Patient generated aerosol in the context of ophthalmic surgery

2021 ◽  
pp. 112067212110378
Author(s):  
Rodrigo Anguita ◽  
Nicholas Brennan ◽  
Conor M Ramsden ◽  
Manjit Mehat ◽  
David Keegan ◽  
...  
Keyword(s):  
High Speed ◽  
Face Mask ◽  
Simulated Patients ◽  
Protective Equipment ◽  
Schlieren Imaging ◽  
Ophthalmic Surgery ◽  
Clinical Scenarios ◽  
Surgical Field ◽  
Medical Teams ◽  
Continuous Suction

Objective: To assess the patterns of patient generated aerosol in the context of ophthalmic surgery and ophthalmic examinations. To inform medical teams regarding potential hazards and suggest mitigating measures. Methods: Qualitatively, real-time time videography assessed exhalation patterns from simulated patients under different clinical scenarios using propylene glycol from an e-cigarette. Quantitatively, high-speed Schlieren imaging was performed to enable high resolution recordings analysable by MATLAB technical computing software. Results: Without a face mask, the standard prior to COVID 19, vapour was observed exiting through the opening in the drape over the surgical field. The amount of vapour increased when a surgical mask was worn. With a taped face mask, the amount of vapour decreased and with inclusion of a continuous suction device, the least amount of vapour was seen. These results were equivocal when the patient was supine or sitting upright. High-speed Schlieren imaging corroborated these findings and in addition showed substantial increase in airflow egress during coughing and with ill-fitting face masks. Conclusion: Advising patients to wear a surgical mask at the time of ophthalmic interventions potentially contaminants the ocular field with patient generated aerosol risking endophthalmitis. Surgeon safety can be maintained with personal protective equipment to mitigate the increased egress of vapour from the surgical drape and taping, with or without suction is advisable, whilst meticulous hygiene around lenses is required at the time of slit lamp examination.

scholarly journals Use of Respiratory Protection Devices by Medical Students During the COVID-19 Pandemic

2021 ◽  
Vol 18 (11) ◽  
pp. 5834
Author(s):  
Ekaterina A. Shashina ◽  
Valentina V. Makarova ◽  
Denis V. Shcherbakov ◽  
Tatiana S. Isiutina-Fedotkova ◽  
Nadezhda N. Zabroda ◽  
...  
Keyword(s):  
Medical Students ◽  
Face Mask ◽  
Protective Measure ◽  
Protective Equipment ◽  
Respiratory Protection ◽  
Prevention Measures ◽  
Protection Devices ◽  
Individual Use

The use of face masks has assumed a leading spot among nonspecific prevention measures during the coronavirus pandemic. The effectiveness of this protective measure depends on the specifics of individual use. The purpose of our study was to analyze the use of respiratory protective equipment (RPE) by medical students during the COVID-19 pandemic. The evaluation of face mask use was based on the results of a survey of medical students at Sechenov University. There were 988 participants in the study: 97.5% used RPE during the pandemic, 89.1% used disposable medical and hygienic face masks, 27.4% used reusable cloth face masks, and 13.2% used respirators. The majority of respondents (75.2%) were found to wear face masks correctly. However, 17.0% of the respondents were found to cover only their mouths with a face mask, while 7.8% reported often shifting their face mask under the chin due to perceived discomfort. Only 25.1% of respondents changed their disposable face mask after 2-3 h of wearing, while 13.0% decontaminated and used it several times. Most cloth face mask users (93.7%) decontaminated their marks, but only 55.7% of respondents did so daily. Face masks were most often worn in medical organizations (91.5%), and 1.4% of respondents did not use respiratory protection anywhere. In conclusion, we consider it necessary to introduce a special module on nonspecific prevention in the discipline of hygiene.

Feasibility study: Proposed alternative to N95 respirator during the personal protective equipment shortage from COVID-19 pandemic

2021 ◽  
Vol 19 (7) ◽  
pp. 192-202
Author(s):  
Ahel El Haj Chehade, MD ◽  
Jesintha Stephenson, MD ◽  
Evan Floyd, PhD ◽  
Jean Keddissi, MD, FCCP ◽  
Tony Abdo, MD ◽  
...  
Keyword(s):  
Pulse Oximetry ◽  
Feasibility Study ◽  
Personal Protective Equipment ◽  
Geometric Mean ◽  
Face Mask ◽  
The United States ◽  
Geometric Standard Deviation ◽  
Protective Equipment ◽  
Health Administration ◽  
Fit Testing

Introduction: Having an adequate supply of personal protective equipment during the COVID-19 pandemic has been a constant challenge for hospitals across the United States. In the event of shortages, our assembled mask might offer noninferior protection compared to an N95 respirator. Objective: To study the ability of an assembled mask to pass a quantitative fit testing.Methods: We conducted a feasibility study at the Oklahoma City Veteran Affairs Health Care System. Volunteers were fitted with an assembled mask made of either a Hans Rudolph half-face mask or a Respironics Performax full-face mask, attached to an Iso-Gard HEPA light Filter 28022 through a Performax SE elbow hinge. Quantitative fit testing was conducted using the Occupation Safety and Health Administration fit testing protocol. The primary outcome was the percentage of participants who pass the quantitative fit test. Secondary outcomes included the overall fit factor (FF), average FF for different exercises, changes in pulse oximetry and endtidal CO2 at 0 and 15 minutes, willingness to use the mask, and visibility assessment.Results: Twenty participants completed the study, and all (100 percent) passed the quantitative fit testing. The overall FF had a geometric mean of 2,317 (range: 208-16,613) and a geometric standard deviation of 3.8. The lowest FF was recorded while the subjects were talking. Between time 0 and 15 minutes, there was no clinically significant change in pulse oximetry and end-tidal CO2 levels. Most participants reported “very good” visibility and were “highly likely” to use the Hans Rudolph half-face mask in the case of shortage.Conclusion: Our assembled respirator offers noninferior protection to N95 respirators in the setting of hypothetical protective equipment shortage.

Respiratory viruses on personal protective equipment and bodies of healthcare workers

2019 ◽  
Vol 40 (12) ◽  
pp. 1356-1360 ◽  
Author(s):  
Linh T. Phan ◽  
Dagmar Sweeney ◽  
Dayana Maita ◽  
Donna C. Moritz ◽  
Susan C. Bleasdale ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Viral Infections ◽  
Quantitative Polymerase Chain Reaction ◽  
Face Mask ◽  
Respiratory Viruses ◽  
The Body ◽  
Protective Equipment ◽  
Bare Hand ◽  
Polymerase Chain

AbstractObjective:To characterize the magnitude of virus contamination on personal protective equipment (PPE), skin, and clothing of healthcare workers (HCWs) who cared for patients having acute viral infections.Design:Prospective observational study.Setting:Acute-care academic hospital.Participants:A total of 59 HCWs agreed to have their PPE, clothing, and/or skin swabbed for virus measurement.Methods:The PPE worn by HCW participants, including glove, face mask, gown, and personal stethoscope, were swabbed with Copan swabs. After PPE doffing, bodies and clothing of HCWs were sampled with Copan swabs: hand, face, and scrubs. Preamplification and quantitative polymerase chain reaction (qPCR) methods were used to quantify viral RNA copies in the swab samples.Results:Overall, 31% of glove samples, 21% of gown samples, and 12% of face mask samples were positive for virus. Among the body and clothing sites, 21% of bare hand samples, 11% of scrub samples, and 7% of face samples were positive for virus. Virus concentrations on PPE were not statistically significantly different than concentrations on skin and clothing under PPE. Virus concentrations on the personal stethoscopes and on the gowns were positively correlated with the number of torso contacts (P < .05). Virus concentrations on face masks were positively correlated with the number of face mask contacts and patient contacts (P < .05).Conclusions:Healthcare workers are routinely contaminated with respiratory viruses after patient care, indicating the need to ensure that HCWs complete hand hygiene and use other PPE to prevent dissemination of virus to other areas of the hospital. Modifying self-contact behaviors may decrease the presence of virus on HCWs.

Full-scale high-speed schlieren imaging of explosions and gunshots

2005 ◽  
Author(s):  
Gary S. Settles ◽  
Torben P. Grumstrup ◽  
Lori J. Dodson ◽  
J. D. Miller ◽  
Joseph A. Gatto
Keyword(s):  
High Speed ◽  
Full Scale ◽  
Schlieren Imaging

High-Speed Schlieren Imaging and Hot-wire Characterization of Cylinder-Induced Hypersonic Shock Boundary Layer Interactions

2018 ◽  
Author(s):  
Andrew Leidy ◽  
Ian T. Neel ◽  
Nathan R. Tichenor ◽  
Rodney D. Bowersox ◽  
John D. Schmisseur
Keyword(s):  
Boundary Layer ◽  
High Speed ◽  
Hot Wire ◽  
Schlieren Imaging ◽  
Hypersonic Shock

scholarly journals COVID-19 Disposable Face Masks: a Precursor for Synthesis of Valuable Bioproducts

2021 ◽  
Author(s):  
Oluwatosin Oginni
Keyword(s):  
Environmental Impact ◽  
Environmental Pollution ◽  
Personal Protective Equipment ◽  
Face Mask ◽  
Protective Equipment ◽  
Thermoplastic Polymers ◽  
Secondary Transmission

Abstract Disposable face mask has become a mandatory personal protective equipment in order to prevent contracting COVID-19. With the significant surge in its usage, its adverse environmental impact is becoming a source of concern. Disposable face masks are made from thermoplastic polymers and therefore they can be safely converted into valuable bioproducts. This paper discussed the possibility of converting waste/contaminated face masks into valuable bioproducts, which will essentially eliminate secondary transmission of the coronavirus and the concerns of environmental pollution.

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