BACKGROUND: The need to administer ribavirin to pediatric patients with res- piratory syncytial virus (RSV) pneumonia has generated major concerns related to the risk of drug exposure for caregivers and family members at the bedside. We sought to lower the possible exposure of those attending nonventilated patients to a time-weighted average of < 2.7 µg/m³. METHOD & MATERIALS: In Phase 1, ri- babirin was administered to a simulated patient within a hood placed in an oxygen tent; for Phase 2, a high-flow vacuum exhaust system was added; and for Phase 3, the mist generator of the oxygen tent was activated to saturate the environment of the tent external to the hood. Air samples were taken at three points: nearest, mid- point, and farthest from the source, for 5 to 6 hours each. Sample filters identified only by random numbers were sent for analysis by liquid chromatography. RE- SULTS: Time-weighted averages indicated a high exposure level for Phase 1 (123.0 µg/m³), an 83.2% reduction for Phase 2 (20.7 µg/m³), and a 98.3% reduction dur- ing Phase 3 (< 2.13 µg/m³). CONCLUSION: We recommend that ribavirin ad- ministration to nonventilated patients incorporate a double-chambered hood and canopy, a high-flow vacuum exhaust pump, and a high-density mist generator.
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