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1.
J Infect Chemother ; 27(1): 120-122, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32988731

RESUMEN

INTRODUCTION: Information on the effectiveness of personal protective equipment (PPE) for preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among healthcare workers (HCWs), especially among HCWs with frequent contact with patients with SARS-CoV-2, is limited. METHODS: We conducted a prospective cohort study on 49 HCWs who worked in close contact with patients with SARS-CoV-2 infection. HCWs had blood samples taken every 2 weeks to test for SARS-CoV-2 antibodies using two different types of assay. RESULTS: Forty-nine participants (31 nurses, 15 doctors, 3 other workers) were enrolled. In total, 112 blood samples are obtained from participants. The median work days in 2 weeks was 9 (interquartile range (IQR): 5-10) days. In a single work day, 30 of the 49 participants (61.5%) had contact with patients with suspected or conformed SARS-CoV-2 at least 8 times, and approximately 60% of participants had more than 10 min of contact with a single patient. The median self-reported compliance to PPE was 90% (IQR: 80-100%). Seven participants tested positive for SARS-CoV-2 antibody using enzyme-linked immunosorbent assay (ELISA); however, none were seropositive for SARS-CoV-2 neutralizing antibody, so the positive ELISA results were assumed to be false-positive. CONCLUSIONS: The study provides evidence that appropriate PPE is sufficient to prevent infection amongHCWs. It is necessary to establish a system that provides a stable supply of PPE for HCWs to perform their duties.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Personal de Salud , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Pandemias/prevención & control , Equipo de Protección Personal , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Adulto , Anciano , Anticuerpos Antivirales/sangre , Betacoronavirus/inmunología , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neumonía Viral/diagnóstico , Estudios Prospectivos , Adulto Joven
2.
Rev. enferm. UERJ ; 28: 49923, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1097213

RESUMEN

Objetivo: refletir sobre as intervenções/ações de cuidado em saúde mental voltados aos profissionais da saúde que prestam assistência ao paciente suspeito ou diagnosticado com COVID-19. Conteúdo: A pandemia de COVID-19 traz o desafio para profissionais da saúde em lidar com sua própria saúde mental e a dos pacientes. É fundamental conhecer e refletir sobre iniciativas que países apresentam para lidar com a manutenção da saúde mental de profissionais da saúde em tempos de pandemia e que contribuem para repensar o planejamento, execução e avaliação de estratégias a serem utilizadas no Brasil. Considerações finais: foi possível elencar ações em saúde mental que têm se mostrado assertivas no cuidado aos trabalhadores de saúde, atuantes na ponta do cuidado, sobretudo as baseadas no esclarecimento da doença, uso adequado de equipamentos de proteção individual, além do mapeamento daqueles profissionais fragilizados emocionalmente e/ou com sofrimento mental anterior à pandemia, além do suporte emocional oferecido por meio de plataformas digitais.


Objective: to reflect on mental health care interventions/actions aimed at health professionals who provide assistance to patients suspected or diagnosed with COVID-19. Content: The COVID-19 pandemic challenges health professionals to lead with their own and patients' mental health. It is essential to know and to reflect about countries' initiatives to deal with health professional's mental health maintenance in times of pandemic, and to help to re-think strategies planning, execution and evaluation to be used in Brazil. Final considerations: it was possible to list actions in mental health that have shown to be assertive in the care of health workers who are in the front line of caring, especially those based on clarifying the disease, appropriate use of individual protective equipment, in addition to mapping those emotionally weakened professionals and or with mental suffering prior to the pandemic, in addition to the emotional support offered through digital platforms.


Objetivo: reflexionar sobre las intervenciones/acciones de atención de salud mental dirigidas a profesionales de la salud que prestan asistencia a pacientes sospechosos o diagnosticados con COVID-19. Contenido: La pandemia COVID-19 desafía a los profesionales de la salud a hacer frente con la salud mental propia y de los pacientes. Es esencial conocer y reflexionar sobre las iniciativas de los países para enfrentar al mantenimiento de la salud mental de los profesionales de la salud en tiempos de pandemia, y para ayudar a repensar la planificación, ejecución y evaluación de estrategias que se utilizarán en Brasil. Consideraciones finales: fue posible enumerar acciones en salud mental que han demostrado ser asertivas en la atención de los trabajadores de salud que trabajan en la primera línea de atención de la salud, especialmente aquellos basados en la aclaración de la enfermedad, el uso apropiado de equipos de protección individual, además de mapear aquellos profesionales debilitados emocionalmente y / o con sufrimiento mental antes de la pandemia, además del apoyo emocional ofrecido a través de plataformas digitales.


Asunto(s)
Humanos , Masculino , Femenino , Salud Mental/normas , Personal de Salud/psicología , Infecciones por Coronavirus , Pandemias , Betacoronavirus , Brasil , Salud Laboral , Difusión de la Información , Equipo de Protección Personal
3.
Rev. enferm. UERJ ; 28: e51476, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1119621

RESUMEN

Objetivo: desenvolver um modelo de máscara de tecido, com aplicação do elemento filtrante em celulose, para fins de utilização como barreira física segura para aerossóis, como estratégia de resposta emergencial à pandemia provocada pelo SARS-CoV-2. Método: pesquisa laboratorial realizada por meio de protótipos, testagens empíricas e análises e discussões junto a expertises. Resultados: a condução da pesquisa demonstrou que os aerossóis são retidos pela barreira física de celulose introduzida à estrutura das máscaras, o que motivou a segunda fase do estudo em unidade da Rede Brasileira de Laboratórios Analíticos de Saúde sobre a eficácia desses materiais. Conclusão: a confecção de máscaras de tecido é um fenômeno mundial importante e urgente frente à pandemia da COVID-19. Em função da crise de abastecimento e dos parâmetros ressaltados neste estudo, acredita-se que o uso desse equipamento possa ser estendido a setores não críticos de unidades de saúde, além da população em geral.


Objective: to develop a model of fabric mask, with the application of a cellulose filter element, for use as a safe physical barrier for aerosols, as an emergency response strategy for the SARS-CoV-2 pandemic. Method: laboratory research carried out by means of prototypes, empirical tests and analyses, and discussions with experts. Results: the research demonstrated that aerosols are retained by the physical cellulose barrier introduced into the structure of the masks, which motivated the second phase of the study into the effectiveness of these materials at a unit of the Brazilian Analytical Health Laboratories Network. Conclusion: the making of fabric masks is an important and urgent worldwide phenomenon in tackling the COVID-19 pandemic. In view of the supply crisis and the parameters highlighted in this study, it is believed that the use of this equipment can be extended to non-critical sectors of health units, as well as to the general population.


Objetivo: desarrollar un modelo de mascarilla de tela, con la aplicación de un elemento filtrante de celulosa, para su uso como barrera física segura para aerosoles, como estrategia de respuesta de emergencia para la pandemia SARS-CoV-2. Método: investigación de laboratorio realizada mediante prototipos, pruebas y análisis empíricos y discusiones con expertos. Resultados: la investigación demostró que los aerosoles son retenidos por la barrera física de celulosa introducida en la estructura de las máscaras, lo que motivó la segunda fase del estudio sobre la efectividad de estos materiales en una unidad de la Red Brasileña de Laboratorios Analíticos de Salud. Conclusión: la fabricación de máscaras de tela es un fenómeno mundial importante y urgente para hacer frente a la pandemia de COVID-19. Ante la crisis de oferta y los parámetros resaltados en este estudio, se cree que el uso de este equipamiento puede extenderse a sectores no críticos de las unidades de salud, así como a la población en general.


Asunto(s)
Humanos , Infecciones por Coronavirus/prevención & control , Equipo de Protección Personal/normas , Betacoronavirus , Máscaras/normas , Ensayo de Materiales , Brasil , Celulosa , Filtros , Capacidad de Reacción , Pandemias/prevención & control
4.
Texto & contexto enferm ; 29: e20200106, Jan.-Dec. 2020. tab, graf
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1101977

RESUMEN

ABSTRACT Objective: to analyze the COVID-19 pandemic and what we have (re)learned from the world experience of adopting prevention measures recommended by the World Health Organization as well as the epidemiological overview in the world, in Latin America and in Brazil. Results: the World Health Organization has pointed out that the path to reduce the speed of circulation of the virus, control and decrease in the number of cases and deaths resulting from this pandemic can only be accomplished with mass adoption of fundamental measures that include hand hygiene, alcohol gel use, cough etiquette, cleaning surfaces, avoiding agglomerations and social distancing. The epidemiological curve of the disease clearly shows the devastating proportions in Italy, Spain and the United States, surpassing China in death records, due to the delay in adopting the aforementioned measures. In Brazil, the rapid progression in relation to the world and Latin America points to an important increase in the number of cases. Conclusion: this is possibly the most serious pandemic in recent human history, and its course can be influenced by the rigor in adopting individual and collective behavioral measures.


RESUMEN Objetivo: analizar la pandemia de COVID-19 y lo que hemos (re)aprendido de la experiencia mundial para la adopción de las medidas de prevención recomendadas por la Organización Mundial de la Salud, así como el panorama epidemiológico en el mundo, en América Latina y en Brasil. Resultados: la Organización Mundial de la Salud ha señalado que el camino hacia la reducción de la velocidad de circulación del virus, el control y la reducción del número de casos y muertes resultantes de esta pandemia solo se puede lograr con la adopción masiva de medidas fundamentales que incluyan la higiene de las manos, uso de alcohol en gel, etiqueta respiratoria, limpieza de superficies, evitando hacinamiento y distancia social. La curva epidemiológica de la enfermedad muestra claramente las proporciones devastadoras en Italia, España y Estados Unidos, superando a China en los registros de defunciones, debido a la demora en la adopción de estas medidas. En Brasil, la rápida progresión en relación con el mundo y América Latina apunta a un aumento importante en el número de casos. Conclusión: esta pandemia es posiblemente la más grave en la historia humana reciente y su curso puede verse influenciado por el rigor en la adopción de medidas de comportamiento individuales y colectivas.


RESUMO Objetivo: analisar a pandemia da Covid-19 e o que temos (re)aprendido com a experiência mundial para adoção das medidas de prevenção preconizadas pela Organização Mundial de Saúde bem como o panorama epidemiológico no mundo, na América Latina e no Brasil. Resultados: a Organização Mundial de Saúde tem apontado que o caminho para a redução da velocidade de circulação do vírus, o controle e queda do número de casos e óbitos decorrentes dessa pandemia só poderá ser alcançado com adoção em massa de medidas fundamentais que incluem higienização das mãos, uso do álcool em gel, etiqueta respiratória, limpeza de superfícies, evitar aglomerações e distanciamento social. A curva epidemiológica da doença mostra claramente as proporções devastadoras na Itália, Espanha e nos Estados Unidos, superando a China em registros de óbitos, devido ao atraso na adoção dessas medidas. No Brasil, a progressão rápida em relação ao mundo e à América Latina aponta um importante aumento do número de casos. Conclusão: essa pandemia possivelmente é a mais grave da história recente da humanidade e seu curso pode ser influenciado pelo rigor na adoção de medidas comportamentais individuais e coletivas.


Asunto(s)
Humanos , Infecciones por Coronavirus , Prevención de Enfermedades , Pandemias , Equipo de Protección Personal , Betacoronavirus , Aislamiento de Pacientes , Distancia Social , Conducta , Educación en Salud
5.
Rev. enferm. UERJ ; 28: e50360, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1097275

RESUMEN

Objetivo: descrever as recomendações sobre o uso racional e seguro dos equipamentos de proteção individual (EPI) no transcorrer da cadeia assistencial de pessoas com suspeita ou confirmação de contaminação pelo novo coronavírus. Conteúdo: o novo coronavírus é responsável pela doença Covid-19, e dentre as pessoas com maior risco de desenvolver a infecção estão os trabalhadores de saúde, devido ao contato muito próximo a pacientes. Desse modo, a utilização de EPI é recomendação prioritária a estes trabalhadores. Todavia, em função do desabastecimento internacional e nacional relacionado a estes equipamentos, o uso racional é fundamental a fim de evitar que o impacto do desabastecimento seja ainda maior. Conclusão: o uso de EPI é indispensável aos trabalhadores de saúde durante a pandemia de Covid-19, contudo, é imprescindível coordenar a cadeia de fornecimento destes insumos, implementar estratégias que minimizem a necessidade de EPI e garantir o uso de maneira adequada.


Objective: to describe the recommendations on the rational, safe use of personal protective equipment (PPE) throughout the chain of care for people with suspected or confirmed contamination by the new coronavirus. Content: the new coronavirus is responsible for the disease Covid-19, and among those at high risk of infection are health workers in very close contact with patients. It is thus a priority recommendation for these workers to use PPE. However, international and national shortages of this equipment make rational use essential in order to prevent even greater impact from these shortages. Conclusion: it is essential that health workers use PPE during the Covid-19 pandemic, but it is also essential to coordinate the supply chain for these inputs, implement strategies that minimize the need for PPE and ensure proper use.


Objetivo: describir las recomendaciones sobre el uso racional y seguro del equipo de protección personal (EPP) en toda la cadena de atención para las personas con sospecha o confirmación de contaminación por el nuevo coronavirus. Contenido: el nuevo coronavirus es responsable de la enfermedad de Covid-19, y entre aquellos con alto riesgo de infección se encuentran los trabajadores de la salud en contacto muy cercano con los pacientes. Por lo tanto, es una recomendación prioritaria para estos trabajadores usar EPP. Sin embargo, la escasez internacional y nacional de este equipo hace que el uso racional sea esencial para evitar un impacto aún mayor de esta escasez. Conclusión: es esencial que los trabajadores de la salud usen EPP durante la pandemia de Covid-19, pero también es esencial coordinar la cadena de suministro para estos insumos, implementar estrategias que minimicen la necesidad de EPP y garantizar un uso adecuado.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Equipo de Protección Personal/provisión & distribución , Betacoronavirus , Máscaras/provisión & distribución , Riesgos Laborales , Contención de Riesgos Biológicos/normas , Equipo de Protección Personal/normas , Máscaras/normas
6.
J Acoust Soc Am ; 148(4): 2322, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33138475

RESUMEN

Respiratory droplets emitted during speech can transmit oral bacteria and infectious viruses to others, including COVID-19. Loud speech can generate significantly higher numbers of potentially infectious respiratory droplets. This study assessed the effect of speech volume on respiratory emission of oral bacteria as an indicator of potential pathogen transmission risk. Loud speech (average 83 dBA, peak 94 dBA) caused significantly higher emission of oral bacteria (p = 0.004 compared to no speech) within 1 ft from the speaker. N99 respirators and simple cloth masks both significantly reduced emission of oral bacteria. This study demonstrates that loud speech without face coverings increases emission of respiratory droplets that carry oral bacteria and may also carry other pathogens such as COVID-19.


Asunto(s)
Microbiología del Aire , Bacterias/patogenicidad , Infecciones Bacterianas/transmisión , Exposición por Inhalación , Boca/microbiología , Respiración , Acústica del Lenguaje , Aerosoles , Infecciones Bacterianas/microbiología , Infecciones Bacterianas/prevención & control , Humanos , Exposición por Inhalación/prevención & control , Máscaras , Equipo de Protección Personal , Dispositivos de Protección Respiratoria
7.
BMC Oral Health ; 20(1): 301, 2020 11 04.
Artículo en Inglés | MEDLINE | ID: mdl-33148254

RESUMEN

BACKGROUND: The aim of this paper is to assess an innovative risk score for common dental procedures, based on the most recent contaminant SARS-CoV-2. After scoring the level of infection risk, safety procedures, advice and personal protective equipment (PPE) are recommended for the dental team in each dental practice. METHODS: The authors of this research analysed 42 common dental procedures on the basis of known transmission risks. In increasing order, many consider the parameters leading to different risk scores for the dental team and patients for each procedure to be: direct contact with saliva (score 1), direct contact with blood (score 2), production of low levels of spray/aerosol via air-water syringes (score 3), the production of high levels of spray/aerosol from rotating, ultrasound and piezoelectric tools (score 4); and the duration of the procedure, which may increase the risk of procedures producing droplets and aerosols. RESULTS: Using this innovative risk-scoring system, the authors classified the different dental procedures according to low, medium or high risk: low (1-3), medium (4-5), high (≥ 6). A safety protocol for each procedure was thereafter matched with the calculated risk level. CONCLUSIONS: The innovative risk-scoring system presented in this research permits the reclassification of dental procedures according to the infection risk level. Consequently, specific procedures, previously considered as entry level, will now merit revision. This paper also highlighted an effective and routine clinical tool for general dentists and oral medicine practitioners.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Odontología/métodos , Odontología/normas , Neumonía Viral/epidemiología , Medición de Riesgo/métodos , Administración de la Seguridad , Betacoronavirus , Infecciones por Coronavirus/prevención & control , Humanos , Pandemias/prevención & control , Equipo de Protección Personal , Neumonía Viral/prevención & control
9.
BMC Health Serv Res ; 20(1): 1035, 2020 Nov 12.
Artículo en Inglés | MEDLINE | ID: mdl-33176775

RESUMEN

BACKGROUND: To cope with shortages of equipment during the COVID-19 pandemic, we established a nonprofit end-to-end system to identify, validate, regulate, manufacture, and distribute 3D-printed medical equipment. Here we describe the local and global impact of this system. METHODS: Together with critical care experts, we identified potentially lacking medical equipment and proposed solutions based on 3D printing. Validation was based on the ISO 13485 quality standard for the manufacturing of customized medical devices. We posted the design files for each device on our website together with their technical and printing specifications and created a supply chain so that hospitals from our region could request them. We analyzed the number/type of items, petitioners, manufacturers, and catalogue views. RESULTS: Among 33 devices analyzed, 26 (78·8%) were validated. Of these, 23 (88·5%) were airway consumables and 3 (11·5%) were personal protective equipment. Orders came from 19 (76%) hospitals and 6 (24%) other healthcare institutions. Peak production was reached 10 days after the catalogue was published. A total of 22,135 items were manufactured by 59 companies in 18 sectors; 19,212 items were distributed to requesting sites during the busiest days of the pandemic. Our online catalogue was also viewed by 27,861 individuals from 113 countries. CONCLUSIONS: 3D printing helped mitigate shortages of medical devices due to problems in the global supply chain.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Equipos y Suministros/provisión & distribución , Pandemias , Equipo de Protección Personal/provisión & distribución , Neumonía Viral/epidemiología , Impresión Tridimensional , Hospitales , Humanos
10.
Appl Clin Inform ; 11(5): 733-741, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33147644

RESUMEN

BACKGROUND: As the coronavirus disease 2019 pandemic exerts unprecedented stress on hospitals, health care systems have quickly deployed innovative technology solutions to decrease personal protective equipment (PPE) use and augment patient care capabilities. Telehealth technology use is established in the ambulatory setting, but not yet widely deployed at scale for inpatient care. OBJECTIVES: This article presents and describes our experience with evaluating and implementing inpatient telehealth technologies in a large health care system with the goals of reducing use of PPE while enhancing communication for health care workers and patients. METHODS: We discovered use cases for inpatient telehealth revealed as a result of an immense patient surge requiring large volumes of PPE. In response, we assessed various consumer products to address the use cases for our health system. RESULTS: We identified 13 use cases and eight device options. During device setup and implementation, challenges and solutions were identified in five areas: security/privacy, device availability and setup, device functionality, physical setup, and workflow and device usage. This enabled deployment of more than 1,800 devices for inpatient telehealth across seven hospitals with positive feedback from health care staff. CONCLUSION: Large-scale setup and distribution of consumer devices is feasible for inpatient telehealth use cases. Our experience highlights operational barriers and potential solutions for health systems looking to preserve PPE and enhance vital communication.


Asunto(s)
Betacoronavirus/fisiología , Comunicación , Infecciones por Coronavirus/epidemiología , Desastres , Pacientes Internos , Pandemias , Equipo de Protección Personal , Neumonía Viral/epidemiología , Telemedicina , Retroalimentación , Personal de Salud , Humanos , Unidades de Cuidados Intensivos
12.
Antimicrob Resist Infect Control ; 9(1): 185, 2020 11 10.
Artículo en Inglés | MEDLINE | ID: mdl-33168097

RESUMEN

BACKGROUND: Prehospital professionals such as emergency physicians or paramedics must be able to choose and adequately don and doff personal protective equipment (PPE) in order to avoid COVID-19 infection. Our aim was to evaluate the impact of a gamified e-learning module on adequacy of PPE in student paramedics. METHODS: This was a web-based, randomized 1:1, parallel-group, triple-blind controlled trial. Student paramedics from three Swiss schools were invited to participate. They were informed they would be presented with both an e-learning module and an abridged version of the current regional prehospital COVID-19 guidelines, albeit not in which order. After a set of 22 questions designed to assess baseline knowledge, the control group was shown the guidelines before answering a set of 14 post-intervention questions. The e-learning group was shown the gamified e-learning module right after the guidelines, and before answering post-intervention questions. The primary outcome was the difference in the percentage of adequate choices of PPE before and after the intervention. RESULTS: The participation rate was of 71% (98/138). A total of 90 answer sets was analyzed. Adequate choice of PPE increased significantly both in the control (50% [33;83] vs 25% [25;50], P = .013) and in the e-learning group (67% [50;83] vs 25% [25;50], P = .001) following the intervention. Though the median of the difference was higher in the e-learning group, there was no statistically significant superiority over the control (33% [0;58] vs 17% [- 17;42], P = .087). The e-learning module was of greatest benefit in the subgroup of student paramedics who were actively working in an ambulance company (42% [8;58] vs 25% [- 17;42], P = 0.021). There was no significant effect in student paramedics who were not actively working in an ambulance service (0% [- 25;33] vs 17% [- 8;50], P = .584). CONCLUSIONS: The use of a gamified e-learning module increases the rate of adequate choice of PPE only among student paramedics actively working in an ambulance service. In this subgroup, combining this teaching modality with other interventions might help spare PPE and efficiently protect against COVID-19 infection.


Asunto(s)
Betacoronavirus/fisiología , Infecciones por Coronavirus/prevención & control , Personal de Salud/educación , Pandemias/prevención & control , Equipo de Protección Personal , Neumonía Viral/prevención & control , Adulto , Técnicos Medios en Salud/educación , Técnicos Medios en Salud/normas , Betacoronavirus/genética , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Educación a Distancia/estadística & datos numéricos , Europa (Continente) , Femenino , Personal de Salud/normas , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional , Internet , Conocimiento , Aprendizaje , Masculino , Equipo de Protección Personal/normas , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Neumonía Viral/virología , Estudiantes/psicología , Adulto Joven
13.
J Infect Dev Ctries ; 14(10): 1111-1116, 2020 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-33175704

RESUMEN

The recent spread of COVID-19 presents a huge public health concern. Clinical presentations of COVID-19 range from asymptomatic cases to severe pneumonia that can lead to death. Drastic measures were necessary to prevent the disease from spreading and protect the most vulnerable groups in the general population. The rapid reorganization of the healthcare system and great efforts made by medical staff were needed to admit to hospitals and then treat a progressively growing number of patients. The predominant route of virus transmission is through direct contact with an infected individual or respiratory droplets, therefore, all dental procedures with aerosol-formation pose an extremely high risk for the spread of infection. The aim of this article is to provide an overview of the current epidemiological situation, routes of transmission, and specific recommendations for dental practices including patient screening and triage, infection control, and treatment protocols. In this situation, it is essential that all dental healthcare workers make wise clinical decisions and educate themselves and their patients on how to prevent the spread of infection.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Atención Odontológica , Odontología/organización & administración , Pandemias/prevención & control , Neumonía Viral/prevención & control , Betacoronavirus , Infecciones por Coronavirus/transmisión , Humanos , Control de Infecciones , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Equipo de Protección Personal , Neumonía Viral/transmisión , Medición de Riesgo
14.
PLoS One ; 15(11): e0242185, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33175877

RESUMEN

Many affected counties have had experienced a shortage of personal protective equipment (PPE) during the coronavirus disease (COVID-19) pandemic. We aimed to investigate the needs of healthcare professionals and the technical difficulties faced by them during the initial outbreak. A cross-sectional web-based survey was conducted among the healthcare workforce in the most populous cities from three Latin American countries in April 2020. In total, 1,082 participants were included. Of these, 534 (49.4%), 263 (24.3%), and 114 (10.5%) were physicians, nurses, and other professionals, respectively. At least 70% of participants reported a lack of PPE. The most common shortages were shortages in gown coverall suits (643, 59.4%), N95 masks (600, 55.5%), and face shields (569, 52.6%). Professionals who performed procedures that generated aerosols reported shortages more frequently (p<0.05). Professionals working in the emergency department and primary care units reported more shortages than those working in intensive care units and hospital-based wards (p<0.001). Up to 556 (51.4%) participants reported the lack of sufficient knowledge about using PPE. Professionals working in public institutions felt less prepared, received less training, and had no protocols compared with their peers in working private institutions (p<0.001). Although the study sample corresponded to different hospital centers in different cities from the participating countries, sampling was non-random. Healthcare professionals in Latin America may face more difficulties than those from other countries, with 7 out of 10 professionals reporting that they did not have the necessary resources to care for patients with COVID-19. Technical and logistical difficulties should be addressed in the event of a future outbreak, as they have a negative impact on healthcare workers. Clinical trial registration: NCT04486404.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Personal de Salud/psicología , Equipo de Protección Personal/estadística & datos numéricos , Neumonía Viral/diagnóstico , Betacoronavirus/aislamiento & purificación , Brasil , Colombia , Infecciones por Coronavirus/virología , Estudios Transversales , Ecuador , Instituciones de Salud , Humanos , Pandemias , Neumonía Viral/virología , Encuestas y Cuestionarios
15.
Sensors (Basel) ; 20(21)2020 Oct 29.
Artículo en Inglés | MEDLINE | ID: mdl-33138092

RESUMEN

Since its beginning at the end of 2019, the pandemic spread of the severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2) caused more than one million deaths in only nine months. The threat of emerging and re-emerging infectious diseases exists as an imminent threat to human health. It is essential to implement adequate hygiene best practices to break the contagion chain and enhance society preparedness for such critical scenarios and understand the relevance of each disease transmission route. As the unconscious hand-face contact gesture constitutes a potential pathway of contagion, in this paper, the authors present a prototype system based on low-cost depth sensors able to monitor in real-time the attitude towards such a habit. The system records people's behavior to enhance their awareness by providing real-time warnings, providing for statistical reports for designing proper hygiene solutions, and better understanding the role of such route of contagion. A preliminary validation study measured an overall accuracy of 91%. A Cohen's Kappa equal to 0.876 supports rejecting the hypothesis that such accuracy is accidental. Low-cost body tracking technologies can effectively support monitoring compliance with hygiene best practices and training people in real-time. By collecting data and analyzing them with respect to people categories and contagion statistics, it could be possible to understand the importance of this contagion pathway and identify for which people category such a behavioral attitude constitutes a significant risk.


Asunto(s)
Personal de Salud , Procesamiento de Imagen Asistido por Computador/métodos , Dispositivos Electrónicos Vestibles , Algoritmos , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/virología , Desinfección/economía , Desinfección/métodos , Humanos , Procesamiento de Imagen Asistido por Computador/economía , Procesamiento de Imagen Asistido por Computador/instrumentación , Salud Laboral , Pandemias/prevención & control , Equipo de Protección Personal , Neumonía Viral/diagnóstico , Neumonía Viral/prevención & control , Neumonía Viral/virología
17.
BMC Nephrol ; 21(1): 470, 2020 11 10.
Artículo en Inglés | MEDLINE | ID: mdl-33172405

RESUMEN

BACKGROUND: Coronavirus Disease 2019 (COVID-19) has substantially impacted the provision of medical services. During the pandemic, many medical services, including facilities providing care to patients with end stage renal disease faced challenges in safeguarding patients and staff while providing clinical care. This study aims to identify the extent, range, and nature of articles related to COVID-19 and maintenance hemodialysis to understand the research gaps and propose recommendations for future research. METHODS: Using the terms: "Dialysis" OR "RRT" OR "Renal replacement therapy" AND "SARS-COV-2" OR "COVID-19" OR "novel coronavirus" OR "2019-nCov", we performed a multi-step systematic search of the literature in the English language in Pubmed, Scopus, Embase, and Web of Science published from December 1, 2019, to May 13, 2020. Two authors separately screened the title and abstracts of the documents and ruled out irrelevant articles. We obtained a full report of the papers that met our inclusion criteria and screened the full texts. We conducted a descriptive analysis of the characteristics of the included articles and performed a narrative synthesis of the results. We conducted this scoping review in accordance with the PRISMA-ScR Checklist. RESULTS: We included 22 articles in this scoping review. Perspectives (n = 9), editorials (n = 4), and case series (n = 5) were the most common types of articles. Most articles were from Italy and the United States. Seventeen (77.3%) of the articles focused on the topic of recommendation for outpatient hemodialysis units. While many of the recommendations overlapped in several articles, there were also many unique recommendations. CONCLUSIONS: most of the articles are based on single-center experience, which spontaneously developed best practices. Many of these practices have formed the basis for policies and guidelines that will guide future prevention of infection and management of patients with End Stage Renal Disease (ESRD) and COVID-19.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Fallo Renal Crónico/terapia , Neumonía Viral/epidemiología , Guías de Práctica Clínica como Asunto , Diálisis Renal/normas , Adulto , Temperatura Corporal , Niño , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Amigos , Personal de Salud/educación , Hemodiálisis en el Domicilio , Humanos , Pandemias/prevención & control , Educación del Paciente como Asunto , Equipo de Protección Personal , Neumonía Viral/diagnóstico , Neumonía Viral/prevención & control , Cuarentena/métodos , Terapia de Reemplazo Renal , Evaluación de Síntomas
18.
BMJ Open Qual ; 9(4)2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33154097

RESUMEN

Since the outbreak of COVID-19 in December 2019, there had been global shortage of personal protective equipment (PPE) supply due to the breakage of supply chain and also the forbidding of PPE exported by various countries. This situation had greatly affected the healthcare services in local hospitals of Hong Kong. To maintain the availability of PPE for healthcare workers in high-risk clinical settings, the cluster management of New Territories West Cluster, Hospital Authority, had implemented a bundle of interventions in controlling and managing the PPE consumption and ensuring its proper use. A Taskforce on Management of PPE was set up in February 2020 with the aim to monitor and manage the use of PPE in five local hospitals and eight general outpatient clinics of New Territories West Cluster, which were governed in a cluster basis, under the COVID-19 epidemic. Interventions including cutting down non-essential services, implementing telecare, monitoring PPE consumption at unit level and PPE stock at the Cluster Central Distribution Centre and forming mobile infection teams were implemented. The updated PPE standards and usage guidelines to clinical staff were promulgated through forums, newsletters and unit visits. The PPE consumption rates of individual unit were reviewed. Significant decrease in PPE consumption rates was noted when comparing with the baseline data. Comparing the data between 20 February and 1 June 2020, the overall PPE consumption rates were reduced by 64% (r=-0.841; p<0.001) while the PPE consumption rates in anaesthesia and operating theatres, and isolation and surveillance wards were reduced by 47% (r=-0.506; p=0.023) and 49% (r=-0.810; p<0.001), respectively. A bundled approach, including both administrative measures and staff education, is effective in managing PPE consumption during major infection outbreaks especially when PPE supply is at risk.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Asignación de Recursos para la Atención de Salud/normas , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Pandemias/prevención & control , Equipo de Protección Personal/provisión & distribución , Neumonía Viral/prevención & control , Comités Consultivos , Betacoronavirus , Hong Kong , Hospitales/estadística & datos numéricos , Humanos
19.
Biomedica ; 40(Supl. 2): 180-187, 2020 10 30.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33152202

RESUMEN

The pandemic caused by COVID19 is associated with an increase in the number of cases of cardiorespiratory arrest, which has resulted in ethical concerns regarding the enforceability of cardiopulmonary resuscitation, as well as the conditions to carry it out. The risk of aerosol transmission and the clinical uncertainties about the efficacy, the potential sequelae, and the circumstances that could justify limiting this procedure during the pandemic have multiplied the ethical doubts on how to proceed in these cases. Based on ethical and legal grounds, this paper offers a practical guide on how to proceed in the clinical setting in cases of cardiopulmonary arrest during the pandemic. The criteria of justice, benefit, no harm, respect for autonomy, precaution, integrity, and transparency are asserted in an organized and practical framework for decision-making regarding cardiopulmonary resuscitation.


Asunto(s)
Betacoronavirus , Reanimación Cardiopulmonar/ética , Infecciones por Coronavirus/complicaciones , Paro Cardíaco/terapia , Pandemias , Neumonía Viral/complicaciones , Guías de Práctica Clínica como Asunto , Directivas Anticipadas , Aerosoles , Microbiología del Aire , Reanimación Cardiopulmonar/métodos , Toma de Decisiones Clínicas , Colombia/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Paro Cardíaco/etiología , Humanos , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Inutilidad Médica , Exposición Profesional , Pandemias/prevención & control , Autonomía Personal , Equipo de Protección Personal , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Justicia Social
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