scholarly journals Risk of COVID-19 Infection in Healthcare Workers Exposed During Use of Non-invasive Ventilation in a Tertiary Care Hospital in OmanRisk of COVID-19 Infection in Healthcare Workers Exposed During Use of Non-invasive Ventilation in a Tertiary Care Hospital in Oman

2021 ◽  
Vol 36 (2) ◽  
pp. e236-e236
Author(s):  
Adil Al Lawati ◽  
Faryal Khamis ◽  
Samiha Al Habsi ◽  
Khazina Al Dalhami
Keyword(s):  
High Risk ◽  
Healthcare Workers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Significant Risk ◽  
High Risk Population ◽  
Care Hospital ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

Objectives: Healthcare workers (HCWs), especially those working on the front line, are considered to be at high risk of nosocomial acquisition of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19). Little is known about the effectiveness of the recommended protective methods as few reports have described spread of the disease in hospital settings among this high-risk population. We describe the hospital-based transmission of SARS-CoV-2 related to non-invasive ventilation (NIV) in one of the main tertiary care hospitals in Oman. Methods: All exposed patients and HCWs from Royal Hospital were screened, quarantined, and underwent telephone interviews to stratify their risk factors, clinical symptoms, and exposure risk assessment. Results: A total of 46 HCWs and patients tested positive for SARS-CoV-2 after exposure to an index case who received 48 hours of NIV before diagnosing COVID-19 infection. Over half of the exposed (56.5%; n = 26) were nurses, 26.1% (n = 12) were patients, and 15.2% (n = 7) were doctors. None of the HCWs required hospitalization. Sore throat, fever, and myalgia were the most common symptoms. Conclusions: NIV poses a significant risk for SARS-CoV-2 transmission within hospital settings if appropriate infection control measures are not taken.

scholarly journals Serological testing reveals the hidden COVID-19 burden among healthcare workers experiencing a SARS-CoV-2 nosocomial outbreak.

2021 ◽  
Author(s):  
Yu Nakagama ◽  
Yuko Komase ◽  
Katherine Candray ◽  
Sachie Nakagama ◽  
Fumiaki Sano ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Nucleic Acid Amplification ◽  
Care Hospital ◽  
Case Detection ◽  
Serological Testing ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Serological Diagnostics

We describe the results of testing healthcare workers from a tertiary care hospital in Japan, which had experienced a COVID-19 outbreak during the first peak of the pandemic, for SARS-CoV-2 specific antibody seroconversion. Using two chemiluminescent immunoassays and a confirmatory surrogate virus neutralization test, serological testing unveiled that a surprising 42.2% (27/64) of overlooked COVID-19 diagnoses had occurred when case detection had relied solely on SARS-CoV-2 nucleic acid amplification testing. This undetected portion of the COVID-19 iceberg beneath the surface may potentially have led to silent transmissions and triggered the spread. A questionnaire-based risk assessment was further indicative of exposures to specific aerosol-generating procedures, i.e. non-invasive ventilation, having had conveyed the highest transmission risks and served as the origin of outbreak. Our observations are supportive of a multi-tiered testing approach, including the use of serological diagnostics, in order to accomplish exhaustive case detection along the whole COVID-19 spectrum.

scholarly journals Time to Act: Set Up for Non-Invasive ventilation in Tertiary Care Hospital

1970 ◽  
Vol 9 (1) ◽  
pp. 54-55
Author(s):  
SS Dhakal ◽  
N Bhatta ◽  
S Rijal
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Set Up

DOI: 10.3126/hren.v9i1.4365Health Renaissance, 2011: Vol.9 No.1:54-55

scholarly journals LO02: Development of the HEARTRISK6 Scale for emergency department patients with acute heart failure

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S7
Author(s):  
I. Stiell ◽  
A. McRae ◽  
B. Rowe ◽  
J. Dreyer ◽  
L. Mielniczuk ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Acute Heart Failure ◽  
Tertiary Care ◽  
Care Hospital ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Risk Patients ◽  
Risk Scale

Introduction: We previously derived (N = 559) and validated (N = 1,100) the 10-item Ottawa Heart Failure Risk Scale (OHFRS), to assist with disposition decisions for patients with acute heart failure (AHF) in the emergency department (ED). In the current study we sought to use a larger dataset to develop a more concise and more accurate risk scale. Methods: We analyzed data from the prior two studies and from a new cohort. For all 3 groups we conducted prospective cohort studies that enrolled patients who required treatment for AHF at 8 tertiary care hospital EDs. Patients were followed for 30 days. The primary outcome was short-term serious outcome (SSO), defined as death within 30 days, intubation or non-invasive ventilation (NIV) after admission, myocardial infarction, or relapse resulting in hospital admission within 14 days. The fully pre-specified logistic regression model with 13 predictors (where age, pCO2, and SaO2 were modeled using spline functions) was fitted to 10 multiple imputation datasets. Harrell's fast stepdown procedure reduced the number of variables. We calculated the potential impact on sensitivity (95% CI) for SSO and hospital admissions, and estimated a sample size of 2,000 patients. Results: The 1,986 patients had mean age 77.3 years, male 54.1%, EMS arrival 41.2%, IV NTG 3.3%, ED NIV 5.4%, admission on initial visit 49.5%. Overall there were 236 (11.9%) SSOs including 61 deaths (3.1%), meaning that current admission practice sensitivity for SSO was only 59.7%. The final HEARTRISK6 scale is comprised of 6 variables (points) (C-statistic 0.68): Valvular heart disease (2) Antiarrhythmic medication (2) ED non-invasive ventilation (3) Creatinine 80–150 (1); ≥150 (3) Troponin ≥3x URL (2) Walk test failed (1). The probability of SSO ranged from 4.8% for a total score of 0 to 62.4% for a score of 10, showing good calibration. Choosing a HEARTRISK6 total point admission threshold of ≥3 would yield sensitivity of 70.8% (95%CI 64.5-76.5) for SSO with a slight decrease in admissions to 47.9%. Choosing a threshold of ≥2 would yield a sensitivity of 84.3% (95%CI 79.0-88.7) but require 66.6% admissions. Conclusion: Using a large prospectively collected dataset, we created a more concise and more sensitive risk scale to assist with admission decisions for patients with AHF in the ED. Implementation of the HEARTRISK6 scale should lead to safer and more efficient disposition decisions, with more high-risk patients being admitted and more low-risk patients being discharged.

scholarly journals A Study of the Awareness Levels of Universal Precautions in High-risk Areas of a Super-specialty Tertiary Care Hospital

2015 ◽  
Vol 3 (2) ◽  
pp. 98-102
Author(s):  
Kanika Jain ◽  
IB Singh ◽  
Amit Lathwal ◽  
Sanjay Kumar Arya ◽  
Ravinder Ahlawat
Keyword(s):  
High Risk ◽  
Healthcare Workers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Universal Precautions ◽  
Adequate Knowledge ◽  
Control And Prevention ◽  
Risk Areas ◽  
Structured Questionnaire

ABSTRACT Centers for disease control and prevention (CDC), Atlanta, in 1987, defined universal precautions and recommended that blood and body fluid precautions be consistently used for all patients. Although universal precautions have been in existence for a long period of time and the risk of transmission of blood borne infections to healthcare workers (HCWs) is very real, the awareness levels among HCWs to these precautions is still far from satisfactory. This study was conceived to study the knowledge of universal precautions in high-risk areas of a super-specialty tertiary care hospital in India among different categories of HCWs. A pretested structured questionnaire common to all the categories of HCWs was used to study the awareness levels of universal precautions. Each question was assigned a unit score. Seventy-five percent score in the questionnaire was taken as cut-off for adequate knowledge. The findings of the study reveal that the HCWs who had adequate knowledge of universal precautions were 29 (30%) out of 96 HCWs. These included 17 (53%) doctors, 8 (36%) nurses, 3 (31%) technical staffs and 1 (5%) housekeeping staff. How to cite this article Lathwal A, Arya SK, Singh IB, Ahlawat R, Jain K. A Study of the Awareness Levels of Universal Precautions in High-risk Areas of a Super-specialty Tertiary Care Hospital. Int J Res Foundation Hosp Healthc Adm 2015;3(2):98-102.

scholarly journals Use of monoclonal antibody therapy for nosocomial SARS-CoV-2 infection in patients at high risk for severe COVID-19: experience from a tertiary-care hospital in Germany

Infection ◽  
2021 ◽  
Author(s):  
Johanna Koehler ◽  
Barbara Ritzer ◽  
Simon Weidlich ◽  
Friedemann Gebhardt ◽  
Chlodwig Kirchhoff ◽  
...  
Keyword(s):  
High Risk ◽  
Tertiary Care Hospital ◽  
Severe Disease ◽  
Treatment Options ◽  
Tertiary Care ◽  
Antibody Therapy ◽  
Additional Treatment ◽  
Care Hospital ◽  
Cross Sectional ◽  
Asymptomatic Patients

AbstractAdditional treatment options for coronavirus disease (COVID-19) are urgently needed, particularly for populations at high risk of severe disease. This cross-sectional, retrospective study characterized the outcomes of 43 patients with nosocomial severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with and without treatment using monoclonal SARS-CoV-2 spike antibodies (bamlanivimab or casirivimab/imdevimab). Our results indicate that treatment with monoclonal antibodies results in a significant decrease in disease progression and mortality when used for asymptomatic patients with early SARS-CoV-2 infection.

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