COVID-19 Cross-Infection and Pressured Ulceration Among Healthcare Workers: Are We Really Protected by Respirators?

A young man presented to our centre needing an urgent debridement of his postcraniotomy wound due to massive myiasis during the COVID-19 pandemic in October 2020. Prior to the surgery, his nasopharyngeal swab real-time PCR test result was unknown. One day later, it returned as SARS-CoV-2 positive. All healthcare workers who were involved in the patient management avoided cross infection as they wore appropriate personal protective equipment. This article depicts the importance of adequate preparations when handling potentially infectious patients and the perioperative issues associated with it.

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Perioperative challenges in a morbidly obese former COVID-19 patient undergoing elective spine surgery

BMJ Case Reports ◽

10.1136/bcr-2021-243950 ◽

2021 ◽

Vol 14 (7) ◽

pp. e243950

Author(s):

Zhen Hao Leo ◽

Fathir Fath Mohammad Iskandar ◽

Tat Boon Yeap ◽

Chin Pei Bong

Keyword(s):

Obese Patient ◽

Spine Surgery ◽

Lung Fibrosis ◽

Healthcare Workers ◽

Cross Infection ◽

Special Consideration ◽

Morbidly Obese ◽

Interesting Article ◽

Morbidly Obese Patient ◽

Severe Lung

Anaesthesia for patients with severe lung fibrosis post COVID-19 infection requires special consideration. This is due to its propensity to cause perioperative anaesthetic catastrophe and possibility of cross infection among healthcare workers if not properly managed. This interesting article elaborates in detail the anaesthetic and surgical challenges in a morbidly obese patient who had a severe COVID-19 infection presenting for an elective spine surgery.

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The Role of Handwashing in Prevention of Endemic Intensive Care Unit Infections

Infection Control and Hospital Epidemiology ◽

10.1086/646100 ◽

1990 ◽

Vol 11 (11) ◽

pp. 589-594 ◽

Cited By ~ 69

Author(s):

Bryan Simmons ◽

Jerri Bryant ◽

Kim Neiman ◽

Linda Spencer ◽

Kris Arheart

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Nosocomial Infection ◽

Healthcare Workers ◽

Cross Infection ◽

Infection Rates ◽

Objective Observer ◽

Important Means ◽

Community Teaching

AbstractHandwashing is believed to be the most important means of preventing nosocomial infections. Previous studies of healthcare workers (HCWs) have shown that handwashing practices are poor. No one has shown that handwashing practices can be easily improved and that this prevents endemic (non-epidemic) nosocomial infection. Handwashing and infection rates were studied in two intensive care units (ICUs) of a community teaching hospital. Handwashing rates were monitored secretly throughout the study. After six months of observation, we started interventions to increase handwashing. Handwashing increased gradually, but overall rates before (22.0%) and after (29.9%) interventions were not significantly different (p = .071). Handwashing never occurred before intravenous care, whereas it occurred 67.5% for all other indications (p<.0001). When questioned, nurses felt they were washing appropriately nearly 90% of the time. Infection rates seemed unrelated to handwashing throughout the study, and no clusters of infection were detected. We conclude that handwashing rates, when measured against arbitrary but reasonable standards, are suboptimal, difficult to change and not closely related to evidence of cross-infection. Further, nurses wash hands selectively, depending on the indication for handwashing, and generally believe they are washing much more frequently than an objective observer believes they are.

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Bland Soap Handwash or Hand Antisepsis? The Pressing Need for Clarity

Infection Control and Hospital Epidemiology ◽

10.1086/646531 ◽

1992 ◽

Vol 13 (5) ◽

pp. 299-304 ◽

Cited By ~ 21

Author(s):

N. Joel Ehrenkranz

Keyword(s):

Infection Control ◽

Healthcare Workers ◽

Cross Infection ◽

Epidemiological Research ◽

Puerperal Sepsis ◽

Hand Antisepsis

A pervasive misconception in infection control circles is that simple bland soap handwash reliably prevents hand transmission of transiently acquired bacteria, disregarding the level of hand contamination. Often cited to support this widespread misapprehension is a bigger misconception-the efficacy of bland soap handwash is rooted in the epidemiological research of Ignaz Semmelweis. As emphasized by Walter and Beck, Semmelweis did no such thing. Indeed, it was the observation by Semmelweis of failure of bland soap handwash to prevent healthcare workers from spreading puerperal sepsis that led to his investigations of chlorine hand antisepsis for control of cross-infection. These studies ultimately resulted in his demonstrating that effective hand antisepsis (and not bland soap handwash) could prevent transmission of the agents of postpartum endometritis, sepsis, and death.

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The Stethoscope, Respiratory Examination and Lung Ultrasound in the COVID-19 Era

10.20944/preprints202004.0452.v1 ◽

2020 ◽

Author(s):

Avinash Aujayeb

Keyword(s):

Respiratory Failure ◽

Computer Tomography ◽

Healthcare Workers ◽

Lung Ultrasound ◽

Clinical Signs ◽

Signs And Symptoms ◽

Cross Infection ◽

Severe Respiratory Failure ◽

Wide Range ◽

Clinical Signs And Symptoms

The current Covid-19 pandemic has hugely disrupted the delivery of routine and established medical care. Patients can develop a wide range of clinical signs and symptoms from a cough and fever to severe respiratory failure. There is an ongoing argument on a concise investigative pathway to ensure the safety of all healthcare workers. The stethoscope can help with any clinical respiratory assessment but the risk of cross infection is high. Computer tomography should not be routinely performed. There is a potential place for lung ultrasound but outcomes are not yet determined.

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