Community-Based Production of Quality Face Masks for Personal Protection During the COVID-19 Pandemic.

The authors developed a process to produce a reliably fitting face mask from materials that were immediately available to health care workers, to reduce the risk of infection. Multiple materials and designs were developed to produce face masks that focused on ease of production, the ability to generate a reliable facial seal, and the ability to tailor the mask for those who did not fit commercially available N95 masks. Two final designs were selected. Mask components were assembled into kits and distributed to community sewists. Plan-Do-Study-Act cycles were developed for quality improvement. A process was successfully developed to produce 5000 face masks in a period of 3 weeks that fit almost all (95%) health care workers who did not fit in a commercially available mask. The process was able to produce quality face masks with specific attention paid to developing masks that would pass qualitative fit testing.

Incorporating airway examination photography into the electronic record.

BACKGROUND: Photography of the airway has been used in research to validate preoperative airway assessment and the likelihood of identifying the difficult-to-mask ventilate and/or intubate patient. Up till now, no study has demonstrated the perceived utility of incorporation of airway photographs into the anesthesia preassessment. METHODS: The University of Florida Health Presurgical Clinic routinely incorporates three photographs of all adult patients during their preanesthesia visit. The first is a head-on view of the patient opening the mouth widely as part of a Mallampati examination, and the second and third are side views of the patient prognathing and with the neck in maximal extension, respectively. After IRB approval, providers of anesthesia were surveyed regarding their opinions on the perceived value of the new process. Chi-square tests were used to determine if the responses to each question significantly differed from the distribution that would be predicted by chance. P < 0.05 was considered statistically significant. RESULTS: The survey was emailed to 180 individuals, with 145 responding. The responses significantly (P < 0.0001) indicated that the photographs helped the providers plan care for their patients and improved their satisfaction with the preoperative assessment. Technical and educational barriers were overcome using iterative Plan-Do-Study-Act cycles and coaching, respectively. CONCLUSIONS: Photographs of the airway assessment can successfully be taken and incorporated into an electronic medical record in a busy presurgical clinic. The pictures provide additional perceived value to the traditional written assessment of a patient's airway examination by someone else.