"Endoshield": A Physical Protective Box for Pediatric Endoscopy during the COVID-19 Pandemic

Background/Aims: The coronavirus disease (COVID)-19 pandemic presents challenges for gastrointestinal endoscopy. Although the virus is transmitted through contact and droplets, aerosol-generating procedures produce aerosols that can spread through airborne routes. Several gastrointestinal societies have released statements to protect patients and health care providers (HCPs). This study describes a barrier box that may be used as an adjunctive device in addition to personal protective equipment during endoscopies. Methods: A transparent acrylic box called "Endoshield" was created to place over patient's head and shoulders and was tested for its ease of use for the endoscopist and suitability for patient size and position. Results: Twelve children (66.67%, male) with a median age of 9 years (range, 2-11 years) underwent emergency or urgent endoscopy between April and June 2020 during the COVID-19 outbreak. The most common presenting symptom was life-threatening gastrointestinal bleeding (8/12, 66.67%), while the rest had urgent symptoms (4/12, 33.33%). The "Endoshield" was suitable for all patient positions (left lateral position: 9/12, 75% and supine position: 3/12, 25%). The patients and HCPs were followed up for their symptoms on day 14, and none of them had any symptoms of concern. Conclusions: The "Endoshield" is affordable, reusable, and suitable for both positions.