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 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.

The operational role of the Royal Marines Band Service during the contingency era: lessons from Op GRITROCK

2015 ◽  
Vol 101 (2) ◽  
pp. 107-109
Author(s):  
CR Brisley ◽  
A Duggan
Keyword(s):  
Personal Protective Equipment ◽  
Medical Service ◽  
Temperature Monitoring ◽  
Protective Equipment ◽  
Medical Environment ◽  
Insight Into

AbstractThe Royal Marines Band Service (RMBS) deploys in support of the Royal Naval Medical Service in a variety of operational roles. This article describes the roles that RMBS personnel performed whilst deployed on board RFA ARGUS during the recent Operation GRITROCK. The article is divided into five main sections, each describing one aspect of the work that RMBS ranks were asked to undertake: casualty handling; working within Primary Casualty Receiving Facility (PCRF) departments; personal protective equipment (PPE) monitoring and drills; temperature monitoring; and last, but not least, musical support. This will provide the reader with an insight into what the RMBS have achieved whilst deployed on board ARGUS and also what skills they are able to bring, both to contingency operations and operations in the medical environment.

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 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 A Personal Respirator to Improve Protection for Healthcare Workers Treating COVID-19 (PeRSo)

2021 ◽  
Vol 3 ◽  
Author(s):  
Paul T. Elkington ◽  
Alexander S. Dickinson ◽  
Mark N. Mavrogordato ◽  
Daniel C. Spencer ◽  
Richard J. Gillams ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
High Efficiency ◽  
Healthcare Delivery ◽  
Protective Equipment ◽  
Low Resource Settings ◽  
Supply Logistics ◽  
Global Pandemic ◽  
Manufacturing Complexity ◽  
Validation Testing

Introduction: SARS-CoV-2 infection is a global pandemic. Personal Protective Equipment (PPE) to protect healthcare workers has been a recurrent challenge in terms of global stocks, supply logistics and suitability. In some settings, around 20% of healthcare workers treating COVID-19 cases have become infected, which leads to staff absence at peaks of the pandemic, and in some cases mortality.Methods: To address shortcomings in PPE, we developed a simple powered air purifying respirator, made from inexpensive and widely available components. The prototype was designed to minimize manufacturing complexity so that derivative versions could be developed in low resource settings with minor modification.Results: The “Personal Respirator – Southampton” (PeRSo) delivers High-Efficiency Particulate Air (HEPA) filtered air from a battery powered fan-filter assembly into a lightweight hood with a clear visor that can be comfortably worn for several hours. Validation testing demonstrates that the prototype removes microbes, avoids excessive CO2 build-up in normal use, and passes fit test protocols widely used to evaluate standard N95/FFP2 and N99/FFP3 face masks. Feedback from doctors and nurses indicate the PeRSo prototype was preferred to standard FFP2 and FFP3 masks, being more comfortable and reducing the time and risk of recurrently changing PPE. Patients report better communication and reassurance as the entire face is visible.Conclusion: Rapid upscale of production of cheaply produced powered air purifying respirators, designed to achieve regulatory approval in the country of production, could protect healthcare workers from infection and improve healthcare delivery during the COVID-19 pandemic.

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 Enveloped Virus Inactivation on Personal Protective Equipment by Exposure to Ozone

2020 ◽  
Author(s):  
Emmeline L. Blanchard ◽  
Justin D. Lawrence ◽  
Jeffery A. Noble ◽  
Minghao Xu ◽  
Taekyu Joo ◽  
...  
Keyword(s):  
Relative Humidity ◽  
Personal Protective Equipment ◽  
Influenza A ◽  
High Efficiency ◽  
Atmospheric Oxygen ◽  
Threshold Value ◽  
Ozone Exposure ◽  
Protective Equipment ◽  
Syncytial Virus ◽  
N95 Respirators

AbstractOzone is a highly oxidizing gas easily generated from atmospheric oxygen with inexpensive equipment and is commonly used for the disinfection of municipal water, foods, and surfaces. We report tests of the ability of ozone to inactivate enveloped respiratory viruses (influenza A virus and respiratory syncytial virus), chosen as more easily handled surrogates for SARS-CoV-2, on N95 respirators and other personal protective equipment (PPE) commonly used in hospitals. At 20 ppm, an ozone concentration easily achieved by standard commercial equipment, the viruses were inactivated with high efficiency as long as the relative humidity was above a threshold value of approximately 50%. In the absence of humidity control, disinfection is more variable and requires considerably longer exposure under relatively dry conditions. This report extends the observations of a previous publication (http://doi.org/10.1080/01919510902747969) to hospital-relevant materials and provides additional details about the relationship of humidity to the antiviral activity of ozone. Home CPAP disinfection devices using ozone can provide effective results for individuals. Ozone did not appear to degrade any of the materials tested except for elastic bands if strained during treatment (such as by the pressure exerted by stapled attachment to N95 respirators). The filtration efficiency of N95 respirator material was not compromised. Overall, we recommend exposures of at least 40 minutes to 20 ppm ozone and >70% relative humidity at ambient temperatures (21-24°C) for 4-log (99.99%) reduction of viral infectivity on a variety of PPE, including gowns, face shields, and respirators. Shorter exposure times are likely to be effective under these conditions, but at the risk of some variability for different materials. Higher ozone concentrations and higher humidity levels promoted faster inactivation of viruses. Our work suggests that ozone exposure can be a widely accessible method for disinfecting PPE, permitting safer re-use for healthcare workers and patients alike in times of shortage.

scholarly journals Stability of SARS-CoV-2 on Critical Personal Protective Equipment

2020 ◽  
Author(s):  
Samantha B Kasloff ◽  
James E Strong ◽  
Duane Funk ◽  
Todd Cutts
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Protective Equipment ◽  
Potential Utility ◽  
Rapid Degradation ◽  
Healthcare Settings ◽  
Interesting Insight ◽  
Mode Of Transmission ◽  
Insight Into ◽  
Shed Light

AbstractThe spread of COVID-19 in healthcare settings is concerning, with healthcare workers representing a disproportionately high percentage of confirmed cases. Although SARS-CoV-2 virus has been found to persist on surfaces for a number of days, the extent and duration of fomites as a mode of transmission, particularly in healthcare settings, has not been fully characterized. To shed light on this critical matter, the present study provides the first comprehensive assessment of SARS-CoV-2 stability on experimentally contaminated personal protective equipment (PPE) widely used by healthcare workers and the general public. Persistence of viable virus was monitored over 21 days on eight different materials, including nitrile medical examination gloves, reinforced chemical resistant gloves, N-95 and N-100 particulate respirator masks, Tyvek®, plastic, cotton, and stainless steel. Unlike previous reports, viable SARS-CoV-2 in the presence of a soil load persisted for up to 21 days on experimentally inoculated PPE, including materials from filtering facepiece respirators (N-95 and N-100 masks) and a plastic visor. Conversely, when applied to 100% cotton fabric, the virus underwent rapid degradation and became undetectable in less than 24 hours. These findings underline the importance of appropriate handling of contaminated PPE during and following use in high-risk settings and provide interesting insight into the potential utility of cotton, including cotton masks, in limiting COVID-19 transmission.

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