PAPR Fix

Students in Jefferson’s Health Design Lab Helping Make Important PPE Fix

A small piece of the PAPR suit battery pack kept breaking, rendering the whole suit useless, so they used 3D printing to fill the gap.

A small, plastic button frame can make quite a difference when it comes to treating suspected COVID-19 patients.

That’s the lesson healthcare workers at Thomas Jefferson University Hospital have learned in recent weeks. It’s also an issue which prompted a group of students—and faculty—from Sidney Kimmel Medical College and Jefferson’s Health Design Lab to spring into action to help, under the guidance of emergency medicine physician Dr. Morgan Hutchinson.

When it comes to personal protective equipment, specifically for airborne protection, healthcare workers frequently use what's known as a PAPR unit, which is a “ghostbuster-type suit that uses a lithium battery-powered fan to blow purified positive pressure air to the wearer’s hood,” explains student Bobby Ries.

However, a glitch in the PAPR design was recently discovered. When healthcare workers disconnected their battery packs from the suit, a single piece repeatedly broke. While it may sound like a minor problem, it’s anything but that, as it renders the suit inoperable.

With a national shortage of replacement batteries, no way to individually procure the broken component, and learning that dozens of the components had broken, the team from Sidney Kimmel Medical College and Thomas Jefferson University Hospital sought alternative solutions.

“PAPRs are one of the most advanced devices used to protect healthcare workers performing high-risk procedures on COVID patients,” Dr. Hutchinson says. “Ten of these pieces were broken in the emergency department and on one weekend alone, six broke in the medical intensive care unit. The battery case is on backorder for several months, and the device cannot be used without it.”

Since the beginning of the pandemic, SKMC students were removed from the clinical space. In one of many ways they pitched in distantly, the team got to work on ways to stave off PAPR problems.

In early April, an opportunity to help became evident when Dr. Ed Jasper and Bob Keough, the administrative charge nurse for the MICU at Thomas Jefferson University Hospital, reached out with word that the battery supply had reached a critical level.

From there, after contacting the manufacturer to confirm that the part itself was not patented, the student-volunteers teamed up with the Jefferson Health Design Lab—with the valuable help of a corporate partner—to 3D print battery case replacements.

Nearly 50 replacement pieces have been 3D printed and are already being used to salvage broken batteries.

The effort has proven to be so successful that replacements are already being used at Thomas Jefferson University Hospital in Center City. The team has also launched Project PAPR, an open-access website that includes a link to their 3D printer code so other hospitals can print their own components.

“The leadership of our hospital and medical school have always supported innovation, and it is an incredible experience to see our students coming together (virtually) to solve problems like this," Dr. Hutchinson shares.

Ries noted that the black, plastic-frame component being replicated allows the battery to be disconnected from the PAPR unit.

It is an incredible experience to see our students coming together (virtually) to solve problems like this.

In regards to the process leading up to this point, users quickly learned that batteries were out of stock nationally and that the manufacturer did not sell individual components prompted the team to try glue and epoxy as fixes.

Since those options were met with limited success, the students—Ries, Dante Varotsis, Kat Linder and Jordan Kurzum—and Michelle Ho, who took a year off from medical school to complete a health-design fellowship, teamed up with engineers from Fishtown fabricator FKB studio to come up with a solution using 3D printing technology.

“Using a standard 3D printer, a near identical component can be recreated on demand,” Ries says of the results. “Nearly 50 replacement pieces have been 3D printed and are already being used to salvage broken batteries.”

In other words, those replacements are already making a positive difference in how suspected COVID-19 patients are being treated, while protecting the healthcare workers involved in that treatment.

“This is all about using ‘design thinking’ to solve problems in healthcare,” Ries adds.

John Spetrino, one of the owners of FKB, already had ties with the Health Design Lab, having had a hand in designing the Airstream trailer now stationed at the testing site in a parking lot at 9th and Sansom streets.

Spetrino reached out to the Health Design Lab's Dr. Bon Ku and Robert Pugliese when the severity of the pandemic became evident, offering any help the team might need. With a mechanical engineering background, Spetrino immediately hopped into both the PAPR and rescue-ventilation efforts.

“They dropped the parts off in my mailbox, and I got to work on it as soon as the kids got to sleep,” he says.

SKMC student Kathryn Linder working to improve the lifespan of the powered air purifying respirator (PAPR), an important piece of personal protective equipment.

The team effort recreated the faulty plastic components using a desktop fused deposition modeling (FDM) 3D printer with polylactic acid filament.

“It was all about reverse engineering, and the easiest solution was being able to print them and have them working in the field,” Spretino explains. “This wasn’t necessarily what our business is about, but it’s within our skillset, so we applied our skills to it, and were able to help find a solution.”

The team is conducting continuous quality improvement and monitoring with its real-time implementation in the clinical setting, Ries says.

“Given the immediate need and lack of other options for this particular part, we are sharing this solution so that others may use it in the near term,” he says. “We advise that anyone using this design perform their own validation and safety testing.”

The Health Design Lab has been a critical asset during the COVID-19 pandemic, not so much because of the equipment inside, but for what it stands for and the people who work within its walls.

Robert Pugliese, director of innovation design for Jefferson and Jefferson Health, is co-founder and managing director of the Jefferson Health Design Lab. He cited this project as being representative of teamwork across many crucial efforts.

“The Health Design Lab has been a critical asset during the COVID-19 pandemic, not so much because of the equipment inside, but for what it stands for and the people who work within its walls,” he says. “This project and others are perfect examples of what is possible when you have a place like the Health Design Lab to help create an ecosystem that brings together our creative and innovative minds in a place purpose build for nurturing creative problem solving.”