scholarly journals Development and Comparison of Complementary Methods to Study Potential Skin and Inhalational Exposure to Pathogens During Personal Protective Equipment Doffing

2019 ◽  
Vol 69 (Supplement_3) ◽  
pp. S231-S240 ◽  
Author(s):  
Jennifer Therkorn ◽  
David Drewry ◽  
Jennifer Andonian ◽  
Lauren Benishek ◽  
Carrie Billman ◽  
...  
Keyword(s):  
Pilot Study ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Recovery Efficiency ◽  
Breathing Zone ◽  
Tracer Method ◽  
Fluorescent Tracer ◽  
Air Sampler ◽  
Airborne Contamination ◽  
Skin Contamination

Abstract Background Fluorescent tracers are often used with ultraviolet lights to visibly identify healthcare worker self-contamination after doffing of personal protective equipment (PPE). This method has drawbacks, as it cannot detect pathogen-sized contaminants nor airborne contamination in subjects’ breathing zones. Methods A contamination detection/quantification method was developed using 2-µm polystyrene latex spheres (PSLs) to investigate skin contamination (via swabbing) and potential inhalational exposure (via breathing zone air sampler). Porcine skin coupons were used to estimate the PSL swabbing recovery efficiency and limit of detection (LOD). A pilot study with 5 participants compared skin contamination levels detected via the PSL vs fluorescent tracer methods, while the air sampler quantified potential inhalational exposure to PSLs during doffing. Results Average PSL skin swab recovery efficiency was 40% ± 29% (LOD = 1 PSL/4 cm2 of skin). In the pilot study, all subjects had PSL and fluorescent tracer skin contamination. Two subjects had simultaneously located contamination of both types on a wrist and hand. However, for all other subjects, the PSL method enabled detection of skin contamination that was not detectable by the fluorescent tracer method. Hands/wrists were more commonly contaminated than areas of the head/face (57% vs 23% of swabs with PSL detection, respectively). One subject had PSLs detected by the breathing zone air sampler. Conclusions This study provides a well-characterized method that can be used to quantitate levels of skin and inhalational contact with simulant pathogen particles. The PSL method serves as a complement to the fluorescent tracer method to study PPE doffing self-contamination.

scholarly journals Safe On-Boat Resuscitation by Lifeguards in COVID-19 Era: A Pilot Study Comparing Three Sets of Personal Protective Equipment

2021 ◽  
pp. 1-7
Author(s):  
Roberto Barcala-Furelos ◽  
Cristian Abelairas-Gómez ◽  
Alejandra Alonso-Calvete ◽  
Francisco Cano-Noguera ◽  
Aida Carballo-Fazanes ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cardiopulmonary Resuscitation ◽  
Severe Acute Respiratory Syndrome ◽  
Personal Protective Equipment ◽  
High Efficiency ◽  
Prehospital Care ◽  
Protective Equipment ◽  
Preparation Time

Abstract Introduction: On-boat resuscitation can be applied by lifeguards in an inflatable rescue boat (IRB). Due to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2) and recommendations for the use of personal protective equipment (PPE), prehospital care procedures need to be re-evaluated. The objective of this study was to determine how the use of PPE influences the amount of preparation time needed before beginning actual resuscitation and the quality of cardiopulmonary resuscitation (CPR; QCPR) on an IRB. Methods: Three CPR tests were performed by 14 lifeguards, in teams of two, wearing different PPE: (1) Basic PPE (B-PPE): gloves, a mask, and protective glasses; (2) Full PPE (F-PPE): B-PPE + a waterproof apron; and (3) Basic PPE + plastic blanket (B+PPE). On-boat resuscitation using a bag-valve-mask (BVM) and high efficiency particulate air (HEPA) filter was performed sailing at 20km/hour. Results: Using B-PPE takes less time and is significantly faster than F-PPE (B-PPE 17 [SD = 2] seconds versus F-PPE 69 [SD = 17] seconds; P = .001), and the use of B+PPE is slightly higher (B-PPE 17 [SD = 2] seconds versus B+PPE 34 [SD = 6] seconds; P = .002). The QCPR remained similar in all three scenarios (P >.05), reaching values over 79%. Conclusion: The use of PPE during on-board resuscitation is feasible and does not interfere with quality when performed by trained lifeguards. The use of a plastic blanket could be a quick and easy alternative to offer extra protection to lifeguards during CPR on an IRB.

scholarly journals The Cupola: An Additional Layer of Protection for Providers Working in the Oropharyngeal Region

2021 ◽  
Author(s):  
Alessandro Villa ◽  
Marlene Grenon
Keyword(s):  
Pilot Study ◽  
Personal Protective Equipment ◽  
Airborne Particles ◽  
Protective Equipment ◽  
Additional Layer ◽  
Dental Procedures ◽  
The Mean ◽  
Mechanical Barrier

Abstract ObjectivesTo reduce the spread of the infection, especially during aerosol generating procedures, we invented “The Cupola”, a shield that creates a mechanical barrier around the patient’s head and body. With this pilot study we aimed to assess the effectiveness of an additional layer of protection (The Cupola) developed for providers working in the oropharyngeal region.ResultsThe mean number of 0.3 μm particles with no Cupola was 3777 (SD: ±556), with The Cupola was 2068 (SD: ±1468) and with the Cupola and Drape was 2031 (SD: ±1108) (p<0.015). The mean number of 0.5 μm airborne particles with no Cupola was 65 (SD: ±7), with The Cupola was 29 (SD: ±28) and with the Cupola and Drape was 28 (SD: ±23) (p<0.05). Results showed a significant reduction of aerosols generated during simulated dental procedures when the Cupola was used. The Cupola offers an extra layer of protection in addition to the recommended personal protective equipment.

scholarly journals Life Plus Mini Capsule S®, Novel Intubating Box – A Pilot Study

2021 ◽  
Vol 15 (1) ◽  
pp. 30-33
Author(s):  
Boris Tufegdzic ◽  
Massimo Lamperti ◽  
Kyne Woodsford
Keyword(s):  
Pilot Study ◽  
Endotracheal Intubation ◽  
Personal Protective Equipment ◽  
High Efficiency ◽  
Protective Equipment ◽  
Test Conditions ◽  
Clinical Conditions ◽  
Larger Sample ◽  
Insight Into

To protect clinicians without access to recommended personal protective equipment during aerosol-generating procedures such as endotracheal intubation, various products have been introduced to clinical practice. The authors would like to present a pilot study with a novel intubating box, the LIFE PLUS MINI CAPSULE S®, which has improved systems to prevent the egress of particles from the box as well as a built-in HEPA (High Efficiency Particulate Air) aspiration filter. Nineteen anesthesiologists simulated endotracheal intubation on a mannequin in test conditions with and without using the LIFE PLUS MINI CAPSULE S®. All anesthesiologists successfully intubated the mannequin at first attempt, and there were no failed intubations. The median (range) intubation time was 9.1 (2.0–25.0) seconds longer when the LIFE PLUS MINI CAPSULE S® was used, and there were no breaches of personal protective equipment. The leakage of airborne particles was analyzed using a Qualitative and a Quantitative Fit Test. Although our pilot study shows promising results, further research is required to validate our results in vivo and in a larger sample size which will provide us with a better insight into the efficacy and applicability of this safety tool in emergency and elective clinical conditions.

scholarly journals The Cupola: an additional layer of protection for providers working in the oropharyngeal region

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Alessandro Villa ◽  
Marlene Grenon
Keyword(s):  
Pilot Study ◽  
Personal Protective Equipment ◽  
Airborne Particles ◽  
Protective Equipment ◽  
Additional Layer ◽  
Dental Procedures ◽  
The Mean ◽  
Mechanical Barrier

Abstract Objectives To reduce the spread of the infection, especially during aerosol generating procedures, we invented “The Cupola”, a shield that creates a mechanical barrier around the patient’s head and body. With this pilot study we aimed to assess the effectiveness of an additional layer of protection (The Cupola) developed for providers working in the oropharyngeal region. Results The mean number of 0.3 μm particles with no Cupola was 3777 (SD: ± 556), with The Cupola was 2068 (SD: ± 1468) and with the Cupola and Drape was 2031 (SD: ± 1108) (p < 0.015). The mean number of 0.5 μm airborne particles with no Cupola was 65 (SD: ± 7), with The Cupola was 29 (SD: ± 28) and with the Cupola and Drape was 28 (SD: ± 23) (p < 0.05). Results showed a significant reduction of aerosols generated during simulated dental procedures when the Cupola was used. The Cupola offers an extra layer of protection in addition to the recommended personal protective equipment.

scholarly journals Personal protective equipment does not sufficiently protect against virus aerosol unless combined with advanced air purification or ventilation techniques

2021 ◽  
Author(s):  
Shane A Landry ◽  
Dinesh Subedi ◽  
Jeremy J Barr ◽  
Martin I MacDonald ◽  
Samantha Dix ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Hospital Capacity ◽  
Degree Of Protection ◽  
Aerosol Exposure ◽  
Skin Contamination ◽  
The Face ◽  
Close Range ◽  
Virus Exposure ◽  
High Virus

ABSTRACTBackgroundHealthcare workers (HCWs) are at risk from nosocomial transmission of SARS-CoV-2 from virus laden aerosols. This study aimed to: 1) quantify the degree of protection from virus aerosol provided by different types of mask (surgical, N95, fit-tested N95) and personal protective equipment (PPE); 2) determine if the use of a portable HEPA filter can enhance the effectiveness of PPE; 3) determine the effectiveness of a decontamination shower to remove virus aerosol contamination of a HCW.MethodsVirus aerosol exposure experiments were conducted using bacteriophage PhiX174 (108copies/mL). A HCW wearing PPE (mask, gloves, gown, faceshield) was exposed to nebulised viruses for 40mins in a sealed clinical room. After exiting, the HCW doffed PPE. Virus exposure was quantified via skin swabs applied to the face and nostrils, forearms, neck, and forehead. Experiments were performed with and without the presence of a portable HEPA filter (set to 470m3/hr).FindingsSwabs quantified significant virus exposure under the surgical and N95 mask. Only the fit-tested N95 resulted in lower virus counts compared to no mask control (p=0.027). Nasal swabs demonstrated very high virus exposure, which was not mitigated by the surgical or N95 masks, although there was a trend for the fit-tested N95 mask to reduce virus counts (p=0.058). The addition of HEPA filtration substantially reduced virus counts from all swab sites, and to near zero levels when combined with a fit-tested N95 mask, gloves, gown and faces shield. Virus counts were substantially reduced to near zero levels following a shower.InterpretationThese data demonstrate that quantitatively fit tested N95 masks combined with a HEPA filter can offer protection against high virus aerosol loads at close range and for prolonged periods of time. Skin contamination from virus aerosol can be effectively by removed by showering.FundingEpworth Hospital Capacity Building Research Grant ID: EH2020-654

Impact of COVID-19 on Nuclear Medicine in Germany, Austria and Switzerland: An International Survey in April 2020

2020 ◽  
Vol 59 (04) ◽  
pp. 294-299 ◽  
Author(s):  
Lutz S. Freudenberg ◽  
Ulf Dittmer ◽  
Ken Herrmann
Keyword(s):  
Nuclear Medicine ◽  
Health Systems ◽  
Personal Protective Equipment ◽  
Large Scale ◽  
Diagnostic Procedures ◽  
Protective Equipment ◽  
Current Crisis ◽  
Web Based ◽  
Public Versus Private ◽  
The Impact

Abstract Introduction Preparations of health systems to accommodate large number of severely ill COVID-19 patients in March/April 2020 has a significant impact on nuclear medicine departments. Materials and Methods A web-based questionnaire was designed to differentiate the impact of the pandemic on inpatient and outpatient nuclear medicine operations and on public versus private health systems, respectively. Questions were addressing the following issues: impact on nuclear medicine diagnostics and therapy, use of recommendations, personal protective equipment, and organizational adaptations. The survey was available for 6 days and closed on April 20, 2020. Results 113 complete responses were recorded. Nearly all participants (97 %) report a decline of nuclear medicine diagnostic procedures. The mean reduction in the last three weeks for PET/CT, scintigraphies of bone, myocardium, lung thyroid, sentinel lymph-node are –14.4 %, –47.2 %, –47.5 %, –40.7 %, –58.4 %, and –25.2 % respectively. Furthermore, 76 % of the participants report a reduction in therapies especially for benign thyroid disease (-41.8 %) and radiosynoviorthesis (–53.8 %) while tumor therapies remained mainly stable. 48 % of the participants report a shortage of personal protective equipment. Conclusions Nuclear medicine services are notably reduced 3 weeks after the SARS-CoV-2 pandemic reached Germany, Austria and Switzerland on a large scale. We must be aware that the current crisis will also have a significant economic impact on the healthcare system. As the survey cannot adapt to daily dynamic changes in priorities, it serves as a first snapshot requiring follow-up studies and comparisons with other countries and regions.

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