scholarly journals High-Risk Aerosol-Generating Procedures in COVID-19: Respiratory Protective Equipment Considerations

2020 ◽  
Vol 163 (1) ◽  
pp. 98-103 ◽  
Author(s):  
Brittany E. Howard
Keyword(s):  
Health Care ◽  
High Risk ◽  
Health Care Workers ◽  
High Efficiency ◽  
Correct Selection ◽  
Protective Equipment ◽  
Respiratory Protection ◽  
Viral Loads ◽  
Care Workers ◽  
Increased Risk

The correct selection and utilization of respiratory personal protective equipment is of the utmost importance in the current COVID-19 pandemic. This is especially true for health care workers exposed to high-risk aerosol-generating procedures, including otolaryngologists, ophthalmologists, neurosurgeons, maxillofacial surgeons, and laparoscopic surgeons. This communication provides a review of approved forms of respiratory protection and compares their characteristics, including surgical masks, N95 respirator, elastomeric respirators, powered air-purifying respirators, and controlled air-purifying respirators. For standard airborne precautions, N95 respirator are appropriate for respiratory protection. However, high-risk aerosol-generating procedures may create aerosolization of high viral loads that represent increased risk to health care workers. In these situations, enhanced respiratory protection with filters certified as 99, 100, or HEPA (high-efficiency particulate air) may be appropriate.

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 Development of an Objective Risk Stratification Tool to facilitate workplace assessments of healthcare workers when dealing with the CoViD-19 pandemic

2020 ◽  
Author(s):  
W David Strain ◽  
Janusz Jankowski ◽  
Angharad Davies ◽  
Peter MB English ◽  
Ellis Friedman ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Risk Stratification ◽  
Health Care Workers ◽  
Healthcare Workers ◽  
List Type ◽  
Care Workers ◽  
Increased Risk ◽  
Objective Risk ◽  
Risk Stratification Tool

SummaryHealthcare workers have a greater exposure to individuals with confirmed SARS-novel coronavirus 2, and thus a higher probability of contracting coronavirus disease (CoViD)-19, than the general population. Employers have a duty of care to minimise the risk for their employees. Several bodies including the Faculty of Occupational Medicine, NHS Employers, and Public Health England have published a requirement to perform risk assessments for all health care workers, however, with the absence of an objective risk stratification tool, comparing assessments between individuals is difficult if not impossible. Using published data, we explored the predictive role of basic demographics such as age, sex, ethnicity and comorbidities in order to establish an objective risk stratification tool that could help risk allocate duties to health care workers. We developed an objective risk stratification tool using a Caucasian female <50years of age with no comorbidities as a reference. Each point allocated to risk factors was associated with an approximate doubling in risk. This tool was then validated against the primary care-based analysis. This tool provides objective support for employers when determining which healthcare workers should be allocated to high-risk vs. lower risk patient facing clinical duties or to remote supportive roles.Strengths and limitations of this studyThere is an increased risk of mortality in the clinical workforce due to the effects of CoViD-19.This manuscript outlines a simple risk stratification tool that helps to quantify an individual’s biological riskThis will assist team leaders when allocating roles within clinical departments.This tool does not incorporate other external factors, such as high-risk household members or those at higher risk of mental health issues, that may require additional consideration when allocating clinical duties in an appropriate clinical domain.This population-based analysis did not explain for the very high risk observed in BAME healthcare workers suggesting there are other issues at play that require addressing. BAME healthcare workers suggesting there are other issues at play that require addressing.

scholarly journals Comparison of psychological symptoms between infected and non-infected COVID-19 health care workers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nami Mohammadian Khonsari ◽  
Gita Shafiee ◽  
Atefeh Zandifar ◽  
Sahar Mohammad Poornami ◽  
Hanieh-Sadat Ejtahed ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Health Care Workers ◽  
Psychological Symptoms ◽  
Infection Prevalence ◽  
Validated Questionnaire ◽  
Care Workers ◽  
Increased Risk ◽  
History Of ◽  
Anxiety Depression

Abstract Background Studies have shown that health care workers (HCWs), as front liners of the coronavirus (COVID-19) pandemic, are at high risk for psychological symptoms, but few studies have compared these symptoms in infected and non-infected HCWs. This study compares psychological symptoms among these two groups. Methods In this cross-sectional study, 938 HCWs from various medical fields working in the leading general hospitals of Alborz province, Iran, were selected using a multistage sampling method. The participants had contact with COVID-19 patients. Post-traumatic stress disorder-8 (PTSD-8) is a validated questionnaire that we used to evaluate PTSD symptoms along with its subscales, including intrusion, avoidance, and hypervigilance. Also, the Depression, Anxiety, and Stress Scale-21 questionnaire was used to assess the severity of the aforementioned conditions in HCWs. Multivariate logistic regression was used to compare psychological symptoms in infected and non-infected HCWs. Results Among 938 included HCWs, 55 had a history of confirmed COVID-19 infection. Prevalence of stress, anxiety, depression, intrusion, hypervigilance, and avoidance among infected HCWs were significantly higher in comparison to non-infected HCWs. In the multivariate logistic model, history of COVID-19 infection among HCWs was associated with a significantly increased risk of anxiety, depression, stress, intrusion, hyper-vigilance, and avoidance. Conclusion The present study showed that the HCWs with COVID-19 infection were at a high risk of displaying psychological symptoms. Therefore, it is also necessary to develop psychological support and interventions for HCWs, especially those who got infected with the virus.

scholarly journals Antibodies Against SARS-CoV-2 among High-Risk Groups: Findings from Serosurveys in 6 Urban Areas of Odisha, India

2021 ◽  
Author(s):  
Srikanta Kanungo ◽  
Sidhartha Giri ◽  
Debdutta Bhattacharya ◽  
Jaya Singh Kshatri ◽  
Subrata Kumar Palo ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Health Care Workers ◽  
Previous History ◽  
Risk Groups ◽  
Suspected Case ◽  
Care Workers ◽  
Increased Risk ◽  
Police Personnel ◽  
History Of

Abstract Background: Personnel involved in essential services or residing in high risk areas during the COVID-19 pandemic are at increased risk of getting infected, and higher infection rates among such personnel can paralyze these services due to shortage of staff. Evaluating the proportion of personnel infected can be done using seroprevalence studies or serosurveys.Methods: During July to November, 2020, individuals from multiple high risk groups in 6 urban centres in the state of Odisha, India, which included health care workers, police personnel, municipality/ sanitation staff, residents of urban slums, vendors, press staff, and prisoners, were recruited into the study after obtaining written informed consent. Blood samples collected from the study participants were tested for IgG antibodies against COVID-19 in Roche Cobas e441. Information on socio-demographic variables, association with a confirmed or suspected case, symptoms profile of individuals within 30 days, travel and history of testing for COVID-19 were collected. All the statistical analyses were performed using STATA 16.0 (Stata corp., Texas). A P value ≤ 0.05 was considered statistically significant. Results: Of the 5434 individuals included in the final analysis, the overall COVID-19 seroprevalence was found to be 34.9% (95% CI 33.6-36.2). The seroprevalence varied from 21.8% (95% CI 19.6-24.1) in Rourkela to 54.9% (95% CI 51.5-58.2) in Bhubaneswar. Seropositivity was maximum among prisoners (47.7%, 138/289), followed by municipality/ sanitation staff (43.5%, 330/758), other office going staff (40.8%, 183/448), slum residents and vendors (39.8%, 252/633), police personnel (38.3%, 354/922), health care workers (27.1%, 536/1977), press staff (27.2%, 18/66) and residents of containment zones (25.2%, 86/341). On multivariate logistic regression, participants aged 18-29 years, 30-44 years, residents of slums and vending zone, municipality staffs, prisoners, residents of urban sites Malkangiri, Cuttack, Paralakhemundi and Bhubaneswar and those with previous history of confirmed COVID-19 were found to be independent co-relates of seropositivity.Conclusions: Risk of COVID-19 infection varied among the various high risk groups of Odisha. Periodic seroprevalence studies in future is essential to protect personnel involved in frontline activities during the ongoing pandemic.

scholarly journals COVID – 19 related knowledge and preventive practices early in the outbreak among health care workers in selected public health facilities of Illu aba Bor and Buno Bedelle zones, Southwest Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dereje Tsegaye ◽  
Muluneh Shuremu ◽  
Dereje Oljira ◽  
Sileshi Dubale ◽  
Getachew Befekadu ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Workers ◽  
Personal Protective Equipment ◽  
Infection Prevention ◽  
Health Facilities ◽  
Protective Equipment ◽  
Southwest Ethiopia ◽  
Preventive Practices ◽  
Care Workers

Abstract Background Novel-coronavirus 2019 (COVID-19) disease is currently a worldwide health risk and public health emergency concern. The virus is transmitted from an infected person to another person through close contact and droplets. Frontline health care workers are the most at risk of infection, and so a WHO interim guidance document was issued by the World Health Organization (WHO) which underscores the importance of proper sanitation and waste management practices for COVID- 19 in health-care settings. This study aimed at assessing knowledge and preventive practices towards Covid-19 among health care providers in selected health facilities of Illu Aba Bor and Buno Bedele zones, Southwest Ethiopia. Methods An institution-based cross-sectional study was conducted from April to May 2020 among 330 health workers in selected health facilities of Illu Aba Bor and Buno-Bedelle Zones, Southwest Ethiopia. Data were collected using a self-administered structured questionnaire. The collected data were entered into Epidata version 3.1 and exported to SPSS version 23 for analysis. Bivariate and multivariable logistic regression analysis was used to identify independent predictors of preventive practices towards Covid-19. Statistical significance was declared at a p-value of < 0.05. Result The majority of respondents (93.3%) demonstrated good knowledge of COVID-19, and the mean (SD) knowledge score was 9.04 ± 1.06. Nearly two-thirds (64.2%) of the study participants had good infection prevention practices. Being male (AOR = 3.65, 95% CI: (1.96, 6.80)), education level (AOR = 1.82, 95% CI (1.02, 3.22)), profession (AOR = 3.17, 95% CI (1.08, 9.33)), service year (5–10 years) (AOR = 2.00 (1.02, 3.92)) and more than 10 years (AOR = 3.14 (1.51, 6.52)), availability of personal protective equipment (AOR = 1.96 (1.06, 3.61)) and Knowledge level (AOR = 2.61 (1.48, 4.62)) were independent predictors of COVID-19 preventive practices. Conclusion The overall level of knowledge of HCWs was good. However, the practice was relatively low. Gender, educational status, profession, year of service, knowledge towards COVID-19, and availability of personal protective equipment were independent predictors of good infection prevention practices. Optimizing the infection prevention and control loop of the health facilities is recommended.

scholarly journals Adherence to personal protective equipment use among healthcare workers caring for confirmed COVID-19 and alleged non-COVID-19 patients

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Meike M. Neuwirth ◽  
Frauke Mattner ◽  
Robin Otchwemah
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
University Hospital ◽  
Protective Equipment ◽  
Care Workers

AbstractAdherence observations of health care workers (HCW) revealed deficiencies in the use of recommended personal protective equipment (PPE) among HCW caring in COVID-19 and non-COVID-19 wards during the first period of the SARS-CoV-2 pandemic in a university hospital in Germany. The adherence to wearing surgical face or FFP2-masks and disinfecting hands prior to donning and after doffing the PPE was significantly higher in COVID-19 wards However, there was no total adherence of 100% in COVID-19 wards.

scholarly journals Incidence of COVID-19 infection amongst the high risk versus low risk health care workers: an audit from a tertiary cancer care centre

2021 ◽  
Vol 8 (7) ◽  
pp. 3474
Author(s):  
Nitin Shetty ◽  
Nivedita Chakrabarty ◽  
Amit Joshi ◽  
Amar Patil ◽  
Suyash Kulkarni ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Health Care Workers ◽  
Cancer Care ◽  
Low Risk ◽  
Care Centre ◽  
Protective Measures ◽  
Care Workers ◽  
Significant Difference ◽  
Treatment Research

Background: Theoretically, health care workers (HCW) are at increased risk of getting infected with COVID-19 compared to the general population. Limited data exists regarding the actual incidence of COVID-19 infection amongst the high risk and low risk HCW of the same hospital. We present an audit from our tertiary cancer care centre comparing the COVID-19 infection rate between the high risk and low risk HCW, all of whom had been provided with adequate protective measures and health education.Methods: This is a retrospective observational study from 01 April 2020 to 30 September 2020, in which all the 970 HCW of Advanced Centre for Treatment, Research and Education in Cancer were divided into high risk and low risk groups. High risk HCW included all the medical and non-medical staff directly involved with the care of COVID-19 patients, and rest were low risk HCW. Adequate protective measures and classes for infection prevention were provided to all the HCW. We calculated the incidence of COVID-19 infection in both these groups based on the positive real time-polymerase chain reaction (RT-PCR) result and also looked for any significant difference in incidence between these two groups.Results: The incidence of COVID-19 infection amongst the high risk HCW was 13% and that of low risk HCW was 14%.Conclusions: We found no significant difference in COVID-19 infection between the high risk and low risk HCW. Thus, along with protective measures, behavior modifications induced by working in high risk areas, prevented the high risk HCW from getting increased COVID-19 infection compared to the low risk HCW.

Sign in / Sign up

Export Citation Format

Share Document