Chest physiotherapy techniques administered by certified specialists to hospitalized patients with COVID-19 in Brazil: A look towards future practice.

BACKGROUND: Chest physiotherapy for hospitalized patients with COVID-19 has been poorly reported. Although recommendations were published to guide physiotherapists, practice might have differed depending on education and training. OBJECTIVE: To analyze the differences in chest physiotherapy applied for hospitalized patients with COVID-19 between certified specialists and non-certified specialists. METHODS: An online questionnaire survey was developed for physiotherapists involved in the management of hospitalized patients with COVID-19. The questionnaire inquired about professional information and characteristics of physiotherapy practice. RESULTS: There were 485 respondents, yielding a completion rate of 76%. Of these, 61 were certified specialists and 424 non-certified specialists. The certified specialists were older, had more years of professional experience, were more qualified, and had better job conditions. For mechanically ventilated patients, the certified specialists used the ventilator hyperinflation maneuver more frequently (50.4% vs 35.1%, p = 0.005), and the hard/brief expiratory rib cage compression (ERCC) (26.9% vs 48.3%, p = 0.016), soft/long ERCC (25.2% vs 39.1%, p = 0.047), and manual chest compression-decompression (MCCD) maneuver (22.4% vs 35.6%, p = 0.001) less often. For spontaneously breathing patients, the certified specialists used the active cycle of breathing technique (30.8% vs 67.1%, p<0.001), autogenic drainage (7.7% vs 20.7%, p = 0.017), and MCCD maneuver (23.1% vs 41.4%, p = 0.018) less frequently. CONCLUSIONS: Certified specialists with higher levels of expertise seem to prefer the use of chest physiotherapy techniques that are applied with the mechanical ventilator over manual techniques. Furthermore, they use techniques that could potentially increase the work of breathing less frequently, mitigating the risk of exacerbating respiratory conditions in patients with COVID-19.

The Role of the Physical Therapist in Cystic Fibrosis Care.

In looking back on 2020 and 2021, this Perspective reflects on the monumental impacts of the rollout of cystic fibrosis (CF) transmembrane conductance regulator highly effective modulator therapies and the COVID-19 pandemic on the management of CF. Advancements in the clinical management of people with CF have been both enormous and rapid, and physical therapists specializing in the care of people with CF have been at the forefront of driving this evolution in care. This year sees the thirtieth anniversary of the UK Association of Chartered Physiotherapists in Cystic Fibrosis and, as is inevitable in reaching such milestones, thoughts have turned to origins, role, impacts, and the future. With the changing demographics of the population of people with CF after the introduction of highly effective modulator therapies, potentially with fewer secondary complications, the future role of the physical therapist who specializes in CF is in question. This Perspective reflects upon and highlights the role of physical therapy within CF and provides insights into how physical therapists and respiratory therapists can evolve their roles to ensure relevance for the future.

Respiratory Therapy and Proning

The novel SARS coronavirus-2 (SARS-CoV-2) is responsible for COVID-19 which primarily affects the respiratory tract, particularly the lungs, of infected patients. The COVID-19 pandemic resulted in a large number of hospitalized patients with respiratory failure reaching the level of acute respiratory distress syndrome (ARDS). ARDS requires prolonged respiratory care. Critically ill patients can frequently progress to decompensation and death. Respiratory therapy is therefore important in response to such a health crisis as COVID-19, to improve patient care and ultimately prevent mortality. Modern respiratory care science has shown that proning can improve oxygenation of patients with ARDS. Planning and preparation for a viral respiratory health crisis require a strategy and system to prone patients effectively and safely. In this two-part chapter, perspectives are presented on respiratory therapy and proning during the pandemic. The experience of respiratory therapy at the SBH Health System during the COVID-19 crisis surge in Spring 2020 presents rich lessons to be learned about health crisis planning, preparation, and management with respect to respiratory therapy. © SBH Health System 2022.

Year in Review: Long COVID and Pulmonary Rehabilitation.

There have been an estimated 100 million people diagnosed with COVID-19 in the United States, with a majority of patients reporting persistent symptoms expressed as long COVID. The 2 most frequently reported long COVID symptoms are shortness of breath and fatigue. Exercise training during pulmonary rehabilitation (PR) is a successful strategy for improving the lives of people with persistent respiratory symptoms caused by a variety of lung diseases. This narrative review assessed the impact of exercise interventions on functional exercise capacity measures and related symptoms (dyspnea, fatigue) in people with long COVID over the last year. Articles were accessed through electronic databases including PubMed, Embase, CINAHL Plus with full text (EBSCO), and LitCovid. Findings for this Year in Review revealed that exercise interventions and PR show promise for improving functional exercise capacity, dyspnea, and fatigue in people with long COVID. This review supports the need for more rigorous scientific studies on the benefits of structured PR in people with long COVID who have respiratory-related symptoms.

Use of Non-Invasive Respiratory Support Strategies in pediatric patients with SARS-CoV-2. A Scoping Review

Introduction: The use of non-invasive respiratory support strategies (NIRS) has been shown to reduce the consumption of resources associated with the requirement of intensive care unit and hospital stay in pediatric patients with acute respiratory failure, however, it is considered important to identify their frequency of use in pediatric patients with SARSCoV-2 and its relationship with the hospital stay. Objective: To identify the frequency of use of noninvasive respiratory support strategies (NIRS) in pediatric patients with SARS-CoV-2. Material and methods: Scoping review of the frequency of use of NIRS in pediatric SARS-CoV-2 between January 2020 and September 2021. The search was executed in the Cochrane Library, PubMed, Scopus databases, and the bibliographic search engines Science Direct and Oxford. Results: It was found that conventional, follow-up, or high-flow oxygen therapy and noninvasive mechanical ventilation are used more frequently in hospital settings. Conclusion: The NIRS of greater implementation in the pediatric patient with SARS-CoV-2 was conventional oxygen therapy and as a finding of interest its association with higher hospital stays was evidenced. © 2023 Academia Nacional de Medicina. All rights reserved.

Use of the Revised Second Victim Experience and Support Tool to Examine Second Victim Experiences of Respiratory Therapists.

BACKGROUND: Respiratory therapists (RTs) work alongside allied health staff, nurses, and physicians during stressful and traumatic events that can be associated with emotional and physiological implications known as second victim (SV) experiences (SVEs). This study aimed to evaluate SVEs of RTs, including both positive and negative implications. METHODS: RTs within a large academic health care organization across Minnesota, Wisconsin, Florida, and Arizona were asked to participate in an anonymous survey that included the validated Second Victim Experience and Support Tool-Revised to assess SVEs as well as desired support services. RESULTS: Of the RTs invited to participate, 30.8% (171/555) completed the survey. Of the 171 survey respondents, 91.2% (156) reported that they had been part of a stressful or traumatic work-related event as an RT, student, or department support staff member. Emotional or physiologic implications experienced by respondents as SVs included anxiety 39.1% (61/156), reliving of the event 36.5% (57/156), sleeplessness 32.1% (50/156), and guilt 28.2% (44/156). Following a stressful clinical event, 14.8% (22/149) experienced psychological distress, 14.2% (21/148) experienced physical distress, 17.7% (26/147) indicated lack of institutional support, and 15.6% (23/147) indicated turnover intentions. Enhanced resilience and growth were reported by 9.5% (14/147). Clinical and non-clinical events were reported as possible triggers for SVEs. Nearly half of respondents 49.4% (77/156) indicated feeling like an SV due to events related to COVID-19. Peer support was the highest ranked form of desired support following an SVE by 57.7% (90/156). CONCLUSIONS: RTs are involved in stressful or traumatic clinical events, resulting in psychological/physical distress and turnover intentions. The COVID-19 pandemic has had a significant impact on RTs' SVEs, highlighting the importance of addressing the SV phenomenon among this population.

Comparing Knowledge Acquisition and Retention Between Mobile Learning and Traditional Learning in Teaching Respiratory Therapy Students: A Randomized Control Trial.

Purpose: Mobile learning (m-learning) is one of the trends in health professions' education. It has a promising future in education, but it also presents various challenges and risks. This research seeks to highlight some of the greatest accomplishments, opportunities, and issues related to m-Learning in teaching and learning. We believe the findings help us maximize the positive effects of m-Learning while minimizing any potential drawbacks associated with the technological changes taking place in education. The study aimed to compare respiratory therapy students' knowledge acquisition and retention between using m-learning and traditional learning. Participants and Methods: Randomized pre-test, post-test, control group design was used. All 3rd year (N = 46) respiratory therapy students in one governmental university in Saudi Arabia were randomly assigned to either intervention or control group. Both groups took the same content of arterial blood gas lecture for 2 hours. The intervention group took the lecture using m-learning; two mobile apps: (1) ABG Book, (2) Arterial Blood Gas (Lite). The traditional learning (lecture-based learning) was used for the control group. The same test was conducted before, immediately after, and two weeks after the lecture. The duration of the test was 30 minutes. The data were analyzed using independent t-test and repeated measured ANOVA using p < 0.05. IRB Approval was obtained. Results: Forty-five students participated. Although no statistically significant difference was found on knowledge acquisition and retention between the two types of learning (p = 0.305, p = 0.904, respectively), it was found among the three time-points within each group (p < 0.001). Conclusion: Both m-learning and traditional learning are effective in increasing knowledge acquisition and retention. However, no one is better than the other. Further researches were needed with larger sample size through multi-institutional studies to validate the results of this study.

Ejercicio físico y terapia respiratoria sobre la condición física, la calidad de vida y las funciones ejecutivas en un superviviente de neumonía inducida por SARS-CoV-2

This study aimed to determine the effects of a moderate aerobic exercise program combined with respiratory therapy on physical condition, health-related quality of life, executive functions, and lung function in a SARS-induced bilateral atypical pneumonia survivor. CoV-2, after discharge from hospital. The subject studied is a 35-year-old man, single, sedentary, and with elementary studies, who was admitted to the emergency room for 14 days for a bilateral atypical pneumonia caused by SARS-CoV-2. The 8-week intervention program consisted of the application of different respiratory exercises plus others aimed at improving cardiorespiratory endurance and muscular strength. The results show an improvement in physical condition, executive functions, and lung function. However, no obvious changes were observed in certain dimensions related to the quality of life expressed by the subject. Therefore, it can be concluded that this mixed intervention program, based on physical exercise and respiratory therapy, generates positive effects on the physical condition, respiratory function and cognitive capacity of the patient participating in this research. Key words: pneumonia, physical exercise, respiratory therapy, SARS-CoV-2, physical condition, executive functions. Alternate :Este estudio tuvo como objetivo determinar los efectos de un programa de ejercicio aeróbico moderado combinado con terapia respiratoria sobre la condición física, la calidad vida relacionada con la salud, las funciones ejecutivas y la función pulmonar en un sobreviviente de neumonía atípica bilateral inducida por SARS-CoV-2, tras su alta hospitalaria. El sujeto estudiado es un hombre de 35 años, soltero, sedentario, y con estudios elementales, que fue ingresado durante 14 días en urgencias por una neumonía atípica bilateral provocada por SARS-CoV-2. El programa de intervención, de 8 semanas de duración, consistió en la aplicación de diferentes ejercicios respiratorios más otros destinados a la mejora de la resistencia cardiorrespiratoria y de la fuerza muscular. Los resultados muestran una mejora de la condición física, de las funciones ejecutivas, y de la función pulmonar. Sin embargo, no se observaron cambios evidentes en ciertas dimensiones relacionadas con la calidad de vida expresada por el sujeto. Se puede concluir, por tanto, que este programa de intervención mixto, basado en ejercicio físico y terapia respiratoria, genera efectos positivos sobre la condición física, la función respiratoria y la capacidad cognitiva del paciente participante en esta investigación.Alternate :Este estudo teve como objetivo determinar os efeitos de um programa de exercícios aeróbicos moderados combinados com terapia respiratória na aptidão física, qualidade de vida relacionada à saúde, funções executivas e função pulmonar em um sobrevivente de pneumonia atípica bilateral induzida por SARS. CoV-2, após alta hospitalar. O sujeito estudado é um homem de 35 anos, solteiro, sedentário e com ensino fundamental, que foi admitido há 14 dias no pronto-socorro por pneumonia atípica bilateral causada por SARS-CoV-2. O programa de intervenção, com duração de 8 semanas, consistiu na aplicação de diferentes exercícios respiratórios e outros que visavam a melhora da resistência cardiorrespiratória e força muscular.Os resultados mostram uma melhora na aptidão física, funções executivas e função pulmonar. No entanto, não foram observadas mudanças óbvias em determinadas dimensões relacionadas à qualidade de vida expressa pelo sujeito. Pode-se concluir, portanto, que este programa de intervenção misto, baseado em exercício físico e fisioterapia respiratória, gera efeitos positivos na condição física, função respiratória e capacidade cognitiva do paciente participante desta pesquisa.Palavras-chave: pneumonia, exercício físico, fisioterapia respiratória, SARS-CoV-2, condição física, funções executivas.

Experiences of moral distress in a COVID-19 intensive care unit: A qualitative study of nurses and respiratory therapists in the United States.

The COVID-19 pandemic has placed extraordinary stress on frontline healthcare providers as they encounter significant challenges and risks while caring for patients at the bedside. This study used qualitative research methods to explore nurses and respiratory therapists' experiences providing direct care to COVID-19 patients during the first surge of the pandemic at a large academic medical center in the Northeastern United States. The purpose of this study was to explore their experiences as related to changes in staffing models and to consider needs for additional support. Twenty semi-structured interviews were conducted with sixteen nurses and four respiratory therapists via Zoom or by telephone. Interviews were transcribed verbatim, identifiers were removed, and data was coded and analyzed thematically. Five major themes characterize providers' experiences: a fear of the unknown, concerns about infection, perceived professional unpreparedness, isolation and alienation, and inescapable stress and distress. This manuscript analyzes the relationship between these themes and the concept of moral distress and finds that some, but not all, of the challenges that providers faced during this time align with previous definitions of the concept. This points to the possibility of broadening the conceptual parameters of moral distress to account for providers' experiences of treating patients with novel illnesses while encountering institutional and clinical challenges.

Physical, Functional, Psychological, and Social Effects of a Physical Activity Program in Adults and Older Adults During and/or After Hospitalization for COVID-19: A Systematic Review.

Background: It is necessary to investigate the effects of physical activity (PA) on the recovery of adults and the elderly, considering PA positively affects pathologies that share similarities with COVID-19. We present the results of a systematic review whose objective was to analyze the physical, functional, psychological, and social effects of PA in adults and the elderly during and/or after hospitalization for COVID-19. Methods: Searches were conducted between July and August 2021, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Randomized clinical trials (RCTs) and non-randomized interventional studies were included in the databases: PubMed, Web of Science, Scopus, EBSCOhost, Science Direct, Cochrane Library, Physiotherapy Evidence Database (PEDro), and electronic search engines. Study quality was assessed using the PEDro for RCTs and the methodological index scale for non-randomized studies. This systematic review included original articles investigating the physical, functional, psychological, and social effects of any PA program on adults and older adults. Results: A total of 302 studies were found. After applying filters according to the eligibility criteria, five studies were finally included for analysis, three RCTs and two intervention studies without a control group. Although the studies measured different variables of the physical, functional, and psychological components, the results showed significant differences in the variables between the control and intervention groups in both the RCTs and the single-group studies. The variables assessed in the social aspect were less homogeneous. Conclusion: In the available scientific evidence, respiratory muscle training was the most widely used intervention, which showed positive results in the physical, pulmonary, psychological, and social components. More research is required on the effects of PA on the population studied.

Underrepresentation of Respiratory Therapists as Experts in Delphi Studies on Respiratory Practices and Research Priorities.

Delphi survey techniques are a common consensus method used to collect feedback from an expert panel to inform practices, establish guidelines, and identify research priorities. Collecting respiratory therapists' (RT) expertise and experiences as part of consensus-building methodologies is one way to ensure that they align with RT practices and to better influence respiratory care practice. This narrative review aimed to report the RT representation in expert panels of Delphi studies focused on respiratory therapy practices and research priorities. The research question that guided this review is: to what extent are RTs included as expert participants among published Delphi studies relate to respiratory therapy and research topics? We conducted a structured search of the literature and identified 23 papers that reported Delphi studies related to respiratory care practices and 15 that reported on respiratory-related research priorities. Delphi studies that focused on reporting consensus on respiratory care practices included the following: (1) mechanical ventilation, (2) high-flow nasal cannula therapy, (3) COVID-19 respiratory management, (4) home oxygen therapy, (5) cardiopulmonary monitoring, and (6) disease-specific guidelines. Delphi studies that focused on establishing respiratory research priorities included the following: (1) theory and practice-orientated knowledge gaps, and (2) priority research topics for empirical investigation. The results of this review suggest that RTs were rarely included as expert participants and, when involved, were minimally represented (5% to 33%). Given RTs' diverse and relevant experience in respiratory care, incorporating their perspectives to inform future education, respiratory care practices, and research priorities would allow evidence to better align with knowledge gaps deemed important for the respiratory therapy profession.

Physical exercise and respiratory therapy on physical fitness, quality of life and executive functions in a survivor of SARS-CoV-2-induced pneumonia

This study aimed to determine the effects of a moderate aerobic exercise program combined with respiratory therapy on physical condition, health-related quality of life, executive functions, and lung function in a SARS-induced bilateral atypical pneumonia survivor. CoV-2, after discharge from hospital. The subject studied is a 35-year-old man, single, sedentary, and with elementary studies, who was admitted to the emergency room for 14 days for a bilateral atypical pneumonia caused by SARS-CoV-2. The 8-week intervention program consisted of the application of different respiratory exercises plus others aimed at improving cardiorespiratory endurance and muscular strength. The results show an improvement in physical condition, executive functions, and lung function. However, no obvious changes were observed in certain dimensions related to the quality of life expressed by the subject. Therefore, it can be concluded that this mixed intervention program, based on physical exercise and respiratory therapy, generates positive effects on the physical condition, respiratory function and cognitive capacity of the patient participating in this research.

A Pre-Pandemic Evaluation of the State of Staffing and Future of the Respiratory Care Profession: Perceptions of Louisiana Respiratory Therapists.

BACKGROUND: Workforce development for the respiratory therapy (RT) profession is a growing concern. Upcoming staffing difficulties are expected due to retirement, attrition from the profession, and decreased enrollment in accredited RT programs nationwide. This study assessed respiratory therapists' perceptions of staffing needs and future trajectory of the RT profession. METHODS: This cross-sectional study utilized a modified 39-question survey tool delivered via e-mail to 618 Louisiana members of the American Association for Respiratory Care (AARC) between November 2019-February 2020. RESULTS: The response rate was 19% (118/618). Although 50% of respondents perceived understaffing, 77.6% indicated the importance to remain in the RT profession. A majority (93.1%) agreed on the importance of maintaining an active membership in the AARC. Respondents working in a hospital setting perceived understaffed work environments more often than other groups. Salary was most important to the employee (33.6%, 39/116), followed equally by room for growth (14.7%, 17/116) and scope of practice (14.7%, 17/116). For the future of the profession, the ability to assess patients and develop care plans and the ability to receive reimbursement for services were indicated as most important factors. Most (69.8%) agreed that the entry-level minimum should be increased to the bachelor's degree, and 21.6% agreed the master's degree in RT should be supported to increase scope of practice. CONCLUSIONS: This study indicated a consistent perception of understaffed work environments in respiratory care, and respondents expressed a perceived importance of remaining in the RT profession. This study also indicated support for raising the entry-level standard in RT and a desire for higher education to achieve professional growth and advancement.

Outcomes of COVID-19 Patients Admitted to the Intermediate Respiratory Care Unit: Non-Invasive Respiratory Therapy in a Sequential Protocol.

The intermediate respiratory care units (IRCUs) have a pivotal role managing escalation and de-escalation between the general wards and the intensive care units (ICUs). Since the COVID-19 pandemic began, the early detection of patients that could improve on non-invasive respiratory therapies (NRTs) in IRCUs without invasive approaches is crucial to ensure proper medical management and optimize limiting ICU resources. The aim of this study was to assess factors associated with survival, ICU admission and intubation likelihood in COVID-19 patients admitted to IRCUs. Observational retrospective study in consecutive patients admitted to the IRCU of a tertiary hospital from March 2020 to April 2021. Inclusion criteria: hypoxemic respiratory failure (SpO2 ≤ 94% and/or respiratory rate ≥ 25 rpm with FiO2 > 50% supplementary oxygen) due to acute COVID-19 infection. Demographic, comorbidities, clinical and analytical data, and medical and NRT data were collected at IRCU admission. Multivariate logistic regression models assessed factors associated with survival, ICU admission, and intubation. From 679 patients, 79 patients (12%) had an order to not do intubation. From the remaining 600 (88%), 81% survived, 41% needed ICU admission and 37% required intubation. In the IRCU, 51% required non-invasive ventilation (NIV group) and 49% did not (non-NIV group). Older age and lack of corticosteroid treatment were associated with higher mortality and intubation risk in the scheme, which could be more beneficial in severe forms. Initial NIV does not always mean worse outcomes.

Effects of the COVID-19 Pandemic on Respiratory Care Student Enrollment, Retention, and Success on the National Board for Respiratory Care Credentialing Examinations.

BACKGROUND: The purpose of this study was to ascertain whether the COVID-19 pandemic and the instructional changes implemented in response to it affected student enrollment, retention, or success on the National Board for Respiratory Care credentialing examinations at an associate degree respiratory care program in the state of Texas. METHODS: A retrospective analysis of student enrollment, retention data, and graduate success rates on the National Board for Respiratory Care credentialing examinations were used in this study. The data were collected from an associate degree respiratory care program in Texas and included 69 graduates for the 5-year study period. The 3 academic years that led up to the COVID-19 pandemic served as a "pre-pandemic" baseline for comparison. The cohort of 2019-2020 was labeled "early pandemic," the cohort of 2020-2021 was labeled "mid pandemic," and the cohort of 2021-2022 was labeled "late pandemic" for data comparison purposes. Descriptive statistics, the Kruskal-Wallis test, and the Mann-Whitney U test were used for data analysis (P < .05). RESULTS: The number of program applicants significantly decreased between the pre- and late-pandemic groups (P = .001), but overall student enrollment (P = .42) and retention (P = .95) were not significantly affected by the COVID-19 pandemic. The first-time pass rate on the Therapist Multiple-Choice examination low-cut score (P = .005) and high-cut score (P = .007) were significantly reduced in the mid-pandemic group when compared with the previous cohorts. There were no statistically significant differences in the demographic data or online questionnaire responses from the early- and mid-pandemic groups. CONCLUSIONS: The COVID-19 pandemic and the instructional changes implemented in response to it decreased students' first-time pass rate on the Therapist Multiple-Choice examination in the mid-pandemic group compared with the pre- and early-pandemic groups.

Airway Management in Covid 19 Patients

BACKGROUND:- Those who work with COVID-19 patients airways are especially vulnerable. We present an empirical bit-by-bit strategy in order to guard in-hospital airway treatment of individual along COVID-19 disease, whether they are suspected or confirmed. The COVID-19 patient's airway care raises the danger of HCW exposure. Challenging extubation takes more time and might even entail many treatments with both the possibility for aerosolization, therefore rigorous attention to personal protective equipment (PPE) regulations is required to keep clinicians safe. Whenever an patient's airway risk evaluation indicates that awake tracheal intubation is the best option, therapies that produce greater secretion aerosolization should have been prevented. For decrease the chances of hypoxemia, optimal preoxygenation with a tight sealed facial mask might well be conducted beforehand to initiation. AMBU Bag during initiation should be avoided unless the patient experiences O2 depletion. Patients must be fully sedated with complete muscular relaxation for such best intubating circumstances. As a first-line technique for airway management, video laryngoscopy be suggested. If urgent invasive airway access is available, we advocate using a surgical approach like scalpelbougie-tube instead of an aerosolizing producing treatment like transtracheal jet ventilation. Invasive mechanical ventilation for individuals with COVID-19 necessitates tracheal intubation. The researchers wanted to characterise immediate intubation procedures, assess success rates & problems, and see if there was any difference in practise and results among high- and low-income nations. The researchers hypothesized that geographical & operational variables influence effective emergency airway care amongst COVID-19 patients. METHODS:- Among March 23, 2020, as well as October 24, 2020, the researchers conducted a prospective interpretive research project that would include 4,476 case of emergencies tracheal intubation done by 1,722 healthcare professionals from 607 institutions throughout 32 nation in patients of suspected or confirmed COVID-19 who required mechanical ventilation. The researchers looked into the links among intubation & operators factors, as well as the key result of first-trail success. CONCLUSIONS:- Incidence of unsuccessful tracheal intubation as well as emergency surgical airway among COVID-19 patients who required emergency airway care were reported, as well as characteristics linked to enhanced efficacy. While treating COVID-19, the chances for tracheal intubation failures must be evaluated. © The Electrochemical Society

The Ocular Surface

This is a study of patients who were diagnosed with COVID-19 between December 30 and February 7, 2020 with a clinical diagnosis of COVID-19, a total of 102 patients (48 males and 47 percent and 54 are female 53 percent) were diagnosed with clinical symptoms, Respiratory therapy and chest computer Tomography (CT) abnormalities. Patient's gestational age is 57.63 [14.90] year on average [SD].A total of 102 patients were recognize, with 72 of them being men (50%) and women (50%) respectively. Only two patients (2.78 percent) were found to have conjunctivitis out of 62 patients with laboratory confirmed COVID-19. SARS-COV2 RT-PCR detected ocular discharges in only one of two patients, SARS-COV-2 fragments. Covid-19 infected about 80,000 people in just three months, according to estimates with the help of 300 medical personal. It attacks the respiratory tract first and foremost, although it also affects extra-pulmonary locations, the gastrointestinal tract, as well as other organs. Fever, tiredness, and cough are the early symptoms of SARS-COV-2 infection,. Which rapidly develops into pneumonia. A large number of patients experience symptoms such as headaches, diarrhea, nausea, and vomiting at the start of their disease, and some patients also experience nausea and vomiting some patients occur with asymptomatic infection. Despite the fact that SARS-COV2 infection via the ocular surface is rare was shown to be astonishingly low in this investigation SARS-COV2 infection transmitted through the eyes as a nosocomial illness following occupation exposure is a viable route. the reduced positive rate of SARS-COV-2 conjunctival swab samples could be due to an ineffective diagnosis technique and a sampling time lag. © The Electrochemical Society

Amplifying patient voices amid pandemic: Perspectives on tracheostomy care, communication, and connection.

OBJECTIVE: To investigate perspectives of patients, family members, caregivers (PFC), and healthcare professionals (HCP) on tracheostomy care during the COVID-19 pandemic. METHODS: The cross-sectional survey investigating barriers and facilitators to tracheostomy care was collaboratively developed by patients, family members, nurses, speech-language pathologists, respiratory care practitioners, physicians, and surgeons. The survey was distributed to the Global Tracheostomy Collaborative's learning community, and responses were analyzed. RESULTS: Survey respondents (n = 191) from 17 countries included individuals with a tracheostomy (85 [45 %]), families/caregivers (43 [22 %]), and diverse HCP (63 [33.0 %]). Overall, 94 % of respondents reported concern that patients with tracheostomy were at increased risk of critical illness from SARS-CoV-2 infection and COVID-19; 93 % reported fear or anxiety. With respect to prioritization of care, 38 % of PFC versus 16 % of HCP reported concern that patients with tracheostomies might not be valued or prioritized (p = 0.002). Respondents also differed in fear of contracting COVID-19 (69 % PFC vs. 49 % HCP group, p = 0.009); concern for hospitalization (55.5 % PFC vs. 27 % HCP, p < 0.001); access to medical personnel (34 % PFC vs. 14 % HCP, p = 0.005); and concern about canceled appointments (62 % PFC vs. 41 % HCP, p = 0.01). Respondents from both groups reported severe stress and fatigue, sleep deprivation, lack of breaks, and lack of support (70 % PFC vs. 65 % HCP, p = 0.54). Virtual telecare seldom met perceived needs. CONCLUSION: PFC with a tracheostomy perceived most risks more acutely than HCP in this global sample. Broad stakeholder engagement is necessary to achieve creative, patient-driven solutions to maintain connection, communication, and access for patients with a tracheostomy.