancer Research.
Volk was one step ahead of Williams, vice chair and division chief of critical care medicine in the Department of Anesthesiology. He had already downloaded a free template to make the headpiece for the face shield. Now all he had to do fire up one of the 3D printers made available through The University of Texas System’s Science and Technology Acquisition and Retention (STARs) program.
“Normally I print medical devices, not PPE prototypes, but I was highly motivated to do my part to protect our physicians and nurses who are caring for patients who may have COVID-19,” Volk said. “Health care providers put on a brave face, but this is scary. We need to protect them.”
In the days ahead, Volk would print a headpiece. Williams would drive by UTHealth’s Fayez S. Sarofim Research Building to pick up the prototype, then he would have colleagues at Harris Health LBJ try it out.
For the initial prototypes, the face shield itself was made of clear transparencies Williams found in his office. He would puncture the transparency using a three-hole punch, then secure it to the headpiece Volk had printed.
Brijesh “Billy” S. Gill, MD, and Max Skibber, a research assistant who works in Gill’s McGovern Medical School lab developing medical devices, quickly joined Williams and Volk in their efforts to design a protective face shield.
Skibber, who begins his first year as student at McGovern Medical School this fall, put his bioengineering background to work. He applied feedback from Williams and other health care providers to optimize the design for rapid injection molding so the face shields could be manufactured quickly in mass quantities.
Early designs held the transparency too close to the face. It provided exceptional protection, but it didn’t allow adequate space for those with glasses or large noses. The transparency fogged up quickly, and produced a bothersome glare. By widening the headpiece, Skibber was able to bring the plastic shield farther away from the face, allowing for both functionality and comfort – a simple, elegant solution.
Next, the team needed to come up with a better substitute for the transparency. The material used for cake collars, plastic sheeting that protects cakes during delivery, seemed to be the best option.
Skibber suggested they use a scrapbooking paper trimmer to easily and evenly cut the cake collars into face shields. He stood in line at a craft store, social distancing and patiently waiting his turn to buy a trimmer that is designed to preserve memories and would now be helping to preserve the health and safety of health care providers.
“I find a lot of inspiration in what Dr. Williams, Dr. Gill, and Dr. Volk are doing,” Skibber said. “This experience will stick with me as I begin medical school and throughout my career.”
While Williams collected data from those wearing the face shields, Volk and Skibber continued to make adjustments. Dustan Brennan, assistant director of Medical School Information Technology (MSIT) for Innovation, Projects, and Research, and his team collaborated on the finalized design. Then his team and Nujoud Merancy, chief of the Exploration Mission Planning Office at NASA Johnson Space Center, used their 3-D printers to make enough of the headpieces to protect several hundred front-line providers until the PPE part could be produced in mass quantities.
Meanwhile, Protolabs got on board to create up to 20,000 injection-molded headpieces. The cake collar material that the team purchased online will only make about 4,000 shields. Piedmont Plastics found an additional supply of high-grade polymer sheeting that will produce 40,000 shields for Houston health care providers.
Chris Okezie, vice president of operations at Harris Health System, said, “We are grateful for the opportunity for the Harris Health System Supply Chain team to collaborate with UTHealth on this development. This product will greatly enhance our ability to protect our clinical staff during this challenging and difficult time, and we are most appreciative to be a beneficiary of this inspiring innovation.”
Stoll, a champion of this initiative, added, “If there was ever a silver lining to COVID-19, it is seeing people working together for the public good. That’s what this is all about – coming together to protect those on the front lines so we provide the very best care to our patients.”