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BACKGROUND: Coronavirus disease-2019 (COVID-19) pandemic has exposed healthcare workers (HCWs) to a unique set of challenges and stressors. Our frontline workers are under tremendous psychological pressure because of the ever-rising crisis. This study was done to assess the magnitude of the psychological impact of the COVID-19 pandemic on clinical and nonclinical HCWs in India. MATERIALS AND METHODS: It was a cross-sectional, online survey that was done from June 1, 2020, to July 4, 2020. A total of 313 clinical and nonclinical HCWs, who were directly or indirectly involved in patient care, participated in the study. The psychological impact was assessed in terms of four variables: insomnia, anxiety, depression, and stress. Insomnia was assessed by the Insomnia Severity Index (ISI). Anxiety and depression were assessed via the Patient Health Questionnaire-4 (PHQ-4), which included a 2-item anxiety scale and a 2-item depression scale (PHQ-2). Stress was assessed via the Perceived Stress Scale (PSS). We also compared the psychological impact of this pandemic between clinical and nonclinical HCWs. RESULTS: 7.3% of HCWs were having moderate insomnia, 3.8% had severe insomnia, and 20.8% were having subthreshold insomnia. Severe anxiety and depression were found in 6.7% of respondents. 8.0 and 32.3% of the respondents had moderate and mild anxiety-depression, respectively. 6.4% had high perceived stress. 47.6 and 46.0% of the respondents had moderate and low stress, respectively. There was a statistically significant difference in severe insomnia between clinical and nonclinical HCWs, whereas no significant difference in anxiety, depression, and stress between clinical and nonclinical HCWs. CONCLUSION: This study suggests that psychological morbidity is prevalent among both clinical and nonclinical HCWs and both males and females. Early intervention may be beneficial to prevent this issue. HOW TO CITE THIS ARTICLE: Sunil R, Bhatt MT, Bhumika TV, Thomas N, Puranik A, Chaudhuri S, et al. Weathering the Storm: Psychological Impact of COVID-19 Pandemic on Clinical and Nonclinical Healthcare Workers in India. Indian J Crit Care Med 2021;25(1):16-20.
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Conventional E-C technique of mask holding is unreliable during single person bag mask ventilation (BMV) due mainly to leak around the mask and inexperience of the persons. In this manikin study, conventional E-C technique was compared with E-O technique during single person BMV both with experienced (n = 50) and novice (n = 50) volunteers. The E-O technique involved encircling the mask neck with the web between thumb and index finger while the other digits provided chin lift. Two independent observers recorded the chest expansion as 1 (nil), 2 (minimal), 3 (moderate) and 4 (good). For analysis ideal and average chest expansion were clubbed as acceptable. E-C technique in experienced volunteers showed acceptable results in 49 (31 + 18) occasions, while with novices acceptable is 39 (17 + 22). With E-O technique, expansion was acceptable in 47 (38 + 9) experienced volunteers, and acceptable in 46 (32 + 14) novices. (P = 0.003). In cross over analysis for experienced volunteers, similar chest expansion was obtained on 30 occasions with both techniques, E-C better than E-O on 8 and E-O better than E-C on 12 occasions. Novices had comparable results on 17 occasions, E-C better than E-O on 8 and E-O better than E-C on 25 occasions (P = 0.016). The conventionally taught E-C technique of single person BMV provides acceptable chest expansion on most occasions with experienced operators than novices. Novices should use E-O technique as the first choice for single person BMV. Both techniques may be used interchangeably when one fails.