scholarly journals The Cupola: An Additional Layer of Protection for Providers Working in the Oropharyngeal Region

2021 ◽  
Author(s):  
Alessandro Villa ◽  
Marlene Grenon
Keyword(s):  
Pilot Study ◽  
Personal Protective Equipment ◽  
Airborne Particles ◽  
Protective Equipment ◽  
Additional Layer ◽  
Dental Procedures ◽  
The Mean ◽  
Mechanical Barrier

Abstract ObjectivesTo reduce the spread of the infection, especially during aerosol generating procedures, we invented “The Cupola”, a shield that creates a mechanical barrier around the patient’s head and body. With this pilot study we aimed to assess the effectiveness of an additional layer of protection (The Cupola) developed for providers working in the oropharyngeal region.ResultsThe mean number of 0.3 μm particles with no Cupola was 3777 (SD: ±556), with The Cupola was 2068 (SD: ±1468) and with the Cupola and Drape was 2031 (SD: ±1108) (p<0.015). The mean number of 0.5 μm airborne particles with no Cupola was 65 (SD: ±7), with The Cupola was 29 (SD: ±28) and with the Cupola and Drape was 28 (SD: ±23) (p<0.05). Results showed a significant reduction of aerosols generated during simulated dental procedures when the Cupola was used. The Cupola offers an extra layer of protection in addition to the recommended personal protective equipment.

scholarly journals The Cupola: an additional layer of protection for providers working in the oropharyngeal region

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Alessandro Villa ◽  
Marlene Grenon
Keyword(s):  
Pilot Study ◽  
Personal Protective Equipment ◽  
Airborne Particles ◽  
Protective Equipment ◽  
Additional Layer ◽  
Dental Procedures ◽  
The Mean ◽  
Mechanical Barrier

Abstract Objectives To reduce the spread of the infection, especially during aerosol generating procedures, we invented “The Cupola”, a shield that creates a mechanical barrier around the patient’s head and body. With this pilot study we aimed to assess the effectiveness of an additional layer of protection (The Cupola) developed for providers working in the oropharyngeal region. Results The mean number of 0.3 μm particles with no Cupola was 3777 (SD: ± 556), with The Cupola was 2068 (SD: ± 1468) and with the Cupola and Drape was 2031 (SD: ± 1108) (p < 0.015). The mean number of 0.5 μm airborne particles with no Cupola was 65 (SD: ± 7), with The Cupola was 29 (SD: ± 28) and with the Cupola and Drape was 28 (SD: ± 23) (p < 0.05). Results showed a significant reduction of aerosols generated during simulated dental procedures when the Cupola was used. The Cupola offers an extra layer of protection in addition to the recommended personal protective equipment.

scholarly journals Safe On-Boat Resuscitation by Lifeguards in COVID-19 Era: A Pilot Study Comparing Three Sets of Personal Protective Equipment

2021 ◽  
pp. 1-7
Author(s):  
Roberto Barcala-Furelos ◽  
Cristian Abelairas-Gómez ◽  
Alejandra Alonso-Calvete ◽  
Francisco Cano-Noguera ◽  
Aida Carballo-Fazanes ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cardiopulmonary Resuscitation ◽  
Severe Acute Respiratory Syndrome ◽  
Personal Protective Equipment ◽  
High Efficiency ◽  
Prehospital Care ◽  
Protective Equipment ◽  
Preparation Time

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.

scholarly journals Development and Comparison of Complementary Methods to Study Potential Skin and Inhalational Exposure to Pathogens During Personal Protective Equipment Doffing

2019 ◽  
Vol 69 (Supplement_3) ◽  
pp. S231-S240 ◽  
Author(s):  
Jennifer Therkorn ◽  
David Drewry ◽  
Jennifer Andonian ◽  
Lauren Benishek ◽  
Carrie Billman ◽  
...  
Keyword(s):  
Pilot Study ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Recovery Efficiency ◽  
Breathing Zone ◽  
Tracer Method ◽  
Fluorescent Tracer ◽  
Air Sampler ◽  
Airborne Contamination ◽  
Skin Contamination

Abstract Background Fluorescent tracers are often used with ultraviolet lights to visibly identify healthcare worker self-contamination after doffing of personal protective equipment (PPE). This method has drawbacks, as it cannot detect pathogen-sized contaminants nor airborne contamination in subjects’ breathing zones. Methods A contamination detection/quantification method was developed using 2-µm polystyrene latex spheres (PSLs) to investigate skin contamination (via swabbing) and potential inhalational exposure (via breathing zone air sampler). Porcine skin coupons were used to estimate the PSL swabbing recovery efficiency and limit of detection (LOD). A pilot study with 5 participants compared skin contamination levels detected via the PSL vs fluorescent tracer methods, while the air sampler quantified potential inhalational exposure to PSLs during doffing. Results Average PSL skin swab recovery efficiency was 40% ± 29% (LOD = 1 PSL/4 cm2 of skin). In the pilot study, all subjects had PSL and fluorescent tracer skin contamination. Two subjects had simultaneously located contamination of both types on a wrist and hand. However, for all other subjects, the PSL method enabled detection of skin contamination that was not detectable by the fluorescent tracer method. Hands/wrists were more commonly contaminated than areas of the head/face (57% vs 23% of swabs with PSL detection, respectively). One subject had PSLs detected by the breathing zone air sampler. Conclusions This study provides a well-characterized method that can be used to quantitate levels of skin and inhalational contact with simulant pathogen particles. The PSL method serves as a complement to the fluorescent tracer method to study PPE doffing self-contamination.

scholarly journals The impact of COVID-19 pandemic on dental practice in Iran: a questionnaire-based report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hanie Ahmadi ◽  
Alireza Ebrahimi ◽  
Farhad Ghorbani
Keyword(s):  
Personal Protective Equipment ◽  
Dental Health ◽  
Protective Equipment ◽  
Dental Practice ◽  
Online Questionnaire ◽  
Dental Services ◽  
Emergency Procedures ◽  
Dental Procedures ◽  
Dental Practitioners ◽  
The Impact

Abstract Background The highly contagious nature of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), besides the fact that dental procedures commonly generate blood and saliva droplets that could lead to the contagion have resulted in the closure of many dental clinics. In the present study, we aimed to evaluate the impact of coronavirus disease 2019 (COVID-19) pandemic on dental practice by conducting an online questionnaire among the Iranian dental practitioners and finding their perspectives on the subject. Methods This report is based on a questionnaire that was conducted among Iranian dentists. The survey included questions that evaluate the dentists’ perceptions and attitudes toward the COVID-19 pandemic and its effect on their personal life, financial status, and the quality of dental services for patients. Results Overall, 240 dentists contributed to this study (214 general dentists and 26 specialists). The majority of the participants (n = 170, 70%) did not perform non-emergency procedures during the pandemic. The dental practitioners have suggested several strategies to decrease the risk of contagion, such as reducing treatment sessions (n = 90, 37%), strict triage of patients (n = 156, 64%), and using personal protective equipment (n = 108, 45%). However, most of the dentists (n = 210, 87%) had problems, providing personal protective equipment during the pandemic. Moreover, 97% (n = 234) of the participants reported that they encountered a decrease in their financial income since the eruption of the pandemic. Conclusion Dental health care workers are at the highest risk of contracting COVID-19. Thus, dental practitioners ought to execute the standard protocols more cautiously during the pandemic. They could also lower their work hours and limit dental procedures to emergency treatments to reduce the risk of COVID-19 transmission. Besides, the public organizations should provide proper equipment for the dental practitioners to decrease the risk of contagion.

scholarly journals Life Plus Mini Capsule S®, Novel Intubating Box – A Pilot Study

2021 ◽  
Vol 15 (1) ◽  
pp. 30-33
Author(s):  
Boris Tufegdzic ◽  
Massimo Lamperti ◽  
Kyne Woodsford
Keyword(s):  
Pilot Study ◽  
Endotracheal Intubation ◽  
Personal Protective Equipment ◽  
High Efficiency ◽  
Protective Equipment ◽  
Test Conditions ◽  
Clinical Conditions ◽  
Larger Sample ◽  
Insight Into

To protect clinicians without access to recommended personal protective equipment during aerosol-generating procedures such as endotracheal intubation, various products have been introduced to clinical practice. The authors would like to present a pilot study with a novel intubating box, the LIFE PLUS MINI CAPSULE S®, which has improved systems to prevent the egress of particles from the box as well as a built-in HEPA (High Efficiency Particulate Air) aspiration filter. Nineteen anesthesiologists simulated endotracheal intubation on a mannequin in test conditions with and without using the LIFE PLUS MINI CAPSULE S®. All anesthesiologists successfully intubated the mannequin at first attempt, and there were no failed intubations. The median (range) intubation time was 9.1 (2.0–25.0) seconds longer when the LIFE PLUS MINI CAPSULE S® was used, and there were no breaches of personal protective equipment. The leakage of airborne particles was analyzed using a Qualitative and a Quantitative Fit Test. Although our pilot study shows promising results, further research is required to validate our results in vivo and in a larger sample size which will provide us with a better insight into the efficacy and applicability of this safety tool in emergency and elective clinical conditions.

scholarly journals Systematic review and meta-analysis comparing ventilatory support in chemical, biological and radiological emergencies

2020 ◽  
Vol 28 ◽  
Author(s):  
Israel Baptista de Souza Borges ◽  
Magali Rezende de Carvalho ◽  
Marcel de Souza Quintana ◽  
Alexandre Barbosa de Oliveira
Keyword(s):  
Personal Protective Equipment ◽  
Health Professionals ◽  
Meta Analysis ◽  
Ventilatory Support ◽  
Orotracheal Intubation ◽  
Protective Equipment ◽  
Laryngeal Masks ◽  
Orotracheal Tube ◽  
The Mean ◽  
Meta Analyses

Objective: to compare the mean development time of the techniques of direct laryngoscopy and insertion of supraglottic devices; and to evaluate the success rate in the first attempt of these techniques, considering health professionals wearing specific personal protective equipment (waterproof overalls; gloves; boots; eye protection; mask). Method: meta-analysis with studies from LILACS, MEDLINE, CINAHL, Cochrane, Scopus and Web of Science. The keywords were the following: personal protective equipment; airway management; intubation; laryngeal masks. Results: in the “reduction of the time of the procedures” outcome, the general analysis of the supraglottic devices in comparison with the orotracheal tube initially presented high heterogeneity of the data (I2= 97%). Subgroup analysis had an impact on reducing heterogeneity among the data. The “laryngeal mask as a guide for orotracheal intubation” subgroup showed moderate heterogeneity (I2= 74%). The “2ndgeneration supraglottic devices” subgroup showed homogeneity (I2= 0%). All the meta-analyses favored supraglottic devices. In the “success in the first attempt” outcome, moderate homogeneity was found (I2= 52%), showing a higher proportion of correct answers for supraglottic devices. Conclusion: in the context of chemical, biological or radiological disaster, the insertion of the supraglottic device proved to be faster and more likely to be successful by health professionals. PROSPERO record (CRD42019136139).

scholarly journals Routine personal protective equipment in COVID-19 pandemic: What dentists need to know

2021 ◽  
Vol 4 ◽  
pp. 102-106
Author(s):  
Ankita Kar ◽  
Udayan Bhaumik ◽  
Vineeth Kumar ◽  
V. Shwetha ◽  
Shruthi Nagaraja
Keyword(s):  
Disease Control ◽  
World Health Organization ◽  
Personal Protective Equipment ◽  
Dental Health ◽  
World Health ◽  
Protective Equipment ◽  
Dental Procedures ◽  
Outpatient Procedures ◽  
Close Proximity ◽  
Health Organization

The coronavirus pandemic of 2019 has increased the risk of occupational cross infections among dentists. Dental procedures are inherently risky in this scenario due to the need for close proximity with patients and generation of aerosols and splatters. Regulatory dental health bodies, including World Health Organization, Center for Disease Control, and American Dental Association, have devised guidelines for various forms Personal protective equipment for routine outpatient procedures during this pandemic and in the post-COVID-19 world. Stringent regulations are also advisable to conserve these resources at a time when the threat of COVID-19 is likely to persist indefinitely.

scholarly journals Forecast predictions for the COVID-19 pandemic in Brazil by statistical modeling using the Weibull distribution for daily new cases and deaths

2020 ◽  
Author(s):  
Vitor Hugo Moreau
Keyword(s):  
Decision Making ◽  
Weibull Distribution ◽  
Statistical Modeling ◽  
Personal Protective Equipment ◽  
Educational Level ◽  
Protective Equipment ◽  
Preventive Strategies ◽  
Health Authorities ◽  
Total Death ◽  
The Mean

Abstract COVID-19 has killed more than 330.000 people worldwide and more than 21,000 Brazilians. Since there are no specific drugs or vaccines, the available tools against COVID-19 are preventive, such as the use of personal protective equipment, social distancing, lockdowns and mass testing. Such measures are hindered in Brazil due to a restrict budget, low educational level of the population and misleading attitudes from the federal authorities. Predictions for COVID-19 are of pivotal importance to subsidize and mobilize health authorities’ efforts in applying the necessary preventive strategies. The Weibull distribution was used to model the forecast prediction of COVID-19, in four scenarios, based on the curve of daily new deaths as a function of time. The date in which the number of daily new deaths will fall below the rate of 3 deaths per million, the mean level considered by some countries to relax stay-at-home measures, was estimated. If the daily new deaths curve was bended today (i. e. about 1,250 deaths per day), the predicted date would be on June 18th. Analysis of the lethality rate allowed the estimation of daily new cases and total death toll at the end of the outbreak. Our results suggest that each additional day that lasts to bend the daily new deaths curve can correspond to additional 3,718 deaths at the end of COVID-19 outbreak in Brazil (R2 = 0.9938). Predictions of the outbreak can be used to guide Brazilian health authorities in the decision making to properly fight COVID-19 pandemic.

scholarly journals EP.FRI.221Safe delivery of emergency laparotomy using Personal Protective Equipment (PPE) during the first peak of the COVID-19 pandemic

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Adam O'Connor ◽  
Jayne Bennett ◽  
Imran Alam
Keyword(s):  
Personal Protective Equipment ◽  
Cerebrovascular Accident ◽  
Emergency Laparotomy ◽  
Protective Equipment ◽  
Acute Cerebrovascular Accident ◽  
Risk Of Mortality ◽  
Co Morbidity ◽  
Timely Access ◽  
The Mean ◽  
Operating Surgeon

Abstract Aims To evaluate emergency laparotomies and examine operating surgeon use of PPE as per guidelines in the first COVID-19 peak. Methods The NELA database for our hospital was interrogated to examine for emergency laparotomy cases between March to September 2020. Data was recorded on age, pathology, NELA mortality score, post-operative destination, mortality COVID-19 swab status as an inpatient and use of PPE. Results 55 laparotomies were undertaken. The median age was 67 years. 48% had a Clinical Frailty Score &gt;4. 53% of patients were 'high-risk' in their NELA mortality score (&gt;5%). 56% were ASA &gt;3. 44% went to intensive care post-operatively. 18% and 36% had significant cardiac and respiratory co-morbidities. The mean NELA mortality score was 10% pre-operatively. Mean post-operative risk of mortality score was 67%. Only 1 patient contracted COVID-19 whilst an inpatient and subsequently died of acute cerebrovascular accident unrelated to her COVID-19. PPE was available and used as per guidelines in all cases. Conclusions Our department remained busy throughout the first peak however there was a reduction in cases compared with 2019. Our population is generally heavily co-morbid based on ASA scores and cardiorespiratory co-morbidity. Nevertheless only 1 patient contracted COVID whilst an inpatient in this cohort. Access to adequate amounts of personal protective equipment is paramount to ensure safe and timely access to emergency laparotomy for patients and surgeons alike.

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