ABSTRACT
BACKGROUND: Surgeons need guidance regarding appropriate personal protective equipment (PPE) during the COVID-19 pandemic based on scientific evidence rather than availability. The aim of this article is to inform surgeons of appropriate PPE requirements, and to discuss usage, availability, rationing and future solutions. METHODS: A systematic review was undertaken in accordance with PRISMA guidelines using MEDLINE, Embase and WHO COVID-19 databases. Newspaper and internet article sources were identified using Nexis. The search was complemented by bibliographic secondary linkage. The findings were analysed alongside guidelines from the WHO, Public Health England, the Royal College of Surgeons and specialty associations. RESULTS: Of a total 1329 articles identified, 95 studies met the inclusion criteria. Recommendations made by the WHO regarding the use of PPE in the COVID-19 pandemic have evolved alongside emerging evidence. Medical resources including PPE have been rapidly overwhelmed. There has been a global effort to overcome this by combining the most effective use of existing PPE with innovative strategies to produce more. Practical advice on all aspects of PPE is detailed in this systematic review. CONCLUSION: Although there is a need to balance limited supplies with staff and patient safety, this should not leave surgeons treating patients with inadequate PPE.
Subject(s)
COVID-19/prevention & control , Health Care Rationing , Infection Control/instrumentation , Personal Protective Equipment/supply & distribution , Practice Patterns, Physicians' , Surgeons , COVID-19/epidemiology , Global Health , Humans , Infection Control/methods , PandemicsABSTRACT
Static electricity is the build up of an electrical charge secondary to the redistribution of electrons between two non-conducting materials as they rub against one another. In the domestic setting, a static discharge rarely causes significant injury, as although the voltage can be higher than normal domestic voltage (240V), the current is relatively low. However, in cases where highly flammable substances are used, the risk of a static charge causing a flash is much greater. Our institution presents the first documented case of static electrical ignition of a substance causing facial burns. While cleaning a large plastic bin sprayed with 'Ambersil', a highly flammable mould-removing aerosol spray that can be purchased for domestic use, the 60-year-old female patient placed her face inside the bin to reach the bottom and received a large flash burn to her face and right arm that was 2.5% TBSA (total body surface area) and superficial dermal in nature. She was treated conservatively and discharged. Despite advances in electrical safety in the domestic and industrial settings, there are still real risks of significant burn injuries, which manufacturers, employers and the general public should be made aware of.
L'électricité statique est générée par la redistribution des électrons lors du frottement entre 2 matériaux non conducteurs. Au domicile, une décharge d'électricité statique est rarement délétère car, bien que pouvant être d'un voltage > 240V, l'intensité est habituellement faible. Toutefois, un matériau inflammable peut alors être mis à feu. Nous présentons le premier cas de brûlure du visage due à ce phénomène. Alors qu'elle nettoyait une grande cuvette en plastique avec un spray d'Ambersil® (produit anti- moisissure utilisable à domicile, très inflammable), une femme de 60 ans s'est penchée dedans et a subi une brûlure superficielle du visage et du membre supérieur droit (2,5% SB) due la flamme allumée par une étincelle d'électricité statique. Cette brûlure a guéri sans intervention chirurgicale. Malgré les progrès dans la sécurité électrique et industrielle, il existe toujours des risques de brûlure dont les employeurs et le public devraient être avertis.
