"Bubble Helmets" common in Italy ICUs; staff surprised they aren’t used in the US
Updated: Jul 23, 2020
Italian medical staff prioritize helmets rather than face masks when providing noninvasive ventilation to hospital COVID-19 patients in intensive care units (ICU).
An ER nurse who works in Italy also was surprised to learn that helmets are not being used in the US. Staff assumed helmet use was as widespread in the United States as it is in Italy, Valerio Korrado said to Aurika Savickaite via chat.
Noninvasive ventilation (NIV) via helmet was tested successfully in a three-year study at the University of Chicago Medical Center. Researchers found helmets were more effective than face masks for patients with acute respiratory distress. Patients using helmets were less likely to be intubated, had fewer days in the ICU and hospital, and had a lower mortality rate.
Valerio Korrado, a nurse and triage-nurse in the ER at Ospedale Civile Santo Spirito of Pscara, said hospital staff is using NIV via helmet for COVID-19 patients with mild dyspnea in ICUs, but in the ER they use full-face masks due to an equipment shortage.
“Our recommendations say that the first choice for NIV should be helmets,” Korrado said because there is less risk for operators. The national guidelines of SIAARTI (Italian Society of Anesthesia and Intensive Care) advise using a helmet rather than face mask in the ICU for COVID-19 patients who are not intubated, Korrado said.
Helmets can create a closed system to limit the possibility of contaminating others, especially when they are used with an antiviral/antibacterial filter.
“During specific clinical conditions of the patient, we totally agree about considering this kind of treatment the best practice among the other NIV methods (face or full face) that many times create discomfort and complications, even to the operator that can be easily contaminated,” Korrado said.
Korrado added that the helmets usually are connected to a mechanical ventilator, although they can be connected to wall gas.
Helmets can be used without mechanical ventilation as an alternative for some patients and provide the same benefits as a CPAP machine would do if ventilators are in short supply. Watch our video to learn how to connect a helmet to wall gases.