ABSTRACT
The spread of the new coronavirus SARS-CoV-2 has substantial social, health, and economic impacts. High viral load in the air in hospitals poses a risk to medical personnel. Cold atmospheric plasma (CAP) is a new technology based on the emission in the air of reactive species, neutral particles, UV radiation, and electromagnetic field. CAP has the potential as an antiviral agent. In this study, an 80-day clinical trial took place at Nicosia General Hospital to evaluate the application of CAP devices for lowering the viral load in the COVID rooms. A total of 284 indoor environment samples were tested by RT-PCR, for which 9 were positive (~3% Positive Rate). After analyzing the initial results, an ion emitter was paired with each patient, and the results showed that the method could eliminate the virus from the COVID wards up to 100%. The number of patients discharged from the hospital in the ionizer group was 4.8% higher than in the non-ionizer group, and 45% fewer patients in the ionizer group who remained in the rooms required oxygen support. The clinical trial shows evidence that composite CAP can decrease coronavirus spread in hospital environments and potentially prevent virus transmission.
ABSTRACT
BACKGROUND: Telemedicine offers convenient and affordable health care, overcoming the logistical challenges of face-to-face encounters. Clinicians increasingly relied on telemedicine during the global pandemic. To assess the ongoing role for telemedicine in orthopaedics, we prospectively analyzed the failure rate, safety and patient-reported experience of telephone consultations for 12 months. METHODS: 265 telephone Foot/Ankle consultations were conducted in April 2020 and were prospectively analyzed over 12 months. The primary outcome measure was the rate of failed telephone consultations. A consultation was deemed unacceptable if the patient did not answer, if the clinician could not reach a conclusion or if any outcome changed over 12 months. Secondary outcome measures included patient-reported satisfaction and time saved by avoiding a face-to-face visit. RESULTS: A clinical decision was reached in 84% of follow-up telephone consultations and 64% of new patient consultations (P = 0.001). Sixty-six percent were managed with nonoperative therapies, 16% were discharged, and 11% were added to the waiting list for surgery. The reasons for failing to achieve a clinical decision included failure to contact the patient (12.8%), inappropriate discharge with subsequent rereferral (1.9%), and insufficient clinical information (1.5%). Overall, 84.7% of patients reported that the telephone consultation was highly useful and 71.9% would recommend it to a friend or family member. Patients reported a mean time saving of 120 minutes. CONCLUSION: Based on our experience, we provide recommended criteria for the safe and practical use of telephone consultations and suggest versatile patient care pathways into which a telephone consultation can be incorporated. LEVEL OF EVIDENCE: Level IV, prospective cohort series (noncomparative).