scholarly journals Lung Ultrasonography in Ruling Out COVID-19 Among Health Care Workers in Two Italian Emergency Departments: A Multicenter Study

2021 ◽  
pp. 875647932110376
Author(s):  
Roberto Copetti ◽  
Giulia Amore ◽  
Caterina Anna Giudice ◽  
Daniele Orso ◽  
Silvia Cola ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Emergency Departments ◽  
Nasopharyngeal Swab ◽  
Lung Ultrasonography ◽  
Viral Spread ◽  
Health Care Employees ◽  
Multicenter Prospective Observational Study ◽  
Low Sensitivity ◽  
Pcr Test

Objective: The low sensitivity of the real-time reverse transcription-polymerase chain reaction (rRT-PCR) test on the nasopharyngeal swab for SARS-CoV2 virus could cause infections among health care professionals and could be a source of viral spread. The aim of this study was to verify whether lung ultrasonography (LUS) had a negative predictive value (NPV) high enough to rule out coronavirus disease 2019 (COVID-19) in a cohort of health care employees, working in emergency departments (EDs). Materials and Methods: A multicenter prospective observational study was conducted in two EDs in Northeast Italy. An adjudication committee established the definitive diagnosis of COVID-19. Results: A cohort was enrolled of 155 possible patient cases (two true positives). Twenty-one health care employees presented with suggestive symptoms for COVID-19. The rRT-PCR test was positive in one of the two patients. LUS was suggestive for COVID-19 pneumonia in four patients. The diagnostic accuracy of LUS was 98.7% (95% confidence interval [CI] = 95.4%–99.8%). The NPV was 100% (95% CI = 100%–100%). Conclusion: LUS has a high enough NPV for excluding a COVID-19-related pneumonia in a cohort of health care employees who were exposed to the SARS-CoV2 virus.

scholarly journals SARS-CoV-2 antigen rapid diagnostic test enhanced with silver amplification technology

2021 ◽  
Author(s):  
Kei Miyakawa ◽  
Rikako Funabashi ◽  
Yutaro Yamaoka ◽  
Sundararaj Stanleyraj Jeremiah ◽  
Junichi Katada ◽  
...  
Keyword(s):  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Point Of Care ◽  
Rapid Diagnosis ◽  
Clinical Samples ◽  
Nasopharyngeal Swab ◽  
Special Equipment ◽  
Viral Spread ◽  
Silver Amplification ◽  
Low Sensitivity

AbstractRapid diagnosis of COVID-19 is essential for instituting measures to prevent viral spread. SARS-CoV-2 antigen rapid diagnostic test (Ag-RDT) based on lateral flow immunochromatography assay (LFIA) principle can visually indicate the presence of SARS-CoV-2 antigens as a band. Ag-RDT is clinically promising as a point-of-care testing because it can give results in a short time without the need for special equipment. Although various antigen capture LFIAs are now available for rapid diagnosis for SARS-CoV-2 infection, they face the problems of low sensitivity. We have previously developed highly specific monoclonal antibodies (mAb) against SARS-CoV-2 nucleocapsid protein (NP) and in this study, we have employed these mAbs to develop a new LFIA that can detect SARS-CoV-2 NP in nasopharyngeal swab samples with higher sensitivity by combining them with silver amplification technology. We also compared the performance of our Ag-RDT against the commercially available Ag-RDTs using clinical samples to find that our newly developed LFIA performed best among tested, highlighting the superiority of silver amplification technology.

scholarly journals Knowledge sharing between general and pediatric emergency departments: connections, barriers, and opportunities

CJEM ◽  
2018 ◽  
Vol 20 (4) ◽  
pp. 523-531 ◽  
Author(s):  
Leah K. Crockett ◽  
Carly Leggett ◽  
Janet A. Curran ◽  
Lisa Knisley ◽  
Gwenyth Brockman ◽  
...  
Keyword(s):  
Health Care ◽  
Knowledge Sharing ◽  
Health Care Professionals ◽  
Emergency Departments ◽  
Pediatric Emergency ◽  
System Level ◽  
Standards Of Care ◽  
Easy Access ◽  
Network Analyses ◽  
Barriers And Opportunities

ABSTRACTObjectiveTranslating Emergency Knowledge for Kids (TREKK) is a national network aimed at improving emergency care for children by increasing collaborations and knowledge sharing between general and pediatric emergency departments (EDs). This study aimed to determine patterns of knowledge sharing within the network and to identify connections, barriers, and opportunities to obtaining pediatric information and training.MethodsWe conducted 22 semi-structured interviews with health care professionals working in general EDs, purposefully sampled to represent connected and disconnected sites, based on two previous internal quantitative social network analyses (SNA). Data were analyzed by two independent reviewers.ResultsParticipants included physicians (59%) and nurses (41%) from 18 general EDs in urban (68%) and rural/remote (32%) Canada. Health care professionals sought information both formally and informally, by using guidelines, talking to colleagues, and attending pediatric related training sessions. Network structure and processes were found to increase connections, support practice change, and promote standards of care. Participants identified personal, organizational and system level barriers to information and skill acquisition, including resources and personal costs, geography, dissemination, and time. Providing easy access to information at the point of care was promoted through enhancing content visibility and by embedding resources into local systems. There remains a need to share successful methods of local dissemination and implementation across the network, and to leverage local professional champions such as clinical nurse liaisons.ConclusionsThese findings reinforce the critical role of ongoing network evaluation to improve the design and delivery of knowledge mobilization initiatives.

scholarly journals The value of anal swab RT-PCR for COVID-19 diagnosis in adult Indonesian patients

2021 ◽  
Vol 8 (1) ◽  
pp. e000590
Author(s):  
Murdani Abdullah ◽  
Dedy Gunawanjati Sudrajat ◽  
Virly Nanda Muzellina ◽  
Juferdy Kurniawan ◽  
Aulia Rizka ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Gastrointestinal Symptoms ◽  
High Specificity ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Severe Condition ◽  
Hospitalised Patients ◽  
Anal Swab ◽  
Low Sensitivity ◽  
Pcr Test

ObjectiveThis study will test the performance of the anal swab PCR test when compared with the nasopharyngeal swab PCR test as a diagnostic tool for COVID-19.DesignAn observational descriptive study which included hospitalised suspected, or probable cases of hopitalised COVID-19 patients, conducted in Dr. Cipto Mangunkusumo National Hospital, Ciputra Hospital, Mitra Keluarga Depok Hospital and Mitra Keluarga Kelapa Gading Hospital, Indonesia. Epidemiological, clinical, laboratory and radiology data were obtained. Nasopharyngeal and anal swabs specimens were collected for SARS-CoV-2 RNA detection.ResultsWe analysed 136 subjects as part of this study. The clinical spectrum of COVID-19 manifesation in this study was typical of hospitalised patients, with 25% classified as mild cases, 14.7% in severe condition and 12.5% of subjects classified as having acute respiratory distress syndrome. When compared with nasopharyngeal swab as the standard specimen for reverse transcription polymerase chain reaction (RT-PCR) detection of SARS-CoV-2 antigen, the sensitivity and specificity of the anal swab was 36.7% and 93.8%, respectively. The positive and negative predictive value were 97.8% and 16.5 %, respectively. The performance of the anal swab remained similar when only the subgroup of patients with gastrointestinal symptoms (n=92, 67.6%) was analysed (sensitivity 40% and specificity 91.7%). Out of all the subjects included in analysis, 67.6% had gastrointestinal symptoms. Similarly, 73.3% of patients in the anal swab-positive group had gastrointestinal symptoms. The two most common gastrointestinal symptoms in the subjects’ population were nausea and anorexia.ConclusionAnal swab specimen has low sensitivity (36.7%) but high specificity (93.8%) for detecting SARS-CoV-2 antigen by RT-PCR. Only one additional positive result was found by anal swab among the nasopharyngeal swab-negative group. Anal swab may not be needed as an additional test at the beginning of a patient’s diagnostic investigation and nasopharyngeal swab RT-PCR remains as the standard diagnostic test for COVID-19.

scholarly journals Influenza vaccination: opinions of health care professionals working in pediatric emergency departments

2019 ◽  
Vol 45 (1) ◽  
Author(s):  
Luciano Pinto ◽  
Raffaele Falsaperla ◽  
Alberto Villani ◽  
Giovanni Corsello ◽  
Roberto Del Gado ◽  
...  
Keyword(s):  
Health Care ◽  
Influenza Vaccination ◽  
Health Care Professionals ◽  
Emergency Departments ◽  
Pediatric Emergency

scholarly journals Pediatric information seeking behaviour, information needs, and information preferences of health care professionals in general emergency departments: Results from the Translating Emergency Knowledge for Kids (TREKK) Needs Assessment

CJEM ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 89-99 ◽  
Author(s):  
Shannon D. Scott ◽  
Lauren Albrecht ◽  
Lisa M. Given ◽  
Lisa Hartling ◽  
David W. Johnson ◽  
...  
Keyword(s):  
Professional Development ◽  
Health Care ◽  
Child Health ◽  
Emergency Care ◽  
Health Care Professionals ◽  
Information Seeking ◽  
Emergency Departments ◽  
Information Needs ◽  
Pediatric Emergency ◽  
Information Preferences

AbstractThe majority of children requiring emergency care are treated in general emergency departments (EDs) with variable levels of pediatric care expertise. The goal of the Translating Emergency Knowledge for Kids (TREKK) initiative is to implement the latest research in pediatric emergency medicine in general EDs to reduce clinical variation.ObjectivesTo determine national pediatric information needs, seeking behaviours, and preferences of health care professionals working in general EDs.MethodsAn electronic cross-sectional survey was conducted with health care professionals in 32 Canadian general EDs. Data were collected in the EDs using the iPad and in-person data collectors.ResultsTotal of 1,471 surveys were completed (57.1% response rate). Health care professionals sought information on children’s health care by talking to colleagues (n=1,208, 82.1%), visiting specific medical/health websites (n=994, 67.7%), and professional development opportunities (n=941, 64.4%). Preferred child health resources included protocols and accepted treatments for common conditions (n=969, 68%), clinical pathways and practice guidelines (n=951, 66%), and evidence-based information on new diagnoses and treatments (n=866, 61%). Additional pediatric clinical information is needed about multisystem trauma (n=693, 49%), severe head injury (n=615, 43%), and meningitis (n=559, 39%). Health care professionals preferred to receive child health information through professional development opportunities (n=1,131, 80%) and printed summaries (n=885, 63%).ConclusionBy understanding health care professionals’ information seeking behaviour, information needs, and information preferences, knowledge synthesis and knowledge translation initiatives can be targeted to improve pediatric emergency care. The findings from this study will inform the following two phases of the TREKK initiative to bridge the research-practice gap in Canadian general EDs.

Sign in / Sign up

Export Citation Format

Share Document