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

Author(s):  
Jongtak Jung ◽  
Kyoung-Ho Song ◽  
Hyeonju Jeong ◽  
Sin Young Ham ◽  
Eu Suk Kim ◽  
...  

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.

2021 ◽  
Author(s):  
Jongtak Jung ◽  
Kyoung-Ho Song ◽  
Hyeonju Jeong ◽  
Sin Young Ham ◽  
Eu Suk Kim ◽  
...  

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 cover for body protection during the management of patients with COVID-19. Methods PPE samples were collected from physicians exiting a room after the management of a patient with severe to critical COVID-19 who was within 14 days after symptom onset. The PPE sites were categorized into coverall-only parts (the 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). Environmental sampling was performed in patient rooms. We tried 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 PPE and 28 swabs from patient rooms were collected. Of the PPE swabs, only three (2.8 %) swabs from gown-covered parts were contaminated by SARS-CoV-2. However, 23 of the total 28 sites (82.1%) from patient rooms were contaminated. There was significant difference in the contamination of PPE between coverall-only and gown-covered parts (0.0 vs 6.7%, p = 0.022). Conclusions Coverall contamination rarely occurred while managing severe to critical COVID-19 patients residing in negative pressure rooms in the early stages of the illness. Long-sleeved gowns may be used safely in the management of COVID-19 patients.


Author(s):  
Roberto Barcala-Furelos ◽  
Cristian Abelairas-Gómez ◽  
Alejandra Alonso-Calvete ◽  
Francisco Cano-Noguera ◽  
Aida Carballo-Fazanes ◽  
...  

Abstract Introduction: On-boat resuscitation can be applied by lifeguards in an inflatable rescue boat (IRB). Due to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2) and recommendations for the use of personal protective equipment (PPE), prehospital care procedures need to be re-evaluated. The objective of this study was to determine how the use of PPE influences the amount of preparation time needed before beginning actual resuscitation and the quality of cardiopulmonary resuscitation (CPR; QCPR) on an IRB. Methods: Three CPR tests were performed by 14 lifeguards, in teams of two, wearing different PPE: (1) Basic PPE (B-PPE): gloves, a mask, and protective glasses; (2) Full PPE (F-PPE): B-PPE + a waterproof apron; and (3) Basic PPE + plastic blanket (B+PPE). On-boat resuscitation using a bag-valve-mask (BVM) and high efficiency particulate air (HEPA) filter was performed sailing at 20km/hour. Results: Using B-PPE takes less time and is significantly faster than F-PPE (B-PPE 17 [SD = 2] seconds versus F-PPE 69 [SD = 17] seconds; P = .001), and the use of B+PPE is slightly higher (B-PPE 17 [SD = 2] seconds versus B+PPE 34 [SD = 6] seconds; P = .002). The QCPR remained similar in all three scenarios (P >.05), reaching values over 79%. Conclusion: The use of PPE during on-board resuscitation is feasible and does not interfere with quality when performed by trained lifeguards. The use of a plastic blanket could be a quick and easy alternative to offer extra protection to lifeguards during CPR on an IRB.


2020 ◽  
Vol 26 (6) ◽  
pp. 1-4
Author(s):  
Melissa Loh ◽  
Karthikeyan Iyengar ◽  
William YC Loh

The effect of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on the NHS in the UK has been profound and unprecedented. Many surgical specialities, including dentistry, throughout the country have not been exempt from this effect. As there are many aerosol-generating procedures and aerosol-generating exposures in surgical specialities, there has been a substantial cancellation of elective treatment. This has been in part because of the limited availability of personal protective equipment for surgeons as this is being use elsewhere by clinicians to aid the reduction of viral spread in the community. As the UK is preparing to emerge from the ‘lockdown’ during the pandemic, restarting elective surgical and dental treatment is an expected challenge. This article looks at the possible roadmap to recovery of elective surgical management and dentistry, taking into consideration possible predicted further peaks and troughs of COVID-19 infections.


2020 ◽  
Vol 35 (4) ◽  
pp. 364-371 ◽  
Author(s):  
Richard J. Salway ◽  
Trenika Williams ◽  
Camilo Londono ◽  
Patricia Roblin ◽  
Kristi Koenig ◽  
...  

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.


2020 ◽  
Vol 38 (8) ◽  
pp. 820-824 ◽  
Author(s):  
Seung-Whee Rhee

With the rapid spread of coronavirus disease 2019 (COVID-19), the amount of used personal protective equipment (PPE) including face masks and protective clothes has significantly increased. This used PPE in a hospital can lead to the indirect infection by COVID-19. Accordingly, it has been recognized that the management of used PPE is very important to prevent the spread of COVID-19. Through the experience of spreading some infectious diseases such as severe acute respiratory syndrome, Middle East respiratory syndrome and Ebola virus in South Korea (Republic of Korea), a safe management method of waste related to infectious diseases has been developed. In addition, regarding waste related to COVID-19, the Ministry of Environment, SK, proposed special measures to strengthen the management process of waste related to COVID-19 based on principles such as sustainability, transparency and safety.


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

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.


2020 ◽  
Vol 10 (02) ◽  
pp. 49-56
Author(s):  
Krishna Prasad D ◽  
Anupama Prasad D ◽  
Mayank Kumar Parakh

AbstractThe coronavirus disease-2019 (COVID-19) is a pandemic the world is currently facing head on. It is a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). No current vaccine is available nor a curative treatment option is available at present, thus making it even more important to prevent the disease. Since dentists are in very close contact with their patients and there is aerosol production in various dental treatments, they are at a heightened risk of contracting the disease. To prevent the disease, strict hand and respiratory hygiene needs to be followed. Personal protective equipment should be used for any emergency procedures and thorough history must be taken of every patient. Digitalization of seminars and classes has been adopted by various dental institutions. With high infectivity of the virus, social distancing and stringent prevention protocols can help in controlling this severe global threat.


Author(s):  
Anoshe Aslam ◽  
Jessica Singh ◽  
Elizabeth Robilotti ◽  
Karin Chow ◽  
Tarun Bist ◽  
...  

Abstract Background New York City (NYC) experienced a surge of coronavirus disease 2019 (COVID-19) cases in March and April 2020. Since then, universal polymerase chain reaction (PCR)–based surveillance testing and personal protective equipment (PPE) measures are in wide use in procedural settings. There is limited published experience on the utility and sustainability of PCR-based surveillance testing in areas with receding and consistently low community COVID-19 rates. Methods The study was conducted at a tertiary care cancer center in NYC from 22 March to 22 August 2020. Asymptomatic patients underwent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing before surgeries, interventional radiology procedures, and endoscopy. Contact tracing in procedural areas was done if a patient with an initial negative screen retested positive within 48 hours of the procedure. Results From March 22 until August 22, 2020, 11 540 unique patients underwent 14 233 tests before surgeries or procedures at Memorial Sloan Kettering Cancer Center. Overall, 65 patients were positive, with a peak rate of 4.3% that fell below 0.3% after April 2020. Among the 65 positive cases, 3 were presymptomatic and 38 were asymptomatic. Among asymptomatic test-positive patients, 76% had PCR cycle threshold &gt;30 at first detection. Five patients tested newly positive in the immediate postoperative period, exposing 82 employees with 1 case of probable transmission (1.2%). Conclusions The prevalence of SARS-CoV-2 infection identified on preprocedural surveillance was low in our study, which was conducted in an area with limited community spread at the later stage of the study. Universal PPE is protective in procedural settings. Optimal and flexible diagnostic strategies are needed to accomplish and sustain the goals of comprehensive preprocedure surveillance testing.


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