scholarly journals Which Personal Protective Equipment Should I Use while Caring for Children Attending the ED? Paediatric Emergency Procedures in the COVID-19 Era and Beyond

Author(s):  
Simon Craig ◽  
Julia Clark ◽  
Mike Starr ◽  
Joanne Grindlay ◽  
Andrew Tagg ◽  
...  

Abstract ObjectivesTo determine recommendations for the use of personal protective equipment (PPE) based on transmission risk for paediatric procedures in the Emergency Department during the COVID-19 pandemic. MethodsTwo survey rounds were conducted in April-May 2020. The survey presented a number of emergency medicine procedures relevant to the care of children, and asked respondents to provide PPE recommendations according to levels of community transmission, and whether or not the child had symptoms of acute respiratory illness. ResultsParticipants were recruited by approaching relevant professional groups, with 15 from the PREDICT network and 12 from the Australasian Society of Infectious Diseases (ASID) Paediatric Infectious Diseases (ANZPID) Group. Airborne PPE is recommended for resuscitative procedures and various respiratory procedures in most situations There were differences in opinion between emergency and paediatric infectious disease specialists with regards to most appropriate PPE for children without symptoms of COVID-19 in a setting of low community transmission, and for procedures involving the head, neck or airway. In general, emergency physicians were more likely to favour airborne PPE than infectious disease specialists. In the setting of high community transmission, there was a stronger tendency to recommend at least droplet precautions for most procedures – regardless of whether or not the child had symptoms. ConclusionsDifferences in PPE recommendations for various paediatric procedures between infectious disease specialists and emergency physicians were identified. Further research is urgently needed to clarify and quantify risks for many common interventions and determine strategies for multidisciplinary consensus regarding future recommendations.

2021 ◽  
pp. bmjinnov-2020-000557
Author(s):  
Sharon Rikin ◽  
Eric J Epstein ◽  
Inessa Gendlina

IntroductionAt the early epicentre of the COVID-19 crisis in the USA, our institution saw a surge in the demand for inpatient consultations for areas impacted by COVID-19 (eg, infectious diseases, nephrology, palliative care) and shortages in personal protective equipment (PPE). We aimed to provide timely specialist input for consult requests during the COVID-19 pandemic by implementing an Inpatient eConsult Programme.MethodsWe used the reach, effectiveness, adoption, implementation and maintenance implementation science framework and run chart analysis to evaluate the reach, adoption and maintenance of the Inpatient eConsult Programme compared with traditional in-person consults. We solicited qualitative feedback from frontline physicians and specialists for programme improvements.ResultsDuring the study period, there were 46 available in-person consult orders and 21 new eConsult orders. At the peak of utilisation, 42% of all consult requests were eConsults, and by the end of the study period, utilisation fell to 20%. Qualitative feedback revealed subspecialties best suited for eConsults (infectious diseases, nephrology, haematology, endocrinology) and influenced improvements to the ordering workflow, documentation, billing and education regarding use.DiscussionWhen offered inpatient eConsult requests as an alternative to in-person consults in the context of a surge in patients with COVID-19, frontline physicians used eConsult requests and decreased use of in-person consults. As the demand for consults decreased and PPE shortages were no longer a major concern, eConsult utilisation decreased, revealing a preference for in-person consultations when possible.ConclusionsLessons learnt can be used to develop and implement inpatient eConsults to meet context-specific challenges at other institutions.


2021 ◽  
Vol 10 (12) ◽  
pp. 2627
Author(s):  
Pierre-Edouard Fournier ◽  
Sophie Edouard ◽  
Nathalie Wurtz ◽  
Justine Raclot ◽  
Marion Bechet ◽  
...  

The Méditerranée Infection University Hospital Institute (IHU) is located in a recent building, which includes experts on a wide range of infectious disease. The IHU strategy is to develop innovative tools, including epidemiological monitoring, point-of-care laboratories, and the ability to mass screen the population. In this study, we review the strategy and guidelines proposed by the IHU and its application to the COVID-19 pandemic and summarise the various challenges it raises. Early diagnosis enables contagious patients to be isolated and treatment to be initiated at an early stage to reduce the microbial load and contagiousness. In the context of the COVID-19 pandemic, we had to deal with a shortage of personal protective equipment and reagents and a massive influx of patients. Between 27 January 2020 and 5 January 2021, 434,925 nasopharyngeal samples were tested for the presence of SARS-CoV-2. Of them, 12,055 patients with COVID-19 were followed up in our out-patient clinic, and 1888 patients were hospitalised in the Institute. By constantly adapting our strategy to the ongoing situation, the IHU has succeeded in expanding and upgrading its equipment and improving circuits and flows to better manage infected patients.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S305-S305
Author(s):  
Se Yoon Park ◽  
Bongyoung Kim ◽  
Dong Sik Jung ◽  
Sook In Jung ◽  
Won Sup Oh ◽  
...  

Abstract Background This study aimed to investigate psychological distress among infectious disease (ID) physicians during the coronavirus disease (COVID-19) outbreak in the Republic of Korea. Methods Using an online-based survey link sent via text message and email, we conducted a survey from April 21 to 25, 2020, targeting all ID physicians currently working in ID (n = 265). The questionnaire was based on the Maslach Burnout Inventory-Human Services Survey and the Depression, Anxiety, and Stress Scales, and information was collected on factors protecting against psychological distress and difficulties in relation to COVID-19. Results Of 265 ID physicians, 115 (43.3%) responded, showing burnout (97, 90.4%), depression (20, 17.4%), anxiety (23, 20.0%), and stress (5, 4.3%). There were no differences in terms of distress between ID physicians who were directly involved in the care of patients with COVID-19 or not (Table 1). Greater than 50% of physicians valued their work and felt recognized by others, whereas < 10% indicated that sufficient human and financial support and private time had been provided during the outbreak. The most challenging issues concerned a lack of human resources for COVID-19 treatment or infection control, a shortage of personal protective equipment or airborne infection isolation rooms, pressure for research, and lack of guidelines for COVID-19 management (Figure 1). Table 1. Figure 1. Difficulties in response to the COVID-19 outbreak. Abbreviations: COVID-19, coronavirus disease 19; HCWs, healthcare workers; ICPs, infection control practitioners; IRB, Institutional Review Board; PPE, personal protective equipment Conclusion During the COVID-19 outbreak in the ROK, most respondents reported psychological distress. Preparing strategies for infectious disease outbreaks that support ID physicians is essential. Disclosures All Authors: No reported disclosures


2021 ◽  
Vol 26 (4) ◽  
pp. 168-174
Author(s):  
Drew Payne ◽  
Martin Peache

Infection control is the responsibility of all nurses, but, traditionally, it has been seen as a priority only in hospitals. Infection control does not stop when a patient is discharged home, but should be practiced wherever clinical care takes place. Community nurses face a unique challenge as they work in patients' homes, and they must manage infection control in that unique environment. This article looks at practical ways to maintain infection control in patients' homes. It covers hand hygiene and personal protective equipment (PPE), including the five moments of hand hygiene, appropriate hand hygiene, the use of all PPE and when gloves are required and when they are not. It also discusses managing clinical equipment, both that taken into the home and that left with a patient, including decontamination, safe storage of sharps and waste management. It touches upon what can be done in a patient's home to reduce the risk of contamination, as well as infectious disease management, including specimens and wound infection management. Lastly, it talks about cross-infection and why staff health is also important.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hanie Ahmadi ◽  
Alireza Ebrahimi ◽  
Farhad Ghorbani

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.


1998 ◽  
Vol 163 (5) ◽  
pp. 324-330 ◽  
Author(s):  
G. David Young ◽  
Sandra Evans

Abstract Many preventable diseases affecting troop strength are directly attributed to disease-carrying insects. The first line of defense against arthropod vectors is the use of personal protective measures. The concurrent application of DEET (N,N-diethyl-m-toluamide) repellent on the skin and permethrin [(3-phenoxy-phenyl)methyl(±)cis,trans-3-(2,2-dichloroethenyl)-2,2-dimethylcyclopropane-carboxylate] insecticide on the battle dress uniform, while the uniform is worn properly, is a personal protective strategy officially known as the DOD Insect Repellent System. It is important for troop commanders and field leaders to enforce the use of personal protective measures to prevent insect-borne infectious diseases and to ensure troop and soldier readiness. DEET is a safe and effective repellent. Permethrin is a synthetic pyrethroid insecticide and repellent. Used in conjunction with proper clothing and other personal protective equipment, these repellents provide the best known protection available and are critical in minimizing the occupational health threat of arthropod-borne diseases to troops in the field.


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.


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.


2020 ◽  
Vol 12 (7) ◽  
pp. 263-268
Author(s):  
Stian Mohrsen

The COVID-19 pandemic is so widespread that any patient in the prehospital environment is considered a significant transmission risk. UK charity air ambulances are affected by challenges regarding air equipment decontamination, staff redeployment and acquisition of personal protective equipment. This has led services to change their mode of operation and contribute to other areas of healthcare that have sprung up in response to the pandemic. Implementing adapted processes and assuming a clear clinical approach can help prevent transmission and uphold service integrity.


Sign in / Sign up

Export Citation Format

Share Document