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1.
Ann Intern Med ; 174(2): JC14, 2021 02.
Article in English | MEDLINE | ID: covidwho-1110692

ABSTRACT

SOURCE CITATION: Lynch JB, Davitkov P, Anderson DJ, et al. Infectious Diseases Society of America guidelines on infection prevention for health care personnel caring for patients with suspected or known COVID-19. Clin Infect Dis. 2020. [Epub ahead of print.] 32716496.


Subject(s)
/prevention & control , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Occupational Health , Personal Protective Equipment , Practice Guidelines as Topic , Humans , Societies, Medical , United States
2.
BMJ Open ; 11(2): e043837, 2021 02 22.
Article in English | MEDLINE | ID: covidwho-1096994

ABSTRACT

OBJECTIVES: Healthcare personnel (HCP) are at an increased risk of acquiring COVID-19 infection especially in resource-restricted healthcare settings, and return to homes unfit for self-isolation, making them apprehensive about COVID-19 duty and transmission risk to their families. We aimed at implementing a novel multidimensional HCP-centric evidence-based, dynamic policy with the objectives to reduce risk of HCP infection, ensure welfare and safety of the HCP and to improve willingness to accept and return to duty. SETTING: Our tertiary care university hospital, with 12 600 HCP, was divided into high-risk, medium-risk and low-risk zones. In the high-risk and medium-risk zones, we organised training, logistic support, postduty HCP welfare and collected feedback, and sent them home after they tested negative for COVID-19. We supervised use of appropriate personal protective equipment (PPE) and kept communication paperless. PARTICIPANTS: We recruited willing low-risk HCP, aged <50 years, with no comorbidities to work in COVID-19 zones. Social distancing, hand hygiene and universal masking were advocated in the low-risk zone. RESULTS: Between 31 March and 20 July 2020, we clinically screened 5553 outpatients, of whom 3012 (54.2%) were COVID-19 suspects managed in the medium-risk zone. Among them, 346 (11.4%) tested COVID-19 positive (57.2% male) and were managed in the high-risk zone with 19 (5.4%) deaths. One (0.08%) of the 1224 HCP in high-risk zone, 6 (0.62%) of 960 HCP in medium-risk zone and 23 (0.18%) of the 12 600 HCP in the low-risk zone tested positive at the end of shift. All the 30 COVID-19-positive HCP have since recovered. This HCP-centric policy resulted in low transmission rates (<1%), ensured satisfaction with training (92%), PPE (90.8%), medical and psychosocial support (79%) and improved acceptance of COVID-19 duty with 54.7% volunteering for re-deployment. CONCLUSION: A multidimensional HCP-centric policy was effective in ensuring safety, satisfaction and welfare of HCP in a resource-poor setting and resulted in a willing workforce to fight the pandemic.


Subject(s)
Infectious Disease Transmission, Patient-to-Professional , Medical Staff, Hospital , Occupational Diseases , Adult , /prevention & control , /transmission , Developing Countries , Female , Hospitals, University/organization & administration , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Male , Medical Staff, Hospital/statistics & numerical data , Models, Organizational , Occupational Diseases/epidemiology , Occupational Diseases/prevention & control , Organizational Policy , Personal Protective Equipment , Prospective Studies , Risk Assessment , Tertiary Care Centers/organization & administration
3.
BMJ Case Rep ; 14(2)2021 Feb 17.
Article in English | MEDLINE | ID: covidwho-1088211

ABSTRACT

Placement of a double-lumen tube to achieve one lung ventilation is an aerosol-generating procedure. Performing it on a patient with COVID-19 will put healthcare workers at high risk of contracting the disease. We herein report a case of its use in a patient with traumatic diaphragmatic rupture, who was also suspected to have COVID-19. This article aims to highlight the issues, it presented and ways to address them as well as the perioperative impact of personal protective equipment.


Subject(s)
/prevention & control , Health Personnel/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , One-Lung Ventilation/standards , Personal Protective Equipment/standards , Accidents, Traffic , Adult , /transmission , Diaphragm/injuries , Diaphragm/surgery , Humans , Male , One-Lung Ventilation/instrumentation , Practice Guidelines as Topic , /etiology , Rupture/etiology , Rupture/therapy
4.
BMJ Open Qual ; 10(1)2021 02.
Article in English | MEDLINE | ID: covidwho-1085260

ABSTRACT

The surge in clinical demand, shortage in personal protective equipment and high-exposure risk for healthcare workers during the COVID-19 pandemic has challenged hospital common practices and forced a reassessment of care delivery models. Code blue teams are highly specialised units that partake in life-saving situations that can jeopardise the safety of team members. There is a paucity of guidance in regards to proper infection control measures to protect the responders.This study describes a methodical approach to assessing vulnerabilities to transmission of SARS-CoV-2 within existing code blue practices, modalities to limit the number of code blue team responders and modifications to the protocol at a large community teaching hospital. The effort undertaken faced challenges due to the nature of the pandemic and the increased demand on healthcare workers. Quality improvement methods facilitated our protocol design and implementation. To this date, there has been no identified COVID-19 disease in any protected code blue (PCB) team members. We recommend that similar practices be considered and adopted widely and practised periodically.


Subject(s)
/prevention & control , Health Personnel/education , Hospital Rapid Response Team/standards , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Adult , Female , Focus Groups , Health Personnel/standards , Hospitals, Teaching , Humans , Infection Control/methods , Male , Middle Aged , Personal Protective Equipment , Quality Improvement
5.
J Wound Care ; 30(Sup2): S12-S17, 2021 Feb 01.
Article in English | MEDLINE | ID: covidwho-1083226

ABSTRACT

COVID-19 is highly contagious and its rapid spread burdens the healthcare system. As the number of confirmed cases goes up, the shortage of medical resources has become a challenge. To avoid the collapse of the healthcare system during the fight with COVID-19, all healthcare workers, including wound care practitioners, should adapt to new roles and use any appropriate methods available to slow the spread of the virus. Integrating telemedicine into wound care during the outbreak helps maintain social distancing, preserve personal protective equipment and medical resources, and eliminate unnecessary exposure for both vulnerable patients and high-risk healthcare workers.


Subject(s)
Ambulatory Care , Diabetic Foot/therapy , Telemedicine , Triage , Wounds and Injuries/therapy , Cross Infection/prevention & control , Elective Surgical Procedures , Hospitalization , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control
6.
Int J Environ Res Public Health ; 18(4)2021 02 08.
Article in English | MEDLINE | ID: covidwho-1079658

ABSTRACT

BACKGROUND: During the SARS-CoV-2 pandemic, there was shortage of the standard respiratory protective equipment (RPE). The aim of this study was to develop a procedure to test the performance of alternative RPEs used in the care of COVID-19 patients. METHODS: A laboratory-based test was developed to compare RPEs by total inward leakage (TIL). We used a crossflow nebulizer to produce a jet spray of 1-100 µm water droplets with a fluorescent marker. The RPEs were placed on a dummy head and sprayed at distances of 30 and 60 cm. The outcome was determined as the recovery of the fluorescent marker on a membrane filter placed on the mouth of the dummy head. RESULTS: At 30 cm, a type IIR surgical mask gave a 17.7% lower TIL compared with an FFP2 respirator. At 60 cm, this difference was similar, with a 21.7% lower TIL for the surgical mask compared to the respirator. When adding a face shield, the TIL at 30 cm was further reduced by 9.5% for the respirator and 16.6% in the case of the surgical mask. CONCLUSIONS: A safe, fast and very sensitive test method was developed to assess the effectiveness of RPE by comparison under controlled conditions.


Subject(s)
/prevention & control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Masks/standards , Personal Protective Equipment/standards , Respiratory Protective Devices/standards , Aerosols/adverse effects , Humans , Occupational Exposure/prevention & control , Ventilators, Mechanical , Water
7.
Cir Cir ; 89(1): 4-11, 2021.
Article in English | MEDLINE | ID: covidwho-1077009

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) outbreak have major implications in conventional surgical practice. As the number of patients with this diagnosis is rising, the infection risk for the surgical staff will be higher. Few publications have addressed the surgical management of patients diagnosed with COVID-19. Objective: To assess recommendations for care of patients and surgical team during the COVID-19 pandemic. Method: MEDLINE, Embase and the Cochrane Database of Systematic Reviews (April 2020) were searched the key words "COVID-19", "PROTOCOL" and "SURGERY". Relevant recommendations, guidelines and cases series were checked for the most accurate information for apply to our center. Results: We found 379 papers that included the key words. A total of 25 papers were included in the manuscript based in the pertinence of the recommendations. Three major topics were selected: perioperative, intraoperative and postoperative. Conclusion: As an attempt to regulate the surgical team approach, we present recommendations to preserve patients and surgical staff safety with high quality standards of care through reproducible strategies applicable in most hospital centers.


Subject(s)
/prevention & control , Cross Infection/prevention & control , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Pandemics , Aerosols , Air Pollution, Indoor , Appointments and Schedules , Disinfection/methods , Equipment Contamination/prevention & control , Humans , Mexico , Occupational Exposure , Operating Rooms , Patient Isolation , Perioperative Care , Personal Protective Equipment , Personnel, Hospital , Recovery Room , Sterilization/methods , Surgical Equipment
8.
Saudi Med J ; 42(2): 166-169, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1076930

ABSTRACT

OBJECTIVES: To avoid hospital spread of Coronavirus-2019 (COVID-19) and to analyze out of hospital outcomes after amputation. METHODS: Prospective analysis of data obtained from 60 diabetic patients in 2020 was performed at Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina. Personal protection equipment included double surgical mask, glasses, disposable surgical coats, and surgical masks for patients. Swabs were used to take samples from wounds. We randomly divided patients in 2 groups of 30 patients each. In pre-operative treatment, we used local anesthesia lidocaine hydrochloride 2% (Belupo, Koprivnica, Croatia) in group A and systemic analgesia intravenous tramadol chloride 100 mg intravenous (Krka, Novo Mesto, Slovenia) in group B. Wounds were surgically treated each day and heal spontaneously. Periodical control exams were performed. RESULTS: Wound healing did not present any statistically significant differences between groups (group A: 69±21.97 and B: 61±22.13 days, t=-1.22; p=0.11). No statistically significant differences (p<0.05) between groups A and B in wound healing regarding to gender or cigarette use was noted. CONCLUSION: No significant differences in amputation treatment between the 2 comparative groups were noted. No confirmed COVID-19 infections in medical staff who performed surgical interventions or in treated patients were detected.


Subject(s)
Amputation , Diabetic Foot/surgery , Infection Control/methods , Perioperative Care/methods , Bosnia and Herzegovina/epidemiology , /epidemiology , Diabetic Foot/complications , Female , Humans , Infection Control/instrumentation , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Male , Pandemics , Personal Protective Equipment , Prospective Studies , Treatment Outcome , Wound Healing
9.
Ann R Coll Surg Engl ; 103(2): e44-e47, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1073076

ABSTRACT

Surgical tracheostomy is a high aerosol-generating procedure that is an essential aid to the recovery of patients who are critically ill with COVID-19 pneumonia. We present a single-centre case series of 16 patients with COVID-19 pneumonia who underwent tracheostomy. We recommend that the patient selection criteria for achieving a favourable outcome should be based on fraction of inspired oxygen together with prone-position ventilation. As with any challenging situation, the importance of effective communication is paramount. The critical modifications in the surgical steps are clearly explained. Timely tracheostomy also leads to an earlier freeing up of ventilator space during a period of a rapidly escalating pandemic. The outcomes in terms of swallow and speech function were also assessed. The study has also helped to remove the anxiety around open a tracheostomy in patients who are COVID-19 positive.


Subject(s)
/therapy , Tracheostomy/methods , Adult , Aged , Airway Extubation , /transmission , Female , Humans , Infection Control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Male , Middle Aged , Personal Protective Equipment , Respiration, Artificial , Treatment Outcome
10.
Ann Ital Chir ; 91: 563-567, 2020.
Article in English | MEDLINE | ID: covidwho-1068445

ABSTRACT

2019-nCoV currently named SARS-CoV-2 is a highly pathogenic Coronavirus identified in Wuhan China in December 2019. Turkey declared the first case relatively late compared to Asian and European countries on March 11, as the first SARS-CoV-2 infection in Turkey. In this study, we aimed to determine patients' outcomes in 50 surgeries done in the incubation period of SARS-CoV-2 in our hospital. METHODS: We retrospectively analyzed the clinical data of 50 patients who underwent surgeries during the incubation period of CoVid-19 at Istinye University Gaziosmanpasa Medical Park Hospital in Istanbul, from March 2 to April 11, 2020. RESULTS: The age of 50 patients range was 21 to 73, and the median age was 43.32 (64%) patients were women. The median length of hospital stay is 2.6 days (1-21). Operations at various difficulty levels were also performed on patients with co-morbidities. No complication or mortality was observed except for 1 patient, and the ICU requirement of that patient was also due to high energy trauma. CONCLUSION: Although contrary claims have been made in various studies; it is the primary duty of us surgeons to operate CoVid-19 positive/suspicious patients safely and without any contamination, and on the other hand, to continue their operations without victimizing negative patients. In this pilot study, we would like to emphasize with necessary and adequate measures these can be achieved. KEY WORDS: CoVid-19, SARS-CoV-2, Surgery.


Subject(s)
/diagnosis , Emergencies/epidemiology , Hospitals, Isolation/statistics & numerical data , Hospitals, University/statistics & numerical data , Infectious Disease Incubation Period , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pandemics , Surgical Procedures, Operative/statistics & numerical data , Adult , Aged , /epidemiology , Comorbidity , Elective Surgical Procedures/mortality , Elective Surgical Procedures/statistics & numerical data , Equipment Contamination/prevention & control , Female , Hospital Mortality , Humans , Infection Control/methods , Male , Middle Aged , Patient Isolation , Pilot Projects , Retrospective Studies , Surgical Procedures, Operative/mortality , Tomography, X-Ray Computed , Turkey/epidemiology , Young Adult
12.
Respiration ; 100(1): 27-33, 2021.
Article in English | MEDLINE | ID: covidwho-1064198

ABSTRACT

BACKGROUND: Bronchoscopic sampling of bronchoalveolar fluid (BAL) should be safe and effective. Current sampling practice risks loss of sample to the attached negative flow, aerosolisation, or spillage, due to repeated circuit breaks, when replacing sample containers. Such concerns were highlighted during the recent coronavirus pandemic. OBJECTIVES: Evaluation of an alternative integrated sampling solution, with the Ambu Bronchosampler with aScope 4, by an experienced bronchoscopist in ICU. METHODS: An observational study of 20 sequential bronchoscopic diagnostic sampling procedures was performed on mechanically ventilated patients with suspected ventilator-associated pneumonia. Mixed methods assessment was done. The predefined outcome measures were (1) ease of set up, (2) ease of specimen collection, (3) ease of protecting specimen from loss or spillage, and (4) overall workflow. The duration of the procedure and the % volume of sample retrieved were recorded. RESULTS: The mean (±standard deviation [SD]) time for collecting 1 sample was 2.5 ± 0.8 min. The mean (±SD) specimen yield for instilled miniBAL was 54.2 ± 17.9%. Compared with standard sampling, the set-up was much easier in 18 (90%), or easier in 2 (10%) of procedures, reducing the connection steps. It was much more intuitive to use in 14 (70%), more intuitive in 4 (20%), and no more intuitive to use in 2 (10%). The overall set-up and workflow was much easier in 69% of the 13 intraprocedural connections and easier or as easy in the remaining 31% procedures. All procedures where pre connection was established were much easier (7, 100%). The Ambu Bronchosampler remained upright in all procedures with no loss or spillage of sample. Obtaining a sample was much easier in 60%, easier in 10%, no different in 20%, and worse in 10%. The ability to protect a sample from start to finish compared to standard procedures was much easier in 80%, easier in 15%, and no different in 5% of procedures. Overall workflow was much easier in 14 (70%), easier in 4 (20%), and no different in 2 (10%) of procedures. CONCLUSIONS: The Ambu Bronchosampler unit was a reliable, effective, and possibly safer technique for diagnostic sampling in ICU. It may improve safety standards during the coronavirus pandemic. A randomized control trial against the standard sampling technique is warranted.


Subject(s)
Bronchoscopes , Bronchoscopy/methods , Disposable Equipment , Respiration, Artificial , Specimen Handling/methods , Bronchoalveolar Lavage/instrumentation , Bronchoalveolar Lavage/methods , Bronchoalveolar Lavage Fluid , Bronchoscopy/instrumentation , /transmission , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Occupational Exposure/prevention & control , Patient Isolators , Personal Protective Equipment , Pneumonia, Ventilator-Associated/diagnosis , Risk Assessment
13.
A A Pract ; 14(14): e01360, 2020 Dec 17.
Article in English | MEDLINE | ID: covidwho-1067373

ABSTRACT

This single-center retrospective study evaluated a protocol for the intubation of patients with confirmed or suspected coronavirus disease 2019 (COVID-19). Twenty-one patients were intubated, 9 of whom were found to have COVID-19. Adherence to the airway management protocol was high. COVID-19 patients had lower peripheral capillary oxygen saturation by pulse oximetry (Spo2) nadirs during intubation (Spo2, 73% [72%-77%] vs 89% [86%-94%], P = .024), and a greater percentage experienced severe hypoxemia defined as Spo2 ≤80% (89% vs 25%, P = .008). The incidence of severe hypoxemia in COVID-19 patients should be considered in the development of guidelines that incorporate high-flow nasal cannula and noninvasive positive pressure ventilation.


Subject(s)
/therapy , Hypoxia/therapy , Intubation, Intratracheal/methods , Rapid Sequence Induction and Intubation/methods , Respiratory Insufficiency/therapy , Adult , Aged , Airway Management , Cannula , Female , Humans , Hypoxia/prevention & control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Laryngoscopy , Male , Middle Aged , Noninvasive Ventilation , Oximetry , Oxygen Inhalation Therapy , Patient Isolators , Personal Protective Equipment , Positive-Pressure Respiration , Practice Guidelines as Topic , Retrospective Studies , Severity of Illness Index
14.
BMC Fam Pract ; 22(1): 22, 2021 01 16.
Article in English | MEDLINE | ID: covidwho-1067188

ABSTRACT

BACKGROUND: Primary care physicians (PCPs) are first points-of-contact between suspected cases and the healthcare system in the current COVID-19 pandemic. This study examines PCPs' concerns, impact on personal lives and work, and level of pandemic preparedness in the context of COVID-19 in Singapore. We also examine factors and coping strategies that PCPs have used to manage stress during the outbreak. METHODS: Two hundred and sixteen PCPs actively practicing in either a public or private clinic were cluster sampled via email invitation from three primary care organizations in Singapore from 6th to 29th March 2020. Participants completed a cross-sectional online questionnaire consisting of items on work- and non-work-related concerns, impact on personal and work life, perceived pandemic preparedness, stress-reduction factors, and personal coping strategies related to COVID-19. RESULTS: A total of 158 questionnaires were usable for analyses. PCPs perceived themselves to be at high risk of COVID-19 infection (89.9%), and a source of risk (74.7%) and concern (71.5%) to loved ones. PCPs reported acceptance of these risks (91.1%) and the need to care for COVID-19 patients (85.4%). Overall perceived pandemic preparedness was extremely high (75.9 to 89.9%). PCPs prioritized availability of personal protective equipment, strict infection prevention guidelines, accessible information about COVID-19, and well-being of their colleagues and family as the most effective stress management factors. CONCLUSIONS: PCPs continue to serve willingly on the frontlines of this pandemic despite the high perception of risk to themselves and loved ones. Healthcare organizations should continue to support PCPs by managing both their psychosocial (e.g. stress management) and professional (e.g. pandemic preparedness) needs.


Subject(s)
Attitude of Health Personnel , Physicians, Primary Care/organization & administration , Primary Health Care/organization & administration , Ambulatory Care Facilities/organization & administration , Cross-Sectional Studies , Disease Outbreaks/prevention & control , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Singapore
15.
BMJ Open Gastroenterol ; 8(1)2021 01.
Article in English | MEDLINE | ID: covidwho-1066882

ABSTRACT

BACKGROUND AND AIMS: Digestive endoscopy is considered a high-risk procedure for COVID-19. Recommendations have been made for its practice during the pandemic. This study was conducted to determine adherence to recommendations for endoscopy practice during the COVID-19 pandemic in Latin America (LA). METHODS: A survey was conducted of endoscopists from LA consisting of 43 questions for the evaluation of four items: general and sociodemographic features, and preprocedure, intraprocedure and postprocedure aspects. RESULTS: A response was obtained from 338 endoscopists (response rate 34.5%) across 15 countries in LA. In preprocedure aspects (hand washing, use of face masks for patients, respiratory triage area, training for the placement/removal of personal protective equipment (PPE) and availability of specific area for the placement/removal of PPE), there was adherence in <75%. Regarding postprocedure aspects, 77% (261/338) had reused PPE, mainly the N95 respirator or higher, and this was with a standardised decontamination procedure only in 32% (108/338) of the time. Postprocedure room decontamination was carried out by 47% on >75% of occasions. In relationship to intraprocedure aspects (knowledge of risk and type of endoscopic procedures, use of PPE, airway management in patients and infrastructure), there was adherence in >75% for all the parameters and 78% of endoscopists only performed emergencies or time-sensitive procedures. CONCLUSIONS: Adherence to the recommendations for endoscopy practice during the COVID-19 pandemic is adequate in the intraprocedure aspect. However, it is deficient in the preprocedure and postprocedure aspects.


Subject(s)
Endoscopy, Gastrointestinal , Guideline Adherence , Practice Guidelines as Topic , Adult , /prevention & control , Female , Health Care Surveys , Humans , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Latin America/epidemiology , Male , Middle Aged , Pandemics , Personal Protective Equipment , Prospective Studies , Risk Factors
16.
BMJ Case Rep ; 14(2)2021 Feb 05.
Article in English | MEDLINE | ID: covidwho-1066846

ABSTRACT

A young man presented to our centre needing an urgent debridement of his postcraniotomy wound due to massive myiasis during the COVID-19 pandemic in October 2020. Prior to the surgery, his nasopharyngeal swab real-time PCR test result was unknown. One day later, it returned as SARS-CoV-2 positive. All healthcare workers who were involved in the patient management avoided cross infection as they wore appropriate personal protective equipment. This article depicts the importance of adequate preparations when handling potentially infectious patients and the perioperative issues associated with it.


Subject(s)
/complications , Debridement/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Myiasis/complications , Myiasis/surgery , Perioperative Care/methods , Scalp/surgery , Adult , Humans , Male , Personal Protective Equipment , Young Adult
17.
Sci Rep ; 11(1): 3179, 2021 02 04.
Article in English | MEDLINE | ID: covidwho-1065959

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected millions and killed more than 1.7 million people worldwide as of December 2020. Healthcare providers are at increased risk of infection when caring for patients with COVID-19. The mechanism of transmission of SARS-CoV-2 is beginning to emerge as airborne spread in addition to direct droplet and indirect contact as main routes of transmission. Here, we report on the design, construction, and testing of the BADGER (Box for Aerosol and Droplet Guarding and Evacuation in Respiratory Infection), an affordable, scalable device that contains droplets and aerosol particles, thus minimizing the risk of infection to healthcare providers. A semi-sealed environment is created inside the BADGER, which is placed over the head of the patient and maintains at least 12-air changes per hour using in-wall vacuum suction. Multiple hand-ports enable healthcare providers to perform essential tasks on a patient's airway and head. Overall, the BADGER has the potential to contain large droplets and small airborne particles as demonstrated by simulated qualitative and quantitative assessments to provide an additional layer of protection for healthcare providers treating COVID-19 and future respiratory contagions.


Subject(s)
Infectious Disease Transmission, Patient-to-Professional/prevention & control , Protective Devices , Aerosols , /transmission , Humans
18.
AORN J ; 113(2): 147-164, 2021 02.
Article in English | MEDLINE | ID: covidwho-1060891

ABSTRACT

The evolution of SARS-CoV-2 from a zoonotic virus to a novel human pathogen resulted in the coronavirus disease 2019 (COVID-19) global pandemic. Health care delivery and infection prevention and control recommendations continue to evolve to protect the safety of health care personnel, patients, and visitors while researchers and policymakers learn more about SARS-CoV-2 and COVID-19. The perioperative setting is unique in that it exposes clinicians and personnel to increased risks through the invasive nature of surgical care. Using the Centers for Disease Control and Prevention's Hierarchy of Controls as a model, this article presents risk mitigation strategies for preventing the transmission of COVID-19 in the perioperative environment. The goals are to identify and eliminate potential exposure to SARS-CoV-2 when surgery is necessary for patients who are suspected or confirmed to have COVID-19 or who have an unknown infection status.


Subject(s)
/transmission , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Perioperative Nursing , /nursing , Humans , Infection Control
19.
Air Med J ; 40(1): 76-78, 2021.
Article in English | MEDLINE | ID: covidwho-1060580

ABSTRACT

This short communication highlights the US Air Force's recent success with having their aeromedical evacuation crews use the Transportation Isolation System for the first time operationally to transport patients positive for coronavirus disease 2019.


Subject(s)
Aerospace Medicine/methods , Air Ambulances , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Military Medicine/methods , Military Personnel , Aerospace Medicine/instrumentation , Aerospace Medicine/trends , Humans , Infection Control/instrumentation , Infection Control/trends , Military Medicine/instrumentation , Military Medicine/trends , United States
20.
Air Med J ; 40(1): 54-59, 2021.
Article in English | MEDLINE | ID: covidwho-1060089

ABSTRACT

OBJECTIVE: The aeromedical transport of coronavirus patients presents risks to clinicians and aircrew. Patient positioning and physical barriers may provide additional protection during flight. This paper describes airflow testing undertaken on fixed wing and rotary wing aeromedical aircraft. METHODS: Airflow testing was undertaken on a stationary Hawker Beechcraft B200C and Leonardo Augusta Westland 139. Airflow was simulated using a Trainer 101 (MSS Professional A/S, Odense Sø, Syddanmark, Denmark) Smoke machine. Different cabin configurations were used along with variations in heating, cooling, and ventilation systems. RESULTS: For the Hawker Beechcraft B200C, smoke generated within the forward section of the cabin was observed to fill the cabin to a fluid boundary located in-line with the forward edge of the cargo door. With the curtain closed, smoke was only observed to enter the cockpit in very small quantities. For the Leonardo AW139, smoke generated within the cabin was observed to expand to fill the cabin evenly before dissipating. With the curtain closed, smoke was observed to enter the cockpit only in small quantities CONCLUSION: The use of physical barriers in fixed wing and rotary wing aeromedical aircraft provides some protection to aircrew. Optimal positioning of the patient is on the aft stretcher on the Beechcraft B200C and on a laterally orientated stretcher on the AW139. The results provide a baseline for further investigation into methods to protect aircrew during the coronavirus pandemic.


Subject(s)
Air Ambulances , Air Conditioning/methods , Air Movements , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Ventilation/methods , Air Conditioning/instrumentation , Humans , Ventilation/instrumentation
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