Powered Respirators Are Effective, Sustainable, and Cost-Effective Personal Protective Equipment for SARS-CoV-2

Objectives: The provision of high-quality personal protective equipment (PPE) has been a critical challenge during the COVID-19 pandemic. We evaluated an alternative strategy, mass deployment of a powered air-purifying respirator (PeRSo), in a large university hospital.Methods: We performed prospective user feedback via questionnaires sent to healthcare workers (HCWs) issued PeRSos, economic analysis, and evaluated the real-world impact.Results: Where paired responses were available, PeRSo was preferred over droplet precautions for comfort, patient response, overall experience, and subjective feeling of safety. For all responses, more participants reported the overall experience being rated “Very good” more frequently for PeRSo. The primary limitation identified was impairment of hearing. Economic simulation exercises revealed that the adoption of PeRSo within ICU is associated with net cost savings in the majority of scenarios and savings increased progressively with greater ITU occupancy. In evaluation during the second UK wave, over 3,600 respirators were deployed, all requested by staff, which were associated with a low staff absence relative to most comparator hospitals.Conclusions: Health services should consider a widespread implementation of powered reusable respirators as a safe and sustainable solution for the protection of HCWs as SARS-CoV-2 becomes an endemic viral illness.

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Contagion Management at the Méditerranée Infection University Hospital Institute

Journal of Clinical Medicine ◽

10.3390/jcm10122627 ◽

2021 ◽

Vol 10 (12) ◽

pp. 2627

Author(s):

Pierre-Edouard Fournier ◽

Sophie Edouard ◽

Nathalie Wurtz ◽

Justine Raclot ◽

Marion Bechet ◽

...

Keyword(s):

Infectious Disease ◽

Early Diagnosis ◽

Personal Protective Equipment ◽

Early Stage ◽

Point Of Care ◽

University Hospital ◽

Protective Equipment ◽

Monitoring Point ◽

Epidemiological Monitoring ◽

Wide Range

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.

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Adherence to personal protective equipment use among healthcare workers caring for confirmed COVID-19 and alleged non-COVID-19 patients

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-020-00864-w ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Meike M. Neuwirth ◽

Frauke Mattner ◽

Robin Otchwemah

Keyword(s):

Health Care ◽

Health Care Workers ◽

Personal Protective Equipment ◽

Healthcare Workers ◽

University Hospital ◽

Protective Equipment ◽

Care Workers

AbstractAdherence observations of health care workers (HCW) revealed deficiencies in the use of recommended personal protective equipment (PPE) among HCW caring in COVID-19 and non-COVID-19 wards during the first period of the SARS-CoV-2 pandemic in a university hospital in Germany. The adherence to wearing surgical face or FFP2-masks and disinfecting hands prior to donning and after doffing the PPE was significantly higher in COVID-19 wards However, there was no total adherence of 100% in COVID-19 wards.

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Portable negative pressure environment to protect staff during aerosol-generating procedures in patients with COVID-19

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2020-000653 ◽

2020 ◽

Vol 7 (1) ◽

pp. e000653

Author(s):

James Nilson ◽

Nikolay Bugaev ◽

Pavan Sekhar ◽

Haracio Hojman ◽

Luis Gonzalez-Ciccarelli ◽

...

Keyword(s):

Viral Load ◽

Personal Protective Equipment ◽

Negative Pressure ◽

Healthcare Providers ◽

Cost Effective ◽

Therapeutic Interventions ◽

Protective Equipment ◽

Cost Effective Method

Patients with COVID-19 often need therapeutic interventions that are considered high aerosol-generating procedures. These are either being performed by healthcare providers with potentially inadequate personal protective equipment or the procedures are being delayed until patients clear their viral load. Both scenarios are suboptimal. We present a simple, cost-effective method of creating a portable negative pressure environment using equipment that is found in most hospitals to better protect healthcare providers and to facilitate more timely care for patients with COVID-19.

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950 A Close Loop Audit to Assess Awareness Among Non-Consultant Hospital Doctors Re Use of Personal Protective Equipment

British Journal of Surgery ◽

10.1093/bjs/znab259.759 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

K Amin ◽

M Fahad Ullah ◽

E Hannon ◽

G Feaney ◽

J Khan

Keyword(s):

Personal Protective Equipment ◽

Healthcare Workers ◽

University Hospital ◽

Protective Equipment ◽

Age Group ◽

Educational Session ◽

Hospital Doctors ◽

Limited Supply ◽

Two Phases ◽

Effective Use

Abstract Introduction Personal protective equipments (PPEs) are like war uniforms in the fight against Corona Pandemic. The limited supply of PPEs warrant their proper use not only to avoid shortage of supplies but also to prevent any infectious spread to healthcare workers. This study aimed at analyzing awareness among non-consultant hospital doctors re proper use of PPEs Method A questionnaire was devised using local available guidelines published by university Hospital Limerick. The study was done in 2 phases. In 1st phase 100 questionnaires were distributed to non-consultant hospital doctors(NCHDs). Results were analysed and after 1st phase and emails were sent with results and local guidelines and a zoom educational session was organized. In 2nd phase, questionnaire was redistributed in a week's time and results were re analysed to close the loop. Results 200 NCHDs participated in the study,100 in each phase. Most common age group in two phases was 21-30 yrs. Awareness about PPEs use for Covid 19 increased significantly in 2nd phase across all domains (what is included in PPEs (100% from 91%), Sequence for putting on PPEs (52% to 88% p < 0.05), steps for FIT test (57% to 74% p = 0.247) and sequence for removing PPEs (47% to 81% p < 0.05). Conclusions Though PPEs donning and doffing sessions were organized by the hospital officially, Awareness about effective use of PPEs among NCHDs further improved after organizing a Zoom educational session and auditing.

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THE EFFICACY OF RADPAD AS A RADIATION PROTECTION TOOL IN CT FLUOROSCOPY GUIDED LUNG BIOPSIES

Radiation Protection Dosimetry ◽

10.1093/rpd/ncaa169 ◽

2020 ◽

Vol 191 (3) ◽

pp. 328-334 ◽

Cited By ~ 1

Author(s):

Michael Lawson ◽

Ahilan Kuganesan ◽

Georgia Parry ◽

Mohamed Khaldoun Badawy

Keyword(s):

Radiation Dose ◽

Dose Reduction ◽

Personal Protective Equipment ◽

Cost Effective ◽

Whole Body ◽

Protective Equipment ◽

Computed Tomography Fluoroscopy ◽

Effective Option ◽

Single Use ◽

Lung Biopsies

Abstract Computed tomography fluoroscopy is now the preferred technique for percutaneous lung biopsies. However, concern regarding operator and patient radiation dose remains, which warrants further exploration into dose optimisation tools. This phantom-study aims to assess the dose reduction capabilities of RADPAD, a single-use patient drape designed to decrease staff exposure to scattered radiation. Dosemeters at the waist and eye levels were used to determine the whole-body and lens exposure during simulated lung biopsy procedures while using RADPAD and other combinations of personal protective equipment. RADPAD resulted in a 36% and 38% dose reduction for whole-body and eye exposure, respectively. However, when used in combination with radioprotective eyewear and aprons, RADPAD did not reduce the radiation dose further. Consequently, the use of standard personal protective equipment is a more cost-effective option for staff dose reduction. RADPAD is useful in the reduction of radiation dose to unprotected regions.

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Early Data From Case Series of Tracheostomy in Patients With SARS-CoV-2

Otolaryngology ◽

10.1177/0194599820940655 ◽

2020 ◽

Vol 163 (6) ◽

pp. 1150-1152 ◽

Cited By ~ 1

Author(s):

Elizabeth Floyd ◽

Scott S. Harris ◽

Jessica W. Lim ◽

David R. Edelstein ◽

Briana Filangeri ◽

...

Keyword(s):

New York ◽

New York City ◽

Respiratory Failure ◽

Personal Protective Equipment ◽

York City ◽

Case Series ◽

University Hospital ◽

Protective Equipment ◽

North Shore

Thirty-eight tracheostomies were performed on patients with respiratory failure secondary to SARS-CoV-2 infection over the month of April at North Shore University Hospital and Lenox Hill Hospital (members of Northwell Health System in Long Island and New York City). Follow-up by May 14 revealed that 21 (55.2%) had been weaned from ventilators and 7 (18.4%) underwent decannulation. Two patients (5.3%) expired in the weeks following tracheostomy. Between the 2 institutions, 10 attending surgeons performed all of the tracheostomies using appropriate personal protective equipment, and none demonstrated seroconversion within 1 to 2 weeks of this article.

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Cost-effective innovative personal protective equipment for the management of COVID-19 patients

Journal of Global Infectious Diseases ◽

10.4103/jgid.jgid_93_20 ◽

2020 ◽

Vol 12 (2) ◽

pp. 113

Author(s):

SManu Ayyan ◽

KN. J Prakash Raju ◽

Naman Jain ◽

M Vivekanandan

Keyword(s):

Personal Protective Equipment ◽

Cost Effective ◽

Protective Equipment

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Lessons learnt from the rapid implementation of reusable personal protective equipment for COVID-19 in Malawi

BMJ Global Health ◽

10.1136/bmjgh-2021-006498 ◽

2021 ◽

Vol 6 (9) ◽

pp. e006498

Author(s):

Fumbani Limani ◽

David Garley ◽

Derek Cocker ◽

Priyanka Patel ◽

Pratiksha Patel ◽

...

Keyword(s):

Low Income ◽

Personal Protective Equipment ◽

Scale Up ◽

Healthcare Providers ◽

Cost Effective ◽

Protective Equipment ◽

Ongoing Training ◽

Early Implementation ◽

Worker Perceptions ◽

The Cost

The SARS-CoV-2 pandemic has challenged health systems and healthcare workers worldwide. Access to personal protective equipment (PPE) is essential to mitigate the risk of excess mortality in healthcare providers. In Malawi, the cost of PPE represents an additional drain on available resources. In the event of repeated waves of disease over several years, the development of sustainable systems of PPE is essential. We describe the development, early implementation and rapid scale up of a reusable gown service at a tertiary-level hospital in Blantyre, Malawi. Challenges included healthcare worker perceptions around the potential of reduced efficacy of cotton gowns, the need to plan for surge capacity and the need for ongoing training of laundry staff in safety and hygiene procedures. Benefits of the system included increased coverage, decreased cost and reduced waste disposal. The implementation of a reusable cotton gown service is feasible, acceptable and cost-effective in tertiary centres providing specialist COVID-19 care at the height of the pandemic. This innovation could be expanded beyond low-income settings.

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A Survey of Psychiatric Healthcare Workers' Perception of Working Environment and Possibility to Recover Before and After the First Wave of COVID-19 in Sweden

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.770955 ◽

2021 ◽

Vol 12 ◽

Author(s):

Eirini Alexiou ◽

Steinn Steingrimsson ◽

Magnus Akerstrom ◽

Ingibjörg H. Jonsdottir ◽

Linda Ahlstrom ◽

...

Keyword(s):

Personal Protective Equipment ◽

Healthcare Workers ◽

Negative Impact ◽

Working Environment ◽

University Hospital ◽

Protective Equipment ◽

Web Based ◽

Before And After ◽

Survey Responses ◽

The Impact

Objective: This study aimed to investigate the impact of the first wave of the COVID-19 pandemic on perceived working environment, including the possibility to recover, among psychiatric healthcare workers (PHCWs) in comparison with pre-pandemic measures.Method: A link to an anonymous, web-based COVID-19 related survey was sent via email to all PHCWs at a university hospital in Sweden (n = 1,618) in September 2020. The response rate was 38% (566 of 1,507 eligible participants). Working environment survey responses collected in 2019 were used as pre-pandemic comparators. Statistical analyses were performed to assess overall impact over time on work demands, support, motivation, and recovery, stratified by professional role, and considering variables such as access to personal protective equipment.Results: The percentage of individuals responding negatively to statements about working environment increased significantly for most items after the first wave. Similarly, the increase of five of the investigated factors indicated a more negative perception of recovery during the pandemic. Registered nurses reported a greater negative impact of the pandemic on perceived working conditions and ability to recover than other professional groups. PHCWs working with patients with COVID-19 (35%) who reported being worried about becoming infected (12%) or infecting others (17%), or lacking adequate personal protective equipment (22%) were more negatively impacted regarding work environment-related items than those who did not.Conclusions: PHCWs' working environment and possibility for recovery were impacted by the first wave of the COVID-19 pandemic, nurses being most affected. Although psychiatric services do not directly care for patients with severe COVID-19 infection, the results from this study suggests that mental health services should also prepare for future pandemics.

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Reusable respirators as personal protective equipment during ENT surgery

The Journal of Laryngology & Otology ◽

10.1017/s0022215120001346 ◽

2020 ◽

Vol 134 (8) ◽

pp. 732-734 ◽

Cited By ~ 1

Author(s):

B Patel ◽

J C Hardman ◽

W Yang ◽

A Robson ◽

G Putnam ◽

...

Keyword(s):

Cost Analysis ◽

Head And Neck ◽

Personal Protective Equipment ◽

Cost Effective ◽

Neck Surgery ◽

Protective Equipment ◽

Staff Members ◽

Collective Experience ◽

Cost Effective Alternative ◽

Single Use

AbstractBackgroundRobust personal protective equipment is essential in preventing the transmission of coronavirus disease 2019 to head and neck surgeons who are routinely involved in aerosol generating procedures.ObjectiveThis paper describes the collective experience, across 3 institutes, of using a reusable half-face respirator in 72 head and neck surgery cases.MethodCost analysis was performed to demonstrate the financial implications of using a reusable respirator compared to single-use filtering facepiece code 3 masks.ConclusionThe reusable respirator is a cost-effective alternative to disposable filtering facepiece code 3 respirators. Supplying reusable respirators to individual staff members may increase the likelihood of them having appropriate personal protective equipment during their clinical duties.

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