scholarly journals Personal protective equipment for reducing the risk of COVID-19 infection among healthcare workers involved in emergency trauma surgery during the pandemic: an umbrella review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e045598
Author(s):  
Dylan P Griswold ◽  
Andres Gempeler ◽  
Angelos G Kolias ◽  
Peter J Hutchinson ◽  
Andres M Rubiano

IntroductionMany healthcare facilities in low-income and middle-income countries are inadequately resourced and may lack optimal organisation and governance, especially concerning surgical health systems. COVID-19 has the potential to decimate these already strained surgical healthcare services unless health systems take stringent measures to protect healthcare workers (HCWs) from viral exposure and ensure the continuity of specialised care for patients. The objective of this broad evidence synthesis is to identify and summarise the available literature regarding the efficacy of different personal protective equipment (PPE) in reducing the risk of COVID-19 infection in health personnel caring for patients undergoing trauma surgery in low-resource environments.MethodsWe will conduct several searches in the L·OVE (Living OVerview of Evidence) platform for COVID-19, a system that performs automated regular searches in PubMed, Embase, Cochrane Central Register of Controlled Trials and over 30 other sources. The search results will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram. This review will preferentially consider systematic reviews of experimental and quasi-experimental studies, as well as individual studies of such designs, evaluating the effect of different PPE on the risk of COVID-19 infection in HCWs involved in emergency trauma surgery. Critical appraisal of eligible studies for methodological quality will be conducted. Data will be extracted using the standardised data extraction tool in Covidence. Studies will, when possible, be pooled in a statistical meta-analysis using JBI SUMARI. The Grading of Recommendations, Assessment, Development and Evaluation approach for grading the certainty of evidence will be followed and a summary of findings will be created.Ethics and disseminationEthical approval is not required for this review. The plan for dissemination is to publish review findings in a peer-reviewed journal and present findings at high-level conferences that engage the most pertinent stakeholders.PROSPERO registration numberCRD42020198267.

2020 ◽  
Author(s):  
Dylan P Griswold ◽  
Andres Gempeler ◽  
Angelos Kolias ◽  
Peter J. Hutchinson ◽  
Andres M. Rubiano

ABSTRACTObjectiveThe objective of this broad evidence synthesis is to identify and summarize the available literature regarding the efficacy of different personal protective equipment (PPE) for reducing the risk of COVID-19 infection in health personnel caring for patients undergoing trauma surgery in low-resource environments (LREs).IntroductionMany healthcare facilities in low-and middle-income countries are inadequately resourced and may lack optimal organization and governance, especially concerning surgical health systems. COVID-19 has the potential to decimate these already strained surgical healthcare services unless health systems take stringent measures to protect healthcare workers from viral exposure and ensure the continuity of specialized care for the patients.Inclusion criteriaThis review will preferentially consider systematic reviews of experimental and quasi-experimental studies, as well as individual studies of such designs, evaluating the effect of different PPE on the risk of COVID-19 infection in healthcare workers (HCWs) involved in emergency trauma surgery.MethodsWe will conduct several searches in the L·OVE (Living OVerview of Evidence) platform for COVID-19, a system that performs automated regular searches in PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and over thirty other sources. The search results will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. Critical appraisal of the eligible studies for methodological quality will be conducted. Data will be extracted using the standardized data extraction tool in Covidence. Studies will, when possible, be pooled in a statistical meta-analysis using JBI SUMARI. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach for grading the certainty of evidence will be followed, and a Summary of Findings (SoF) will be created.Systematic review registration numberCRD42020198267


2020 ◽  
Author(s):  
Dylan Griswold ◽  
Andres Gempeler ◽  
Gail Rosseau ◽  
Neema Kaseje ◽  
WALTER D JOHNSON ◽  
...  

UNSTRUCTURED ABSTRACT Introduction: Many healthcare facilities in low-and middle-income countries are inadequately resourced and may lack optimal organization and governance, especially concerning surgical health systems. COVID-19 has the potential to decimate these already strained surgical healthcare services unless health systems take stringent measures to protect healthcare workers (HCWs) from viral exposure and ensure the continuity of specialized care for the patients. The objective of this broad evidence synthesis is to identify and summarize the available literature regarding the efficacy of chest CT and rapid testing for emergency trauma surgery patients to reduce the risk of COVID-19 infection in trauma surgery staff in low-resource environments (LREs). Methods We will conduct several searches in the L·OVE (Living OVerview of Evidence) platform for COVID-19, a system that performs automated regular searches in PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and over thirty other sources. The search results will be presented according to the PRISMA flow diagram. This review will preferentially consider systematic reviews of experimental and quasi-experimental studies, as well as individual studies of such designs, evaluating the effect of chest CT and rapid testing for emergency trauma surgery patients in preventing COVID-19 infection in emergency trauma surgery staff. Critical appraisal of the eligible studies for methodological quality will be conducted. Data will be extracted using the standardized data extraction tool in Covidence. Studies will, when possible, be pooled in a statistical meta-analysis using JBI SUMARI. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach for grading the certainty of evidence will be followed, and a Summary of Findings (SoF) will be created. Ethics and dissemination Ethical approval is not required for this review. The plan for dissemination is to publish review findings in a peer-reviewed journal and present findings at high-level conferences that engage the most pertinent stakeholders. PROSPERO: CRD42020198267


2020 ◽  
Author(s):  
Dylan Paul Griswold ◽  
Andres Gempeler ◽  
Angelos Kolias ◽  
Peter Hutchinson ◽  
Andres Rubiano

Objective: The objective of this review was to summarise the effects of different personal protective equipment (PPE) for reducing the risk of COVID-19 infection in health personnel caring for patients undergoing trauma surgery. The purpose of the review was to inform recommendations for rational use of PPE for emergency surgery staff, particularly in low resources environments where PPE shortages and high costs are expected to hamper the safety of healthcare workers (HCWs) and affect the care of trauma patients. Introduction: Many healthcare facilities in low-and middle-income countries are inadequately resourced. COVID-19 has the potential to decimate these already strained surgical healthcare services unless health systems take stringent measures to protect healthcare workers from viral exposure. Inclusion criteria: This review included systematic reviews, experimental and observational studies evaluating the effect of different PPE on the risk of COVID-19 infection in HCWs involved in emergency trauma surgery. Indirect evidence from other healthcare settings was considered, as well as evidence from other viral outbreaks summarised and discussed for the COVID-19 pandemic. Methods: We conducted searches in the LOVE (Living OVerview of Evidence) platform for COVID-19, a system that performs automated regular searches in PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and over thirty other sources. The risk of bias assessment of the included studies was planned with the AMSTAR II tool for systematic reviews, the RoBII tool for randomised controlled trials, and the ROBINS-I tool for non-randomised studies. Data were extracted using a standardised data extraction tool and summarised narratively. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach for grading the certainty of the evidence was followed. Results: We identified 17 systematic reviews that fulfilled our selection criteria and were included for synthesis. We did not identify randomised controlled trials during COVID-19 or studies additional to those included in the reviews that discussed other similar viral respiratory illnesses. Conclusions: The use of PPE drastically reduces the risk of COVID-19 compared with no mask use in HCWs in the hospital setting. N95 and N95 equivalent respirators provided more protection and were found to halve the risk of COVID-19 contagion in HCWs from moderate and high-risk environments. Eye protection also offers additional security and is associated with reduced incidence of contagion. These effects apply to emergency trauma care. Decontamination and reuse appear as feasible, cost-effective measures that would likely help overcome PPE shortages and enhance the allocation of limited resources. SUMMARY OF FINDINGS There is high certainty that the use of N95 respirators and surgical masks are associated with a reduced risk of coronaviruses respiratory illness when compared with no mask use. In moderate to high-risk environments, especially in aerosol-generating procedures, N95 respirators are associated with a more significant reduction in risk of COVID-19 infection compared with surgical masks. Eye protection also reduces the risk of contagion. Decontamination of masks and respirators with ultraviolet germicidal irradiation, vaporous hydrogen peroxide, or dry heat is effective and does not affect PPE performance or fit.


2020 ◽  
Vol 59 (04) ◽  
pp. 294-299 ◽  
Author(s):  
Lutz S. Freudenberg ◽  
Ulf Dittmer ◽  
Ken Herrmann

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.


Author(s):  
Nhan Phuc Thanh Nguyen ◽  
Duong Dinh Le ◽  
Robert Colebunders ◽  
Joseph Nelson Siewe Fodjo ◽  
Trung Dinh Tran ◽  
...  

Frontline healthcare workers (HCWs) involved in the COVID-19 response have a higher risk of experiencing psychosocial distress amidst the pandemic. Between July and September 2020, a second wave of the COVID-19 pandemic appeared in Vietnam with Da Nang city being the epicenter. During the outbreak, HCWs were quarantined within the health facilities in a bid to limit the spread of COVID-19 to their respective communities. Using the stress component of the 21-item Depression, Anxiety and Stress Scale (DASS-21), we assessed the level of stress among HCWs in Da Nang city. Between 30 August and 15 September 2020, 746 frontline HCWs were recruited to fill in an online structured questionnaire. Overall, 44.6% of participants experienced increased stress and 18.9% severe or extremely severe stress. In multivariable analysis, increased stress was associated with longer working hours (OR = 1.012; 95% CI: 1.004–1.019), working in health facilities providing COVID-19 treatment (OR = 1.58, 95% CI: 1.04–2.39), having direct contact with patients or their bio-samples (physicians, nurses and laboratory workers; OR = 1.42, 95% CI: 1.02–1.99), low confidence in the available personal protective equipment (OR = 0.846; 95% CI: 0.744–0.962) and low knowledge on COVID-19 prevention and treatment (OR = 0.853; 95% CI: 0.739–0.986). In conclusion, many frontline HCWs experienced increased stress during the COVID-19 outbreak in Da Nang city. Reducing working time, providing essential personal protective equipment and enhancing the knowledge on COVID-19 will help to reduce this stress. Moreover, extra support is needed for HCWs who are directly exposed to COVID-19 patients.


Author(s):  
Stephanie Toigo ◽  
Michel Jacques ◽  
Tarek Razek ◽  
Ewa Rajda ◽  
Sidney Omelon ◽  
...  

ABSTRACT Objective: Bottlenecks in the personal protective equipment (PPE) supply chain have contributed to shortages of PPE during the COVID-19 pandemic, resulting in fractures in the functionality of healthcare systems. This study was conducted with the aim of determining the effectiveness of retrofitted commercial snorkel masks as an alternative respirator for healthcare workers during infectious disease outbreaks. Methods: A retrospective analysis was performed, analyzing qualitative and quantitative fit test results of the retrofitted Aria Ocean Reef® full-face snorkeling mask on healthcare workers at the McGill University Health Centre between April-June 2020. Historical fit test results, using medical-grade respirators, for healthcare workers were also analyzed. Results: During the study period, 71 participants volunteered for fit testing, 60.6% of which were nurses. The overall fit test passing rate using the snorkel mask was 83.1%. Of the participants who did not previously pass fit testing with medical-grade respirators, 80% achieved a passing fit test with the snorkel respirator. Conclusions: The results suggest that this novel respirator may be an effective and feasible alternative solution to address PPE shortages, while still providing healthcare workers with ample protection. Additional robust testing will be required to ensure that respirator fit is maintained, after numerous rounds of disinfection.


Work ◽  
2021 ◽  
pp. 1-14
Author(s):  
Mojtaba K. Danesh ◽  
Ehsan Garosi ◽  
Hamedeh Golmohamadpour

BACKGROUND: The COVID-19 pandemic has put health systems under unprecedented pressure, challenging their workforce, especially nurses. OBJECTIVE: The current paper presented a review of the early literature concerning emerging nursing challenges during the early stages of the COVID-19 pandemic. METHODS: A systematic search of the published literature between January and May 2020 was carried out in Medline, Science Direct, and Google Scholar to identify relevant quantitative and qualitative studies. RESULTS: Twenty-two original articles were retrieved, the majority of which were survey studies from China. Synthesis of the evidence resulted in four overarching themes including “being physically and mentally drained in the face of fear and uncertainty,” “shortage of personal protective equipment and usability issues,” “psychosomatic disturbances among nurses,” and “moderators to mitigate nurses’ challenges.” CONCLUSIONS: Providing care for demanding COVID-19 patients, nurses experienced a gruelling situation, during which a significant amount of psychological and physical distress was inflicted to them. However, receiving proper support from their organization and society could improve the condition substantially. Further research is required to explore the impact of the COVID-19 pandemic on nurses, especially from Western countries.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Duy Duong Nguyen ◽  
Patricia McCabe ◽  
Donna Thomas ◽  
Alison Purcell ◽  
Maree Doble ◽  
...  

AbstractFacemasks are essential for healthcare workers but characteristics of the voice whilst wearing this personal protective equipment are not well understood. In the present study, we compared acoustic voice measures in recordings of sixteen adults producing standardised vocal tasks with and without wearing either a surgical mask or a KN95 mask. Data were analysed for mean spectral levels at 0–1 kHz and 1–8 kHz regions, an energy ratio between 0–1 and 1–8 kHz (LH1000), harmonics-to-noise ratio (HNR), smoothed cepstral peak prominence (CPPS), and vocal intensity. In connected speech there was significant attenuation of mean spectral level at 1–8 kHz region and there was no significant change in this measure at 0–1 kHz. Mean spectral levels of vowel did not change significantly in mask-wearing conditions. LH1000 for connected speech significantly increased whilst wearing either a surgical mask or KN95 mask but no significant change in this measure was found for vowel. HNR was higher in the mask-wearing conditions than the no-mask condition. CPPS and vocal intensity did not change in mask-wearing conditions. These findings implied an attenuation effects of wearing these types of masks on the voice spectra with surgical mask showing less impact than the KN95.


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