scholarly journals Dilemma in Handling Corpse with COVID-19 Protocol at Hospital in Padang, West Sumatera (Indonesia)

2020 ◽  
Author(s):  
Noverika Windasari ◽  
Citra Manela ◽  
Fatimah Azahra Zetta
Keyword(s):  
High Risk ◽  
Personal Protective Equipment ◽  
Negative Response ◽  
Protective Equipment ◽  
Time Process ◽  
Medical Practitioners ◽  
Isolation Room ◽  
Descriptive Research ◽  
Dead Bodies ◽  
The Dead

Abstract Background: The high risk of transmitting Covid-19 from the corpse causes the importance of handling protocols under coronavirus characteristics. Indonesian Forensic Doctor Association (PDFI) recently published a guideline to deal with this situation. Hospitals in Indonesia adapted these instructions as the standard. This process faces some struggle situations since this new guidance different from the usual protocols that are already well known by people in handling the deceased. This research evaluates the implementation of these protocols by medical practitioners in West Sumatera. This descriptive research was conducted in two COVID-19 refferal Hospital in Padang. There are 13 mortuary staffs as respondents from both hospitals who directly deal with the corpses. There were 129 bodies served under Covid-19, the guideline during this period. Results: The mortuary staff comes to the isolation room in about 30 minutes after being called to handling the corpse. Corpses were prepared and packed in this room. The dead bodies were transferred to the mortuary room before being driven to the funeral location by ambulance. The corpse, on average, waited less than 3 hours in the mortuary room. Mortuary staff showed a full sincerity to avoid transmitting Covid-19 as all of them used the recommended Personal Protective Equipment (PPE) while handling the infected corpses. The staff only started their work after the standard tools are available. Mortuary staff reported that 40% of relatives of the deceased gave a negative response to the Covid-19 guidelines. Conclusion: The implementation of the procedure to follow the instruction from PDFI in handling infected bodies has some problems. The process could be delayed if the protective equipment runs out, so the staff should wait for the availability PPE. The number of ambulances also gained the time process because some bodies remained so long for the available transport. Although the mortuary staff showed serious concern on the guidelines, they feel unsupported since some families of deceased show negative respect to the protocols. This research recommended that massive education about the Covid-19 protocol in preparing and packing the infected bodies is essential not only for medical practitioners but also for citizens.

scholarly journals Cost-effectiveness analysis of SARS-CoV-2 infection prevention strategies including pre-endoscopic virus testing and use of high risk personal protective equipment

Endoscopy ◽  
2020 ◽  
Author(s):  
Alanna Ebigbo ◽  
Christoph Römmele ◽  
Christina Bartenschlager ◽  
Selin Temizel ◽  
Elisabeth Kling ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
High Risk ◽  
Personal Protective Equipment ◽  
Infection Prevention ◽  
High Volume ◽  
Protective Equipment ◽  
Prevalence Rates ◽  
Prevention Strategies ◽  
Universal Testing ◽  
Asymptomatic Patients

Abstract Background Infection prevention strategies to protect healthcare workers in endoscopy units during the post-peak phase of the COVID-19 pandemic are currently under intense discussion. In this paper, the cost-effectiveness of routine pre-endoscopy testing and high risk personal protective equipment (PPE) is addressed. Method A model based on theoretical assumptions of 10 000 asymptomatic patients presenting to a high volume center was created. Incremental cost-effectiveness ratios (ICERs) and absolute costs per endoscopy were calculated using a Monte Carlo simulation. Results ICER values for universal testing decreased with increasing prevalence rates. For higher prevalence rates (≥ 1 %), ICER values were lowest for routine pre-endoscopy testing coupled with use of high risk PPE, while cost per endoscopy was lowest for routine use of high risk PPE without universal testing. Conclusion In general, routine pre-endoscopy testing combined with high risk PPE becomes more cost-effective with rising prevalence rates of COVID-19.

scholarly journals A mask-based infection control method for screening endoscopy may prevent SARS-CoV-2 transmission and relieve staff anxiety

2021 ◽  
Vol 9 ◽  
pp. 205031212110470
Author(s):  
Yuji Nadatani ◽  
Akira Higashimori ◽  
Shingo Takashima ◽  
Hirotsugu Maruyama ◽  
Koji Otani ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Personal Protective Equipment ◽  
Medical Staff ◽  
Fluorescent Dyes ◽  
Control Method ◽  
Protective Equipment ◽  
Health Checkup ◽  
Screening Endoscopy ◽  
Droplet Trajectory

Objectives: Endoscopy confers high risk for acquiring coronavirus disease 2019. Although guidelines recommend that medical staff use personal protective equipment, no infection control equipment have been established for patients. This study aimed to clarify the usefulness of two face masks we had designed for transnasal and transoral endoscopy. Methods: The efficacy of the masks was evaluated by simulating coughing in a mannequin with fluorescent dyes and mapping the droplet trajectory and number. The number of aerosols generated during endoscopy was clinically evaluated in the endoscopy room. Overall, 4356 screening endoscopies were performed with the patients wearing our masks at Medcity21, a health checkup facility, between June and December 2020; the effects of the masks on the patient’s condition were evaluated retrospectively. An 11-item paper-based survey was performed by the endoscopy staff 6 months after the adoption of the mask-based infection control method. Results: Use of both masks reduced the number of droplets released during the simulation. Clinically, the use of both masks did not affect the patients’ conditions during endoscopy and prevented an increase in the aerosols in the endoscopy room. This mask-based infection control method was favorably received, and all staff indicated that understanding the efficacy of our mask-based infection control reduced their anxiety regarding infection. Until December 2020, none of our staff had contracted SARS-CoV-2. Conclusion: Our mask-based infection control method is easy to adopt, inexpensive, and effective; understanding its effectiveness may help ease the fear of infection among endoscopy staff.

scholarly journals Utilization of an Orthopedic Hood as Personal Protective Equipment for Intubation of Coronavirus Patients: a Brief Technical Report

2020 ◽  
Vol 11 ◽  
pp. 215145932093055 ◽  
Author(s):  
Timothy T. Wills ◽  
Wilhelm A. Zuelzer ◽  
Bryant W. Tran
Keyword(s):  
Health Care ◽  
High Risk ◽  
Endotracheal Intubation ◽  
Health Care Workers ◽  
Personal Protective Equipment ◽  
Ventilation System ◽  
The United States ◽  
Protective Equipment ◽  
Care Workers ◽  
Technical Report

Background: The novel coronavirus disease (COVID-19) has afflicted millions of people worldwide since its first case was reported in December 2019. Personal protective equipment (PPE) has been tailored accordingly, but as of April 2020, close to 10 000 health care workers in the United States have contracted COVID-19 despite wearing recommended PPE. As such, standard guidelines for PPE may be inadequate for the health care worker performing high-risk aerosolizing procedures such as endotracheal intubation. In this brief technical report, we describe the integration of an orthopedic hood cover as an item for full barrier protection against COVID-19 transmission. Technical Description: The Coronavirus Airway Task Force at Virginia Commonwealth University Medical Center approved this initiative and went live with the full barrier suit during the last week of March 2020. The PPE described in this report includes a Stryker T4 Hood, normally used in conjunction with the Stryker Steri-Shield T4 Helmet. Instead of the helmet, the hood is secured to the head via a baseball cap and binder clip. This head covering apparatus is to be used as an accessory to other PPE items that include an N95 mask, waterproof gown, and disposable gloves. The motor ventilation system is not used in order to prevent airborne viral entry into the hood. Discussion: An advantage of the full barrier suit is an additional layer of droplet protection during intubation. The most notable disadvantage is the absence of a ventilation system within the hood covering. Conclusion: Modification of existing PPE may provide protection for health care workers during high-risk aerosolizing procedures such as endotracheal intubation. Although the integration of this medical equipment meets the immediate needs of an escalating crisis, further innovation is on the horizon. More research is needed to confirm the safety of modified PPE.

scholarly journals PENGGUNAAN MEDIA PEMBELAJARAN POSTER DI BENGKEL

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Indah Wahyuni ◽  
Nur Hidayat
Keyword(s):  
Data Collection ◽  
Personal Protective Equipment ◽  
Civil Engineering ◽  
Department Of Education ◽  
Protective Equipment ◽  
Instructional Media ◽  
Education Department ◽  
Descriptive Research ◽  
The Third ◽  
Descriptive Approach

ABSTRACTThis study is aimed to determine: (1) the use of posters as a medium of learning at the workshop of Education Department of Civil Engineering and Planning FT UNY, (2) requirements in making posters as instructional media, and (3) Correspondence between poster as a learning media with the workshop at Department of Education of Civil Engineering and Planning FT UNY. This study Applies a descriptive approach (descriptive research). In this study, the researchers did not provide any treatment to what is observed however only describes in detail merely to what was found in the data collection. The findings of this study are (1) poster has been used as a medium of learning both in carpentry, plumbing workshop, and rock workshop. Poster is used to convey information such as personal protective equipment, work step, parts of an instrument, learning products, and K3 (2) the factors of the preconditions if poster at carpentry and rock workshop have been fulfilled. However the preconditions the form of size and color of poster at the plumbing workshop still need to be resized. In addition, the suitability factors such as ease of posters indicators in order to be easily seen in carpentry and plumbing workshop also need to be resized. Other indicators contained in preconditions factors such as expediency and suitability in the third workshop have been fulfilled. (3) The compliance of poster in carpentry, plumbing workshop, and rock workshop at the Education Department of Civil Engineering and Planning FT UNY is good. Posters are suitable to the function and purpose of each workshop. They only need resizing and repositioning. Keywords: instructional media, posters, workshop  ABSTRAKPenelitian ini bertujuan untuk mengetahui: (1) penggunaan poster sebagai media pembelajaran di bengkel Jurusan Pendidikan Teknik Sipil dan Perencanaan FT UNY (2) persyaratan dalam pembuatan poster sebagai media pembelajaran (3) Kesesuaian antara media pembelajaran poster dengan bengkel di Jurusan Pendidikan Teknik Sipil dan Perencanaan FT UNY. Penelitian ini menggunaan pendekatan deskriptif (descriptive reasearch). Dalam penelitian ini, peneliti tidak memberikan perlakuan terhadap apa yang diteliti tetapi hanya sebatas mendeskripsikan secara detail terhadap apa yang ditemukan dalam pengambilan data. Hasil penelitian ini adalah (1) Poster telah dimanfaatkan sebagai media pembelajaran baik di bengkel kayu, bengkel plambing, maupun bengkel batu. Poster digunakan untuk menyampaikan informasi alat pelindung diri, langkah kerja, bagian-bagian dari suatu alat, produk pembelajaran, maupun K3 (2) Faktor prasyarat poster di bengkel kayu dan bengkel batu sudah terpenuhi. Hanya saja untuk prasyarat berupa indikator ukuran dan warna poster di bengkel plambing masih perlu ditingkatkan. Selain itu, faktor kesesuaian berupa indikator kemudahan poster untuk terlihat di bengkel kayu dan plambing juga perlu ditingkatkan. Indikator lain yang terdapat pada faktor prasyarat, kemanfaatan, dan kesesuaian di ketiga bengkel tersebut sudah terpenuhi (3) Kesesuaian poster di bengkel kayu, bengkel plambing, dan bengkel batu di Jurusan Pendidikan Teknik Sipil dan Perencanaan FT UNY sudah baik. Poster sudah sesuai dengan fungsi dan maksud masing-masing bengkel. Hanya saja perlu adanya pembenahan dalam penempatan poster.Kata kunci: media pembelajaran, poster, bengkel

scholarly journals Adherence to recommendations for endoscopy practice during COVID-19 pandemic in Latin America: how are we doing it?

2021 ◽  
Vol 8 (1) ◽  
pp. e000558
Author(s):  
Enrique Murcio-Pérez ◽  
Raúl Antonio Zamarripa-Mottú ◽  
Gustavo Andrade-DePaulo ◽  
Octavio Aguilar-Nájera ◽  
Jorge Asadur Tchekmedyian ◽  
...  
Keyword(s):  
Latin America ◽  
High Risk ◽  
Airway Management ◽  
Personal Protective Equipment ◽  
Response Rate ◽  
Specific Area ◽  
Hand Washing ◽  
Protective Equipment ◽  
Digestive Endoscopy ◽  
Endoscopic Procedures

Background and aimsDigestive endoscopy is considered a high-risk procedure for COVID-19. Recommendations have been made for its practice during the pandemic. This study was conducted to determine adherence to recommendations for endoscopy practice during the COVID-19 pandemic in Latin America (LA).MethodsA survey was conducted of endoscopists from LA consisting of 43 questions for the evaluation of four items: general and sociodemographic features, and preprocedure, intraprocedure and postprocedure aspects.ResultsA response was obtained from 338 endoscopists (response rate 34.5%) across 15 countries in LA. In preprocedure aspects (hand washing, use of face masks for patients, respiratory triage area, training for the placement/removal of personal protective equipment (PPE) and availability of specific area for the placement/removal of PPE), there was adherence in <75%. Regarding postprocedure aspects, 77% (261/338) had reused PPE, mainly the N95 respirator or higher, and this was with a standardised decontamination procedure only in 32% (108/338) of the time. Postprocedure room decontamination was carried out by 47% on >75% of occasions. In relationship to intraprocedure aspects (knowledge of risk and type of endoscopic procedures, use of PPE, airway management in patients and infrastructure), there was adherence in >75% for all the parameters and 78% of endoscopists only performed emergencies or time-sensitive procedures.ConclusionsAdherence to the recommendations for endoscopy practice during the COVID-19 pandemic is adequate in the intraprocedure aspect. However, it is deficient in the preprocedure and postprocedure aspects.

scholarly journals Lessons From Other Disciplines About Communication, Human Performance and Situational Awareness While Wearing Personal Protective Equipment

2020 ◽  
Vol 6 ◽  
pp. 237796082096376
Author(s):  
Margaret Scott ◽  
John Unsworth
Keyword(s):  
High Risk ◽  
Personal Protective Equipment ◽  
Human Performance ◽  
Situational Awareness ◽  
Fire Service ◽  
Team Work ◽  
Protective Equipment ◽  
Peak Period ◽  
New Ways Of Working ◽  
Multi Phase

Introduction The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) has quickly accelerated into a pandemic. As COVID-19 has swept across the globe, health systems have adapted, including the cessation of routine surgery and the re-deployment of staff to critical care settings. Prompt interventions such as endotracheal (ET) intubation, are deemed essential in patients with Acute Respiratory Distress Syndrome. Intubation requires a coordinated approach and effective teamwork, as it is a high-risk procedure not least because it is an aerosol-generating intervention with increased infection risk. As a result, teams responsible for performing ET intubation are required to wear Personal Protective Equipment (PPE), which in turn hinders communication and situational awareness, and can hamper team work. Method This review considers the effects of wearing PPE on performance and situational awareness in a healthcare environment. Drawing on literature from the fire service and military, the review will explore approaches to improving communication and situational awareness for teams who, at times, are unfamiliar with one another. The review will consider human factors and, identify approaches that assist teams, including teams that are unfamiliar with one another, to adapt to new ways of working while performing high-risk procedures. Conclusion Literature indicates that standardisation, pre-brief and training are important elements of developing improved situational awareness and team working in individuals whose senses may be affected by PPE. In addition, checklists provide a useful way of standardising procedures and can form the basis of a structured pre-brief. Checklists exist for both intubation and patient proning, which, alongside simulation-based team training, provide a useful method of preparing an often unfamiliar workforce for their roles during an epidemic or pandemic. The multi-phase nature of most pandemics provides an opportunity to review processes and implement such procedures, and to develop staff using team-based training during the post-peak period.

Management of the dead during coronavirus disease 2019 outbreak: Practices and perceptions of forensic practitioners from India

2021 ◽  
pp. 002580242110258
Author(s):  
Vikas P Meshram ◽  
Tanuj Kanchan ◽  
Raghvendra S Shekhawat
Keyword(s):  
Infection Control ◽  
Forensic Medicine ◽  
Health Sector ◽  
The Body ◽  
Local Administration ◽  
Protective Equipment ◽  
Medical Institutions ◽  
Dead Bodies ◽  
The Dead

The coronavirus disease 2019 pandemic has mandated a response from administrative agencies and the health sector globally, however, the number of cases and deaths continue to rise. While management of the living is paramount, the management of the dead is also important. Guidelines for managing the dead have been issued and implemented by various local administrations, in accordance with national and international guidelines. This questionnaire-based research aims to develop an understanding of the knowledge, perceptions and practices of forensic practitioners from India as regards the management of the dead during the coronavirus disease 2019 pandemic. This Pan-India study included 278 forensic medicine experts (249 males and 29 females) working in various hospitals and medical institutions across the country. The questionnaire included various issues involving the management of dead bodies in cases involving coronavirus disease 2019, such as infection control practices, body screening, handling and autopsy, disposal practices, local administrative policies, and available infrastructure and resources. We found that guidelines are mostly being followed across India, barring disparity in issues relating to testing in the dead bodies, the role of local administration in the body disposal, and the use of personal protective equipment while handling bodies and during autopsies. Mortuaries now need to be upgraded, and general infrastructure requires improvement. Periodic training of all stakeholders and assessment of facilities are recommended.

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