• Jack B Anon, Carter Denne, and Darcy Rees.
• Ear Nose and Throat Specialists of Northwestern Pennsylvania, Erie, Pennsylvania, USA.
• Otolaryngol Head Neck Surg. 2020 Aug 1; 163 (2): 280-283.

ObjectivesThe primary objective of this study was to compare the protection afforded by a standard face shield design with a new enhanced design in a controlled setting.MethodsThis study was exempted from review by institutional review board waiver. A flexible fiberoptic endoscopy was placed through stellate openings in the standard face shield and the enhanced face shield. A series of simulated coughs were created with bursts of fluorescein dye through an atomizer tip placed within the test participant's mouth. Ultraviolet lighting illuminated the test area, and areas of dye splatter were noted.ResultsFluorescein dye is easily aerosolized along the lateral inferior aspect of a standard shield with significant contamination of the surrounds. The enhanced face shield maintained a barrier to the aerosolized dye.DiscussionFace shields, rather than face masks, should be considered a preferred alternative for the public and for health care professionals alike, as they address many of the personal protective equipment concerns especially during the COVID-19 pandemic. Otolaryngologists are at high risk from aerosol-generating procedures, such as flexible fiberoptic endoscopy, even when wearing personal protective equipment. Here we describe a uniquely designed face shield to be worn by the patient as another layer of protection for the environment and for medical personnel.Implications For PracticeDuring the course of a flexible fiberoptic endoscopy, medical personnel are safely isolated from potential infectious particles with a newly designed face shield.

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