scholarly journals Intubation using VieScope vs. Video laryngoscopy in full personal protective equipment – a randomized, controlled simulation trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hannes Ecker ◽  
Simone Kolvenbach ◽  
Holger Herff ◽  
Wolfgang A. Wetsch
Keyword(s):  
Difficult Airway ◽  
Success Rate ◽  
Personal Protective Equipment ◽  
Pass Rate ◽  
Video Laryngoscopy ◽  
Tube Placement ◽  
Protective Equipment ◽  
Randomized Controlled ◽  
Link Type ◽  
Significant Difference

Abstract Background VieScope is a new type of laryngoscope, with a straight, transparent and illuminated blade, allowing for direct line of sight towards the larynx. In addition, VieScope is disposed of after single patient use, which can avoid cross-contaminations of contagious material. This has gained importance especially when treating patients with highly contagious infectious diseases, such as during the SARS-CoV2 pandemic. In this context, VieScope has not been evaluated yet in a clinical study. Material and methods This study compared intubation with VieScope to video-laryngoscopy (GlideScope) in normal and difficult airway in a standardized airway manikin in a randomized controlled simulation trial. Thirty-five medical specialists were asked to perform endotracheal intubation in full personal protective equipment (PPE). Primary endpoint was correct tube position. First-pass rate (i.e., success rate at the first attempt), time until intubation and time until first correct ventilation were registered as secondary endpoints. Results For correct tracheal tube placement, there was no significant difference between VieScope and GlideScope in normal and difficult airway conditions. VieScope had over 91% fist-pass success rate in normal airway setting. VieScope had a comparable success rate to GlideScope in difficult airway, but had a significantly longer time until intubation and time until ventilation. Conclusion VieScope and GlideScope had high success rates in normal as well as in difficult airway. There was no unrecognized esophageal intubation in either group. Overall time for intubation was longer in the VieScope group, though in an acceptable range given in literature. Results from this simulation study suggest that VieScope may be an acceptable alternative for tracheal intubation in full PPE. Trial Registration The study was registered at the German Clinical Trials Register www.drks.de (Registration date: 09/11/2020; TrialID: DRKS00023406).

scholarly journals Influence of Personal Protective Equipment on the Quality of Chest Compressions: A Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 8 ◽  
Author(s):  
Ying Cui ◽  
Siyi Jiang
Keyword(s):  
Personal Protective Equipment ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Protective Equipment ◽  
Chest Compressions ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Simulation Based ◽  
Reduced Rate

Background: Randomized controlled trials (RCTs) evaluating the influence of personal protective equipment (PPE) on quality of chest compressions during cardiopulmonary resuscitation (CPR) showed inconsistent results. Accordingly, a meta-analysis was performed to provide an overview.Methods: Relevant studies were obtained by search of Medline, Embase, and Cochrane's Library databases. A random-effect model incorporating the potential heterogeneity was used to pool the results.Results: Six simulation-based RCTs were included. Overall, pooled results showed that there was no statistically significant difference between the rate [mean difference (MD): −1.70 time/min, 95% confidence interval (CI): −5.77 to 2.36, P = 0.41, I2 = 80%] or the depth [MD: −1.84 mm, 95% CI: −3.93 to 0.24, P = 0.11, I2 = 73%] of chest compressions performed by medical personnel with and without PPE. Subgroup analyses showed that use of PPE was associated with reduced rate of chest compressions in studies before COVID-19 (MD: −7.02 time/min, 95% CI: −10.46 to −3.57, P < 0.001), but not in studies after COVID-19 (MD: 0.14 time/min, 95% CI: −5.77 to 2.36, P = 0.95). In addition, PPE was not associated with significantly reduced depth of chest compressions in studies before (MD: −3.34 mm, 95% CI: −10.29 to −3.62, P = 0.35) or after (MD: −0.97 mm, 95% CI: −2.62 to 0.68, P = 0.25) COVID-19. No significant difference was found between parallel-group and crossover RCTs (P for subgroup difference both > 0.05).Conclusions: Evidence from simulation-based RCTs showed that use of PPE was not associated with reduced rate or depth of chest compressions in CPR.

Comparing Training Techniques in Personal Protective Equipment Use

2020 ◽  
Vol 35 (4) ◽  
pp. 364-371 ◽  
Author(s):  
Richard J. Salway ◽  
Trenika Williams ◽  
Camilo Londono ◽  
Patricia Roblin ◽  
Kristi Koenig ◽  
...  
Keyword(s):  
Sample Size ◽  
Personal Protective Equipment ◽  
Emergency Preparedness ◽  
Null Hypothesis ◽  
Small Sample ◽  
Protective Equipment ◽  
Video Training ◽  
Significant Difference ◽  
Demonstration Video ◽  
Training Modalities

AbstractIntroduction:Physicians’ management of hazardous material (HAZMAT) incidents requires personal protective equipment (PPE) utilization to ensure the safety of victims, facilities, and providers; therefore, providing effective and accessible training in its use is crucial. While an emphasis has been placed on the importance of PPE, there is debate about the most effective training methods. Circumstances may not allow for a traditional in-person demonstration; an accessible video training may provide a useful alternative.Hypothesis:Video training of Emergency Medicine (EM) residents in the donning and doffing of Level C PPE is more effective than in-person training.Null Hypothesis:Video training of EM residents in the donning and doffing of Level C PPE is equally effective compared with in-person training.Methods:A randomized, controlled pilot trial was performed with 20 EM residents as part of their annual Emergency Preparedness training. Residents were divided into four groups, with Group 1 and Group 2 viewing a demonstration video developed by the Emergency Preparedness Team (EPT) and Group 3 and Group 4 receiving the standard in-person demonstration training by an EPT member. The groups then separately performed a donning and doffing simulation while blinded evaluators assessed critical tasks utilizing a prepared evaluation tool. At the drill’s conclusion, all participants also completed a self-evaluation survey about their subjective interpretations of their respective trainings.Results:Both video and in-person training modalities showed significant overall improvement in participants’ confidence in doffing and donning PPE equipment (P <.05). However, no statistically significant difference was found in the number of failed critical tasks in donning or doffing between the training modalities (P >.05). Based on these results, the null hypothesis cannot be rejected. However, these results were limited by the small sample size and the study was not sufficiently powered to show a difference between training modalities.Conclusion:In this pilot study, video and in-person training were equally effective in training for donning and doffing Level C PPE, with similar error rates in both modalities. Further research into this subject with an appropriately powered study is warranted to determine whether this equivalence persists using a larger sample size.

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 Are coveralls required as personal protective equipment during the management of COVID-19 patients?

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Jongtak Jung ◽  
Kyoung-Ho Song ◽  
Hyeonju Jeong ◽  
Sin Young Ham ◽  
Eu Suk Kim ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Symptom Onset ◽  
Personal Protective Equipment ◽  
Dorsal Surface ◽  
Protective Equipment ◽  
Anterior Neck ◽  
Frontal Surface ◽  
Significant Difference ◽  
Anterior Side ◽  
Contact Surfaces

Abstract Objectives Few studies have investigated the contamination of personal protective equipment (PPE) during the management of patients with severe-to-critical coronavirus disease (COVID-19). This study aimed to determine the necessity of coveralls and foot covers for body protection during the management of COVID-19 patients. Methods PPE samples were collected from the coveralls of physicians exiting a room after the management of a patient with severe-to-critical COVID-19 within 14 days after the patient’s symptom onset. The surface of coveralls was categorized into coverall-only parts (frontal surface of the head, anterior neck, dorsal surface of the foot cover, and back and hip) and gown-covered parts (the anterior side of the forearm and the abdomen). Sampling of the high-contact surfaces in the patient’s environment was performed. We attempted to identify significant differences in contamination with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between the coverall-only and gown-covered parts. Results A total of 105 swabs from PPEs and 28 swabs from patient rooms were collected. Of the PPE swabs, only three (2.8%) swabs from the gown-covered parts were contaminated with SARS-CoV-2. However, 23 of the 28 sites (82.1%) from patient rooms were contaminated. There was a significant difference in the contamination of PPE between the coverall-only and gown-covered parts (0.0 vs 10.0%, p = 0.022). Conclusions Coverall contamination rarely occurred while managing severe-to-critical COVID-19 patients housed in negative pressure rooms in the early stages of the illness. Long-sleeved gowns may be used in the management of COVID-19 patients.

scholarly journals The midline approach for endotracheal intubation using GlideScope video laryngoscopy could provide better glottis exposure in adults： A randomized controlled trial

2019 ◽  
Author(s):  
Lianxiang Jiang ◽  
Shulin Qiu ◽  
Peng Zhang ◽  
Weidong Yao ◽  
Yan Chang ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Endotracheal Intubation ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Video Laryngoscopy ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Midline Approach ◽  
Approach Group

Abstract Background: Previous studies have demonstrated that the common laryngoscopic approach (right-sided) and midline approach are both used for endotracheal intubation by direct laryngoscopy. Although the midline approach is commonly recommended for video laryngoscopy (VL) in the clinic, there is a lack of published evidences to support this practice. This study aimed to evaluate the effects of different video laryngoscopic approaches on intubation. Methods: Two hundred sixty-two patients aged 18 years who underwent elective surgery under general anaesthesia and required endotracheal intubation were included in the present prospective, randomized, controlled study. The participants were randomly and equally allocated to the right approach (Group R) or midline approach (Group M). All the intubations were conducted by experienced anaesthetists using GlideScope video laryngoscopy. The primary outcomes were Cormack-Lehane laryngoscopic views (CLVs) and first-pass success (FPS) rates. The secondary outcomes were the time to glottis exposure, time to tracheal intubation, haemodynamic responses and other adverse events. Comparative analysis was performed between the groups. Results: Finally, 262 patients completed the study, and all the tracheas were successfully intubated. No significant differences were observed in the patient characteristics and airway assessments ( P >0.05). Compared with Group R, Group M had a better CLV ( χ2 =14.706, P =0.001) and shorter times to glottis exposure (8.82±2.04 vs 12.38±1.81; t =14.94; P <0.001) and tracheal intubation (37.19±5.01 vs 45.23±4.81; t =13.25; P <0.001), but no difference was found in the FPS rate (70.2% vs 71.8%; χ2 =0.074; P =0.446) and intubation procedure time (29.86±2.56 vs 30.46±2.97, t =1.75, P =0.081). Between the groups, the rates of hoarseness or sore throat, minor injury, hypoxemia and changes in SBP and HR showed no significant difference ( P >0.05). Conclusion: Although the FPS rate did not differ based on the laryngoscopic approach, the midline approach could provide better glottis exposure and shorter times to glottis exposure and intubation. The midline approach should be recommended for teaching in VL-assisted endotracheal intubation. Trial registration: The study was registered in the Chinese Clinical Trial Registry ( ChiCTR-RNC-1900023252 ).

scholarly journals Contamination Risk in Indonesian Youtube Videos on Personal Protective Equipment for Corona Virus Disease

2021 ◽  
Vol 9 (2) ◽  
pp. 83-90
Author(s):  
Laksita Barbara ◽  
Mareta Dea Rosaline ◽  
Akhiyan Hadi Susanto
Keyword(s):  
World Health Organization ◽  
Personal Protective Equipment ◽  
Virus Disease ◽  
World Health ◽  
Average Score ◽  
Protective Equipment ◽  
Corona Virus ◽  
Significant Difference ◽  
Youtube Videos ◽  
Health Organization

AbstractThere are numbers of Indonesian Youtube Videos that show steps to wear and remove Personal Protective Equipment (PPE) for Corona Virus Disease (COVID19). However, the conformity with the current guidelines remains unknown. This paper aims to determine the validity of these videos based on the World Health Organization (WHO) guidelines. We searched on the Youtube website for videos in donning and doffing PPE for droplet precaution and selected the videos using inclusion and exclusion criteria. Included videos were then evaluated with a checklist derived from WHO course on donning and doffing PPE for COVID-19 and WHO recommendation on PPE for Covid-19. The search that was undertaken resulted in 66 videos, and 40 videos were included for evaluation. There is no significant difference in the donning and doffing score between account types (personal, organizational/institutional, news). The average number of viewers of all videos is more than 2700 viewers. The average score of donning is less than 70% of the total score, and the average doffing score is under 65%. The vast majority of the videos do not follow the WHO recommendation on the PPE type and use more equipment than recommended. There are several contamination risks shown by the videos. Indonesian Youtube videos on PPE procedures for COVID-19 must be selected carefully to be used as an instructional or educational media since most of it presents a high risk of cross-contamination.Keyword: personal protective equipment, audiovisual, cross-contamination, trainingAbstrakTerdapat video dalam Bahasa Indonesia yang terkait cara memakai dan melepaskan Alat Pelindung Diri (APD) untuk Corona Virus Disease (COVID19). Namun, kesesuaian video terhadap pedoman terkini belum diketahui. Penelitian ini bertujuan untuk menentukan validitas video berdasarkan pedoman World Health Organization. Kami menelusuri Youtube untuk memperoleh video instruksi mengenakan dan melepas APD pencegahan kontaminasi droplet dan menyeleksi video tersebut berdasarkan kriteria inklusi dan eksklusi. Video yang telah diseleksi kemudian dievaluasi menggunakan checklist yang diturunkan dari langkah-langkah yang ditunjukan dalam kursus APD COVID-19 yang disediakan oleh WHO, serta rekomendasi APD dari WHO. Penelusuran Youtube menampilkan 66 video, dan dipilih 40 video yang sesuai dengan kriteria kelayakan. Tidak terdapat perbedaan signifikan dalam skor mengenakan dan melepaskan APD antara akun personal, organisasi/institusi, dan berita. Rata-rata jumlah penonton video adalah lebih dari 2700. Skor rata-rata pemakaian APD kurang dari 70% dari skor total, dan skor pelepasan APD kurang dari 65%. Sebagian besar video tidak mengikuti rekomendasi WHO dalam pemilihan tipe PPE dan menggunakan alat yang lebih banyak dari yang direkomendasikan. Terdapat sejumlah risiko kontaminasi yang dapat diobservasi dari langkah-langkah yang ditunjukan dalam video. Video Youtube prosedur APD untuk COVID-19 perlu diseleksi dengan cermat untuk digunakan sebagai media instruksi maupun pendidikan karena sebagian besar menunjukan risiko tinggi kontaminasi silang.Kata Kunci: alat pelindung diri, audiovisual, kontaminasi silang, pelatihan

scholarly journals 70 Availability of Personal Protective Equipment in NHS Hospitals During COVID-19: A National Survey

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Mantelakis ◽  
H Spiers ◽  
C W Lee ◽  
A Chambers ◽  
A Joshi
Keyword(s):  
Intensive Care ◽  
Personal Protective Equipment ◽  
Healthcare Professionals ◽  
Protective Equipment ◽  
Professional Groups ◽  
Safe Level ◽  
Significant Difference ◽  
The Uk ◽  
Question Survey ◽  
Full Body

Abstract Introduction The continuous supply of personal protective equipment (PPE) in the National Health Service (NHS) is paramount in order to sustain a safe level of staffing and to reduce transmission of COVID-19 to patients, public and staff. Method A 16-question survey was created to assess the availability and personal thoughts of healthcare professionals regarding PPE supply in England. The survey was distributed via social media (Facebook © and Twitter ©) to all UK COVID-19 healthcare professional groups, with responses collected over 3 weeks in March 2020 during the beginning of the pandemic. Results A total of 121 responses from physicians in 35 different hospitals were collected (105 inpatient wards, 16 from intensive care units). In inpatient wards, eye and face protection were unavailable to 19.1% of respondents. Masks were available to 97.7% of respondents and gloves in all respondents (100%). Body protection was available primarily as a plastic apron (83.8%). All of respondents working in intensive care had access to full-body PPE, except FFP3 respirator masks (available in 87.5%). PPE is ‘Always’ available for 29.8% of all respondents, and ‘Never’ or ‘Almost Never’ in 11.6%. There was a statistically significant difference between London and non-London responders that ‘Always’ had PPE available (43.9% versus 19.0%, p = 0.003). Conclusions This is the first survey to evaluate PPE supply in England during the COVID-19 pandemic. Our survey demonstrated an overall lack of PPE volume supply in the UK, with preferential distribution in London. Eye and full body protection are in most lack of supply.

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