scholarly journals Analysis of Droplet Splatter Patterns During Coblation Tonsil Surgery in the Covid-19 Pandemic

2021 ◽  
pp. 000348942110189
Author(s):  
Grace C. Khong ◽  
Jaya Bhat ◽  
Ravi S. Sharma ◽  
Samuel C. Leong
Keyword(s):  
Observational Study ◽  
Personal Protective Equipment ◽  
Mitigation Strategies ◽  
Head Model ◽  
Protective Equipment ◽  
Data Sets ◽  
Level Of Evidence ◽  
Tonsil Surgery ◽  
Surgical Field

Objectives: To assess droplet splatter around the surgical field and surgeon during simulated Coblation tonsil surgery to better inform on mitigation strategies and evaluate choice of personal protective equipment. Methods: This was an observational study performed using a life-size head model to simulate tonsil surgery and fluorescein-soaked strawberries to mimic tonsils. The Coblation wand was activated over the strawberries for 5 minutes. This was repeated 5 times with 2 surgeons (totalling 10 data sets). The presence of droplet around the surgical field and anatomical subsites on the surgeon was assessed in binary fashion: present or not present. The results were collated as frequency of droplet detection and illustrated as a heatmap; 0 = white, 1-2 = yellow, 3-4 = orange, and 5 = red. Results: Fluorescein droplets were detected in all 4 quadrants of the surgical field. The frequency of splatter was greatest in the upper (nearest to surgeon) and lower quadrants. There were detectable splatter droplets on the surgeon; most frequently occurring on the hands followed by the forearm. Droplets were also detected on the visor, neck, and chest albeit less frequently. However, none were detected on the upper arms. Conclusion: Droplet splatter can be detected in the immediate surgical field as well as on the surgeon. Although wearing a face visor does not prevent splatter on the surgical mask or around the eyes, it should be considered when undertaking tonsil surgery as well as a properly fitted goggle. Level of evidence: 5

Management of personal protective equipment during the COVID-19 pandemic in England and the state of New York: A comparative case study

2020 ◽  
Vol 18 (7) ◽  
pp. 71-89
Author(s):  
Amy Barber, BSc ◽  
Annaëlle Vinzent, BS ◽  
Imani Williams, BA
Keyword(s):  
New York ◽  
Supply Chain ◽  
Health Systems ◽  
Personal Protective Equipment ◽  
New York State ◽  
The United States ◽  
Mitigation Strategies ◽  
Comparative Case Study ◽  
Protective Equipment

Background: The COVID-19 crisis placed extraordinary demands on the supply of personal protective equipment (PPE) at the beginning of 2020. These were coupled with shocks to the supply chain resulting from the disease. Many typically well-resourced health systems faced subsequent shortages of equipment and had to implement new strategies to manage their stocks. Stockpiles of protective equipment were held in both the United States and United Kingdom intended to prevent shortages. Method: Cross-comparative case study approach by applying Pettigrew and Whipp’s framework for change management. Setting: The health systems of England and New York state from January 2020 to the end of April 2020. Results: Both cases reacted slowly to their outbreaks and faced problems with supplying enough PPE to their health systems. Their stockpiles were not enough to prevent shortages, with many distribution problems resulting from inadequate governance mechanisms. No sustainable responses to supply disruptions were implemented during the study period in either case. Health systems planned interventions along each part of the supply chain from production and importing, to usage guidelines. Conclusion: Global supply chains are vulnerable to disruptions caused by international crises, and existing mitigation strategies have not been wholly successful. The existence of stockpiles is insufficient to preventing shortages of necessary equipment in clinical settings. Both the governance and quality of stockpiles, as well as distribution channels are important for preventing shortages. At the time of writing, it is not possible to judge the strength of strategies adopted in these cases.

scholarly journals Biosafety conducts adopted by orthodontists

2018 ◽  
Vol 23 (3) ◽  
pp. 73-79 ◽  
Author(s):  
Camila Gonçalves Jezini Monteiro ◽  
Mariana Martins e Martins ◽  
Adriana de Alcantara Cury-Saramago ◽  
Henry Pinheiro Teixeira
Keyword(s):  
Observational Study ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Cross Sectional ◽  
Training Time ◽  
Disinfection Methods ◽  
Significant Difference ◽  
High Incidence ◽  
E Mail

ABSTRACT Objective: This cross-sectional observational study was designed to assess the biosafety conducts adopted by orthodontists, and possible differences regarding training time. Methods: Both the application of methods for sterilization/disinfection of instruments and materials, and the use of personal protective equipment (PPE) were collected through questionnaires via e-mail. Results: The questionnaires were answered by 90 orthodontists with a mean age of 37.19 ± 9.08 years and mean training time of 13.52 ± 6.84 years. Regarding orthodontic pliers, 63.23% use an autoclave, except 1 who does not perform any procedure. All participants use autoclave to sterilize instruments, and 95.6% of respondents perform cleaning with chemicals prior to sterilization. Most of them (65.56%) use an autoclave to sterilize orthodontic bands, with some still associating disinfection methods, while few (18.89%) do nothing at all. There was a high incidence of the answer “nothing” for the methods used for elastic, accessories, bandages, metal springs, and arches. All respondents use mask and gloves in attendance, 78.92% use aprons, 58.92% use protective goggles, and 50.01% use cap. Training time significantly influenced (p = 0.003) only the use of glutaraldehyde for sterilization/disinfection of pliers. Conclusions: The sterilization and cleaning of pliers, instruments, and bands, besides the use of PPE, received more uniform and positive responses, while other items suggest disagreements and possible failures. Only orthodontists trained for more than 13 years choose using glutaraldehyde for pliers sterilization/disinfection, the only adopted method with a significant difference in relation to training time.

scholarly journals Barrier Devices, Intubation, and Aerosol Mitigation Strategies: Personal Protective Equipment in the Time of Coronavirus Disease 2019

2020 ◽  
Vol 132 (1) ◽  
pp. 38-45
Author(s):  
Eric A. Fried ◽  
George Zhou ◽  
Ronak Shah ◽  
Da Wi Shin ◽  
Anjan Shah ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Mitigation Strategies ◽  
Protective Equipment

scholarly journals The effects of COVID-19 on training within urology: Lessons learned in virtual learning, human factors, non-technical skills and reflective practice

2020 ◽  
pp. 205141582095010
Author(s):  
T Fonseka ◽  
R Ellis ◽  
H Salem ◽  
PA Brennan ◽  
T Terry
Keyword(s):  
Human Factors ◽  
Reflective Practice ◽  
Personal Protective Equipment ◽  
Virtual Learning ◽  
Technical Skills ◽  
Lessons Learned ◽  
Protective Equipment ◽  
Level Of Evidence ◽  
The Social ◽  
Urological Training

The COVID-19 pandemic has changed training and recruitment in urology in unprecedented ways. As efforts are made to ensure trainees can continue to progress, lessons can be learned to improve training and urological practice even after the acute phase of the pandemic is over. Novel methods of education through virtual learning have burgeoned amidst the social distancing the pandemic has brought. The importance of training in human factors and non-technical skills has also been brought to the fore while operating under the constraints of personal protective equipment and working in new teams and unfamiliar environments. This paper critically appraises the available evidence of how urological training has been affected by COVID-19 and the lessons we have learned and continue to learn going forward. Level of Evidence: Not Applicable.

scholarly journals Availability, Accessibility and Proper Use of Personal Protective Equipment in Wards at Queen Elizabeth Central Hospital (QECH) Blantyre, Malawi: An Observational Study

2020 ◽  
Vol 32 (3) ◽  
pp. 124-131
Author(s):  
Davie Madziatera
Keyword(s):  
Observational Study ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Low Cost ◽  
College Education ◽  
Protective Equipment ◽  
Management Support ◽  
Central Hospital ◽  
Section Design ◽  
Queen Elizabeth Central Hospital

BackgroundThe purpose of this study was to evaluate the availability, accessibility and proper use of personal protective equipment (PPE) in the wards at Queen Elizabeth Central Hospital (QECH).Methods: We conducted an observational study with a cross-section design. Convenience sampling method was used for selection of healthcare workers (HCWs) in wards. HCWs filled a checklist on accessibility of PPEs and they were observed on proper use of PPE while conducting clinical procedures. Nurse ward in-charge was asked to fill out a checklist on availability of PPE in their ward.Results PPE was available in 75.8% of wards, not available in 12.5%. Goggles were absent in 70.8% of wards. PPEs were 71.4% accessible and 28.6% inaccessible to healthcare workers in the wards. The most inaccessible PPEs were goggles (83.2%) and footwear (73.7%) while facemasks, sterile and non-sterile gloves and aprons were readily accessible. Non sterile gloves were 100% available and accessible. Only 13.5% of the HCWs had good compliance with PPE standard procedures. The average PPE compliance score of those who had been trained was 6 % greater than those who were not trained. ConclusionThis study identified areas of improvement in healthcare system delivery regarding standard precautions with emphasis on PPE. Improvements in training during professional college education and in-service refresher training could improve compliance with appropriate use of PPE for relatively low cost. Management support could improve availability and accessibility of PPE in the wards at QECH, with active supervision to improve adherence levels to personal protective equipment usage. The study can also help in the development of policies and guidelines regarding PPE usage by showing that most HCWs need to be trained in proper PPE usage.

scholarly journals KEPATUHAN TENAGA KERJA DALAM MENGGUNAKAN APD

2019 ◽  
Vol 3 (1) ◽  
pp. 37-43
Author(s):  
Fety 'Izza Luthfiyah
Keyword(s):  
Observational Study ◽  
Personal Protective Equipment ◽  
Cross Sectional Study ◽  
Protective Equipment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Total Study Population ◽  
Production Department ◽  
Training And Supervision ◽  
Study Population

Workers when at working area must use (Personal Protective Equipment) PPE, even though the company has implemented technical controls and administrative controls. But, use of PPE at work is still not good. The purpose of this study was to analyse the compliance of workers in using PPE in production department of PT X. this study was an descriptive observational study with a cross sectional study design. The total study population was 30 people with total sampling. Data were by means as of questionnaire. The result of the study were the average age and length of work of workers in production department of PT X were µ = 29,47 ± 4,99 years old and µ = 7,9 ± 3,96 years. Workers in production department of PT X 60% use PPE and 40% not use PPE. The factor that influence compliance with PPE use was comfort of PPE and factors that don’t affect compliance with PPE use were availability of PPE, PPE training, and supervision of PPE. It is recommended for the company need to approach individually to the workers and need to implement a reward policy.   Keywords: compliance, PPE, worker, factors

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