Protecting healthcare workers during the COVID-19 pandemic: Australian results from the PPE-SAFE survey.

The COVID-19 pandemic has led to global shortages of personal protective equipment (PPE). Healthcare workers (HCW) have comprised a significant proportion of COVID-19 cases in many countries. The PPE-SAFE survey was conducted to study current practices, availability, shortages, training and confidence in PPE amongst intensive care HCWs around the world. Herein, we describe the results of the Australian respondents to the PPE-SAFE survey. 29% of respondents reported that at least one item of usually available PPE was missing, and 12% reported reuse of single-use items. Only 40% felt that the PPE available to them offered adequate protection. Fit-testing of respirators had never been performed for 47% of respondents, and 49% reported at least one adverse effect from the use of PPE.

Feasibility of non-invasive nitric oxide inhalation in acute hypoxic respiratory failure: potential role during the COVID-19 pandemic

Acute hypoxemic respiratory failure (ARF) is characterized by both lower arterial oxygen and carbon dioxide tensions in the blood. First line treatment for ARF includes oxygen therapy - intially admininstered non invasively using nasal prongs, high flow nasal cannulae or masks. Invasive mechancial ventilation (IMV) is usually reserved for patients who are unable to maintain their airway, those with worsening hypoxemia, or those who develop respiratory muscle fatigue and consequent hypercapnia. Inhaled nitric oxide (iNO) gas is known to improve oxygenation in patients with ARF by manipulating ventilation-perfusion matching. Addition of iNO may potentially alleviate the need for IMV in selected patients. This article demonstrates the feasibility of this technique based on our experience of patients with hypoxemic ARF. This technique may also be considered for patients with hypoxic ARF in setting of COVID-19.