scholarly journals High-risk exposure without personal protective equipment and infection with SARS-CoV-2 in-hospital workers - The CoV-CONTACT cohort

2021 ◽  
Author(s):  
Sarah Tubiana ◽  
Charles Burdet ◽  
Nadhira Houhou ◽  
Michael Thy ◽  
Pauline Manchon ◽  
...  
Keyword(s):  
High Risk ◽  
Personal Protective Equipment ◽  
Risk Exposure ◽  
Protective Equipment ◽  
Hospital Workers

scholarly journals High-risk exposure without personal protective equipment and infection with SARS-CoV-2 in healthcare workers: results of the CoV-CONTACT prospective cohort

2020 ◽  
Author(s):  
Sarah Tubiana ◽  
Charles Burdet ◽  
Nadhira Houhou ◽  
Michael Thy ◽  
Pauline Manchon ◽  
...  
Keyword(s):  
High Risk ◽  
Personal Protective Equipment ◽  
Prospective Cohort ◽  
Healthcare Workers ◽  
Risk Exposure ◽  
Protective Equipment ◽  
Risk Of Infection ◽  
Rt Pcr ◽  
Specific Symptom ◽  
Increased Risk

Objective: We aimed to estimate the risk of infection in Healthcare workers (HCWs) following a high-risk exposure without personal protective equipment (PPE). Methods: We conducted a prospective cohort in HCWs who had a high-risk exposure to SARS-CoV-2-infected subject without PPE. Daily symptoms were self-reported for 30 days, nasopharyngeal swabs for SARS-CoV-2 RT-PCR were performed at inclusion and at days 3, 5, 7 and 12, SARS-CoV-2 serology was assessed at inclusion and at day 30. Confirmed infection was defined by positive RT-PCR or seroconversion, and possible infection by one general and one specific symptom for two consecutive days. Results: Between February 5th and May 30th, 2020, 154 HCWs were enrolled within 14 days following one high-risk exposure to either a hospital patient (70/154; 46.1%) and/or a colleague (95/154; 62.5%). At day 30, 25.0% had a confirmed infection (37/148; 95%CI, 18.4%; 32.9%), and 43.9% (65/148; 95%CI, 35.9%; 52.3%) had a confirmed or possible infection. Factors independently associated with confirmed or possible SARS-CoV-2 infection were being a pharmacist or administrative assistant rather than being from medical staff (adjusted OR (aOR)=3.8, CI95%=1.3;11.2, p=0.01), and exposure to a SARS-CoV-2-infected patient rather than exposure to a SARS-CoV-2-infected colleague (aOR=2.6, CI95%=1.2;5.9, p=0.02). Among the 26 HCWs with a SARS-CoV-2-positive nasopharyngeal swab, 7 (26.9%) had no symptom at the time of the RT-PCR positivity. Conclusions: The proportion of HCWs with confirmed or possible SARS-CoV-2 infection was high. There were less occurrences of high-risk exposure with patients than with colleagues, but those were associated with an increased risk of infection.

scholarly journals Cost-effectiveness analysis of SARS-CoV-2 infection prevention strategies including pre-endoscopic virus testing and use of high risk personal protective equipment

Endoscopy ◽  
2020 ◽  
Author(s):  
Alanna Ebigbo ◽  
Christoph Römmele ◽  
Christina Bartenschlager ◽  
Selin Temizel ◽  
Elisabeth Kling ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
High Risk ◽  
Personal Protective Equipment ◽  
Infection Prevention ◽  
High Volume ◽  
Protective Equipment ◽  
Prevalence Rates ◽  
Prevention Strategies ◽  
Universal Testing ◽  
Asymptomatic Patients

Abstract Background Infection prevention strategies to protect healthcare workers in endoscopy units during the post-peak phase of the COVID-19 pandemic are currently under intense discussion. In this paper, the cost-effectiveness of routine pre-endoscopy testing and high risk personal protective equipment (PPE) is addressed. Method A model based on theoretical assumptions of 10 000 asymptomatic patients presenting to a high volume center was created. Incremental cost-effectiveness ratios (ICERs) and absolute costs per endoscopy were calculated using a Monte Carlo simulation. Results ICER values for universal testing decreased with increasing prevalence rates. For higher prevalence rates (≥ 1 %), ICER values were lowest for routine pre-endoscopy testing coupled with use of high risk PPE, while cost per endoscopy was lowest for routine use of high risk PPE without universal testing. Conclusion In general, routine pre-endoscopy testing combined with high risk PPE becomes more cost-effective with rising prevalence rates of COVID-19.

scholarly journals A mask-based infection control method for screening endoscopy may prevent SARS-CoV-2 transmission and relieve staff anxiety

2021 ◽  
Vol 9 ◽  
pp. 205031212110470
Author(s):  
Yuji Nadatani ◽  
Akira Higashimori ◽  
Shingo Takashima ◽  
Hirotsugu Maruyama ◽  
Koji Otani ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Personal Protective Equipment ◽  
Medical Staff ◽  
Fluorescent Dyes ◽  
Control Method ◽  
Protective Equipment ◽  
Health Checkup ◽  
Screening Endoscopy ◽  
Droplet Trajectory

Objectives: Endoscopy confers high risk for acquiring coronavirus disease 2019. Although guidelines recommend that medical staff use personal protective equipment, no infection control equipment have been established for patients. This study aimed to clarify the usefulness of two face masks we had designed for transnasal and transoral endoscopy. Methods: The efficacy of the masks was evaluated by simulating coughing in a mannequin with fluorescent dyes and mapping the droplet trajectory and number. The number of aerosols generated during endoscopy was clinically evaluated in the endoscopy room. Overall, 4356 screening endoscopies were performed with the patients wearing our masks at Medcity21, a health checkup facility, between June and December 2020; the effects of the masks on the patient’s condition were evaluated retrospectively. An 11-item paper-based survey was performed by the endoscopy staff 6 months after the adoption of the mask-based infection control method. Results: Use of both masks reduced the number of droplets released during the simulation. Clinically, the use of both masks did not affect the patients’ conditions during endoscopy and prevented an increase in the aerosols in the endoscopy room. This mask-based infection control method was favorably received, and all staff indicated that understanding the efficacy of our mask-based infection control reduced their anxiety regarding infection. Until December 2020, none of our staff had contracted SARS-CoV-2. Conclusion: Our mask-based infection control method is easy to adopt, inexpensive, and effective; understanding its effectiveness may help ease the fear of infection among endoscopy staff.

scholarly journals Utilization of an Orthopedic Hood as Personal Protective Equipment for Intubation of Coronavirus Patients: a Brief Technical Report

2020 ◽  
Vol 11 ◽  
pp. 215145932093055 ◽  
Author(s):  
Timothy T. Wills ◽  
Wilhelm A. Zuelzer ◽  
Bryant W. Tran
Keyword(s):  
Health Care ◽  
High Risk ◽  
Endotracheal Intubation ◽  
Health Care Workers ◽  
Personal Protective Equipment ◽  
Ventilation System ◽  
The United States ◽  
Protective Equipment ◽  
Care Workers ◽  
Technical Report

Background: The novel coronavirus disease (COVID-19) has afflicted millions of people worldwide since its first case was reported in December 2019. Personal protective equipment (PPE) has been tailored accordingly, but as of April 2020, close to 10 000 health care workers in the United States have contracted COVID-19 despite wearing recommended PPE. As such, standard guidelines for PPE may be inadequate for the health care worker performing high-risk aerosolizing procedures such as endotracheal intubation. In this brief technical report, we describe the integration of an orthopedic hood cover as an item for full barrier protection against COVID-19 transmission. Technical Description: The Coronavirus Airway Task Force at Virginia Commonwealth University Medical Center approved this initiative and went live with the full barrier suit during the last week of March 2020. The PPE described in this report includes a Stryker T4 Hood, normally used in conjunction with the Stryker Steri-Shield T4 Helmet. Instead of the helmet, the hood is secured to the head via a baseball cap and binder clip. This head covering apparatus is to be used as an accessory to other PPE items that include an N95 mask, waterproof gown, and disposable gloves. The motor ventilation system is not used in order to prevent airborne viral entry into the hood. Discussion: An advantage of the full barrier suit is an additional layer of droplet protection during intubation. The most notable disadvantage is the absence of a ventilation system within the hood covering. Conclusion: Modification of existing PPE may provide protection for health care workers during high-risk aerosolizing procedures such as endotracheal intubation. Although the integration of this medical equipment meets the immediate needs of an escalating crisis, further innovation is on the horizon. More research is needed to confirm the safety of modified PPE.

scholarly journals Adherence to recommendations for endoscopy practice during COVID-19 pandemic in Latin America: how are we doing it?

2021 ◽  
Vol 8 (1) ◽  
pp. e000558
Author(s):  
Enrique Murcio-Pérez ◽  
Raúl Antonio Zamarripa-Mottú ◽  
Gustavo Andrade-DePaulo ◽  
Octavio Aguilar-Nájera ◽  
Jorge Asadur Tchekmedyian ◽  
...  
Keyword(s):  
Latin America ◽  
High Risk ◽  
Airway Management ◽  
Personal Protective Equipment ◽  
Response Rate ◽  
Specific Area ◽  
Hand Washing ◽  
Protective Equipment ◽  
Digestive Endoscopy ◽  
Endoscopic Procedures

Background and aimsDigestive 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).MethodsA 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.ResultsA 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.ConclusionsAdherence 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.

scholarly journals Lessons From Other Disciplines About Communication, Human Performance and Situational Awareness While Wearing Personal Protective Equipment

2020 ◽  
Vol 6 ◽  
pp. 237796082096376
Author(s):  
Margaret Scott ◽  
John Unsworth
Keyword(s):  
High Risk ◽  
Personal Protective Equipment ◽  
Human Performance ◽  
Situational Awareness ◽  
Fire Service ◽  
Team Work ◽  
Protective Equipment ◽  
Peak Period ◽  
New Ways Of Working ◽  
Multi Phase

Introduction The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) has quickly accelerated into a pandemic. As COVID-19 has swept across the globe, health systems have adapted, including the cessation of routine surgery and the re-deployment of staff to critical care settings. Prompt interventions such as endotracheal (ET) intubation, are deemed essential in patients with Acute Respiratory Distress Syndrome. Intubation requires a coordinated approach and effective teamwork, as it is a high-risk procedure not least because it is an aerosol-generating intervention with increased infection risk. As a result, teams responsible for performing ET intubation are required to wear Personal Protective Equipment (PPE), which in turn hinders communication and situational awareness, and can hamper team work. Method This review considers the effects of wearing PPE on performance and situational awareness in a healthcare environment. Drawing on literature from the fire service and military, the review will explore approaches to improving communication and situational awareness for teams who, at times, are unfamiliar with one another. The review will consider human factors and, identify approaches that assist teams, including teams that are unfamiliar with one another, to adapt to new ways of working while performing high-risk procedures. Conclusion Literature indicates that standardisation, pre-brief and training are important elements of developing improved situational awareness and team working in individuals whose senses may be affected by PPE. In addition, checklists provide a useful way of standardising procedures and can form the basis of a structured pre-brief. Checklists exist for both intubation and patient proning, which, alongside simulation-based team training, provide a useful method of preparing an often unfamiliar workforce for their roles during an epidemic or pandemic. The multi-phase nature of most pandemics provides an opportunity to review processes and implement such procedures, and to develop staff using team-based training during the post-peak period.

Wound care during the COVID-19 pandemic: improving outcomes through the integration of telemedicine

2021 ◽  
Vol 30 (Sup2) ◽  
pp. S12-S17
Author(s):  
Alisha Oropallo ◽  
John Lantis ◽  
Alexander Martin ◽  
Ammar Al Rubaiay ◽  
Na Wang
Keyword(s):  
High Risk ◽  
Healthcare System ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Wound Care ◽  
Protective Equipment ◽  
Medical Resources ◽  
Social Distancing ◽  
Vulnerable Patients ◽  
Rapid Spread

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.

scholarly journals Kejadian infeksi soil-transmitted helminth pada petani

2020 ◽  
Vol 20 (3) ◽  
Author(s):  
Fitria Saftarina ◽  
Maryatun Hasan ◽  
Jhons Fatriyadi Suwandi ◽  
Anisya Yulida Syani
Keyword(s):  
High Risk ◽  
Personal Protective Equipment ◽  
Direct Contact ◽  
Helminth Infection ◽  
Sampling Technique ◽  
Personal Hygiene ◽  
Stool Examination ◽  
Protective Equipment ◽  
Purposive Sampling ◽  
Hygiene Behavior

Abstrak. Petani memiliki risiko terinfeksi Soil-Transmitted Helminth (STH) akibat sering berkontak langsung dengan tanah yang terkontaminasi oleh telur STH. Tingginya risiko terinfeksi STH pada petani berhubungan dengan perilaku personal hygiene dan pemakaian alat pelindung diri saat bekerja. Tujuan dilakukan penelitian untuk mengetahui angka kejadian infeksi STH dan faktor yang mempengaruhinya. Penelitian dilaksanakan di Kelurahan Pinang Jaya, Lampung. Populasi pada penelitian ini  adalah 63 petani dan sampel dipilih sebanyak 55 petani dengan teknik purposive sampling. Data diperoleh dengan pemeriksaan feses, pengisian kuesioner, dan observasi. Data dianalisis dengan menggunakan α =5%.  Hasil penelitian didapatkan prevalensi STH pada petani sebanyak 40% dengan jenis telur cacing  A.lumbricoides (22,7%), cacing tambang (59,1%), dan  terinfeksi keduanya (18,2%). Sebagian besar personal hygiene petani baik (63,6%) dan sebagian besar petani tidak lengkap menggunakan APD (69,1%). Hasil analisis menunjukkan bahwa personal hygiene dan penggunaan APD berhubungan terhadap kejadian STH (pα). Diperlukan edukasi kepada petani untuk dapat meningkatkan personal hygiene dan menggunakan alas kaki untuk melindungi diri dari risiko STH. Keyword:  infeksi Soil Transmited Helminth, petani Abstract. Farmers have the risk of being infected with STH due to frequent direct contact with the soil which contaminated by STH eggs. The high risk of STH infection among farmers is related to personal hygiene behavior and the use of personal protective equipment while working. The purpose of this study is to determine the prevalence of STH and the factors that influence it. The study was conducted in Pinang Jaya Village, Lampung. The population in this study was 63 farmers and a sample of 55 farmers was selected by purposive sampling technique. Data obtained by stool examination, filling out questionnaires, and observing. Data were analyzed using α = 5%. The results showed that the prevalence of STH among farmers was 40% with A. lumbricoides eggs (22.7%), hookworms (59.1%), and both infected (18.2%). Most of the farmers' personal hygiene was good (63.6%) and most farmers did not completely use PPE (69.1%). The results of the analysis showed that personal hygiene and the use of PPE were related to the incidence of STH (p α. Education is needed for farmers to improve personal hygiene and use footwear to protect themselves from the risks of STH. Keywords: Soil Transmited Helminth  infection, personal hygiene, farmers

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