Sky Factory Panels Turn Intubation Shields

Local designer’s spotting of Aerosol Box for endotracheal intubations spurs COVID-19 relief effort

While searching the Internet for ways to slow down the spread of the Coronavirus, Tim Freeberg-Renwick, a Fairfield designer, spotted an Aerosol Box for endotracheal intubations (ETT), designed by a Taiwanese doctor, Dr. Hsien Yung Lai. He sent it directly to friends at the Sky Factory, thinking that the company’s manufacturing facility could easily build them.intubation shields

“When Tim sent the files over to our engineering department, the idea of helping out our local hospital lit everyone up,” says Skye Witherspoon, Sky Factory CEO.

“We had the acrylic or polycarbonate sheets used for our SkyCeiling image panels, and with Dr. Yung Lai’s design and Tim’s detective work, we had the opportunity to make a difference.” The Taiwanese doctor had registered the protective device under a Creative Commons license, making it freely available worldwide.

With the surge in COVID-19 cases expected to hit the continental U.S. in mid to late April, there was no time to lose. Companies on the West Coast were already replicating these boxes for local use and in the Midwest, we had no time to spare either.

The widespread shortage of tests and personal protective equipment (PPE) in hospitals across the country and the government’s inability to secure desperately needed supplies, meant any additional layer of effective protection for medical staff was critical.

intubation shields“We downloaded the files, cut the material, assembled a prototype Aerosol Box, and ran it across town to Jefferson County Health Center (JCHC), our local hospital, for immediate feedback” adds Skye.

“Bryan Hunger, JCHC’s CEO, and I discussed the use of the box in consultation with Ryan Ford, their Cardiopulmonary Director, and his staff. We then made adjustments to the original design, and had a second prototype in 24 hours.”

Sky Factory’s modified Aerosol Box features a respiratory droplet splatter guard across the top of the cube’s main opening. The guard enhances the device’s ability to sequester the aerosolized particles that could otherwise drift or “hang” in place, increasing the risk of infection to intubation teams.

The modified design also features curved shoulder openings that enhanced the comfort-fit around a patient’s upper body, improving the seal and making it easier to maneuver.

JCHC asked Sky Factory to make four of the modified Aerosol Boxes (now dubbed “Intubation Shields”). But with their colleagues in mind, JCHC didn’t wait to share the news of these devices.

As word-of-mouth spread via phone and e-mail through organizations like the Iowa Hospital Association and the Iowa Organization of Nurse Leaders, device requests skyrocketed.

“At first, we thought we’d make a handful of the shields for nearby hospitals, but the next day, when I checked my e-mails and took the first calls, I realized that we’d tapped into a state-wide need,” adds Witherspoon.

Within 24 hours, requests spanned the state––from Keokuk, in the southeast corner, to Sioux City, on the westernmost border, even hospitals as far as Minnesota and neighboring Illinois wanted Intubation Shields. And not just one or two; Cherokee Regional Medical Center wanted six, Iowa Specialty Hospital in Clarion sought eight, and UnityPoint Health-Trinity in the Quad Cities, requested twelve shields to distribute them among their four affiliate full-service hospitals in Rock Island and Moline, Illinois, and Bettendorf and Muscatine, Iowa.

“We were glad to assist several affiliate hospitals of UnityPoint Health, Iowa’s first and largest integrated healthcare system, which cares for one of every three patients in the state,” adds Skye.

“We are humbled and thankful for the intubation shield donation from Sky Factory. It gives us another vital tool of protection to help keep our team members and patients safe during the COVID-19 pandemic,” said Robert J. Erickson, UnityPoint Health-Trinity President & CEO.

intubation shields“On top of the unexpected response, we plunged forward with volunteer labor that included our President, Lauren Steingreaber, and members of our engineering team who worked long hours—afterhours—to get all the shields completed on time.”

“But by far the thing that moved me most deeply was to hear directly from ER doctors who were literally living at the hospital, working around the clock on preparedness and contingency plans, and taking charge of securing protective equipment for their teams.”

“I’d read the news, but it’s not until you hear a doctor’s voice on the other side of the line, or see the time stamp of the e-mail you just received at half ‘til midnight, that it really hits you.”

Unwilling to lose a single staff member to COVID-19 infection, hospitals knew any additional layer of protection (or safety) could prove decisive. Hence, protecting their teams during the expected surge of endotracheal intubations (ETT), the trauma procedure performed on infected patients who suffer respiratory failure, was imperative.

“The urgency of the matter and their personal resolve was palpable. Their dedication made a deep personal impact, inspiring all of us who worked on the project” adds Skye.

Within 48 hours of the announcement, orders skyrocketed to over 100 intubation shields. As the project outgrew its local intent, ranging from hospitals by the Mississippi, on the eastern border of Iowa, to the Missouri River on the westernmost side, and everywhere in between, the company secured a donation to help cover some material costs.

“Aside from shipping this initial wave of shields out the door just in time to yield the highest benefit,” adds Witherspoon, “we are also making the modified design AutoCAD files available for free to any manufacturer who wants to help their local hospital.”

“Here at the Sky Factory, we are all glad to have found something practical to do that gives us a hand in supporting the safety and well-being of our healthcare workers; those who are so selflessly risking their lives to save us and our families,” adds Skye.

“Times of crisis reveal character and we are overwhelmed by our communities coming together in partnership to mitigate the impact of this pandemic and further the common good. Everybody can make a difference and we applaud Sky Factory for joining us in the fight,” added Mr. Erickson.

Manufacturers/Designers: want to make your own Intubation Shields? If you have the capacity to do your part in producing more of these intubation shields for your area hospitals, please send an e-mail to and they will send the files to you.