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1.
BMJ Case Rep ; 14(2)2021 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-33547110

RESUMEN

A young man presented to our centre needing an urgent debridement of his postcraniotomy wound due to massive myiasis during the COVID-19 pandemic in October 2020. Prior to the surgery, his nasopharyngeal swab real-time PCR test result was unknown. One day later, it returned as SARS-CoV-2 positive. All healthcare workers who were involved in the patient management avoided cross infection as they wore appropriate personal protective equipment. This article depicts the importance of adequate preparations when handling potentially infectious patients and the perioperative issues associated with it.


Asunto(s)
/complicaciones , Desbridamiento/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Miasis/complicaciones , Miasis/cirugía , Atención Perioperativa/métodos , Cuero Cabelludo/cirugía , Adulto , Humanos , Masculino , Equipo de Protección Personal , Adulto Joven
2.
BMJ Open Qual ; 10(1)2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33589506

RESUMEN

The surge in clinical demand, shortage in personal protective equipment and high-exposure risk for healthcare workers during the COVID-19 pandemic has challenged hospital common practices and forced a reassessment of care delivery models. Code blue teams are highly specialised units that partake in life-saving situations that can jeopardise the safety of team members. There is a paucity of guidance in regards to proper infection control measures to protect the responders.This study describes a methodical approach to assessing vulnerabilities to transmission of SARS-CoV-2 within existing code blue practices, modalities to limit the number of code blue team responders and modifications to the protocol at a large community teaching hospital. The effort undertaken faced challenges due to the nature of the pandemic and the increased demand on healthcare workers. Quality improvement methods facilitated our protocol design and implementation. To this date, there has been no identified COVID-19 disease in any protected code blue (PCB) team members. We recommend that similar practices be considered and adopted widely and practised periodically.


Asunto(s)
/prevención & control , Personal de Salud/educación , Equipo Hospitalario de Respuesta Rápida/normas , Control de Infecciones/normas , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Adulto , Femenino , Grupos Focales , Personal de Salud/normas , Hospitales de Enseñanza , Humanos , Control de Infecciones/métodos , Masculino , Persona de Mediana Edad , Equipo de Protección Personal , Mejoramiento de la Calidad
3.
BMJ Case Rep ; 14(2)2021 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-33597165

RESUMEN

Placement of a double-lumen tube to achieve one lung ventilation is an aerosol-generating procedure. Performing it on a patient with COVID-19 will put healthcare workers at high risk of contracting the disease. We herein report a case of its use in a patient with traumatic diaphragmatic rupture, who was also suspected to have COVID-19. This article aims to highlight the issues, it presented and ways to address them as well as the perioperative impact of personal protective equipment.


Asunto(s)
/prevención & control , Personal de Salud/normas , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Ventilación Unipulmonar/normas , Equipo de Protección Personal/normas , Accidentes de Tránsito , Adulto , /transmisión , Diafragma/lesiones , Diafragma/cirugía , Humanos , Masculino , Ventilación Unipulmonar/instrumentación , Guías de Práctica Clínica como Asunto , /etiología , Rotura/etiología , Rotura/terapia
4.
J Wound Care ; 30(Sup2): S12-S17, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33573492

RESUMEN

COVID-19 is highly contagious and its rapid spread burdens the healthcare system. As the number of confirmed cases goes up, the shortage of medical resources has become a challenge. To avoid the collapse of the healthcare system during the fight with COVID-19, all healthcare workers, including wound care practitioners, should adapt to new roles and use any appropriate methods available to slow the spread of the virus. Integrating telemedicine into wound care during the outbreak helps maintain social distancing, preserve personal protective equipment and medical resources, and eliminate unnecessary exposure for both vulnerable patients and high-risk healthcare workers.


Asunto(s)
Atención Ambulatoria , Pie Diabético/terapia , Telemedicina , Triaje , Heridas y Traumatismos/terapia , Infección Hospitalaria/prevención & control , Procedimientos Quirúrgicos Electivos , Hospitalización , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control
5.
Saudi Med J ; 42(2): 166-169, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33563735

RESUMEN

OBJECTIVES: To avoid hospital spread of Coronavirus-2019 (COVID-19) and to analyze out of hospital outcomes after amputation. METHODS: Prospective analysis of data obtained from 60 diabetic patients in 2020 was performed at Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina. Personal protection equipment included double surgical mask, glasses, disposable surgical coats, and surgical masks for patients. Swabs were used to take samples from wounds. We randomly divided patients in 2 groups of 30 patients each. In pre-operative treatment, we used local anesthesia lidocaine hydrochloride 2% (Belupo, Koprivnica, Croatia) in group A and systemic analgesia intravenous tramadol chloride 100 mg intravenous (Krka, Novo Mesto, Slovenia) in group B. Wounds were surgically treated each day and heal spontaneously. Periodical control exams were performed. RESULTS: Wound healing did not present any statistically significant differences between groups (group A: 69±21.97 and B: 61±22.13 days, t=-1.22; p=0.11). No statistically significant differences (p<0.05) between groups A and B in wound healing regarding to gender or cigarette use was noted. CONCLUSION: No significant differences in amputation treatment between the 2 comparative groups were noted. No confirmed COVID-19 infections in medical staff who performed surgical interventions or in treated patients were detected.


Asunto(s)
Amputación , Pie Diabético/cirugía , Control de Infecciones/métodos , Atención Perioperativa/métodos , Bosnia y Herzegovina/epidemiología , /epidemiología , Pie Diabético/complicaciones , Femenino , Humanos , Control de Infecciones/instrumentación , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/prevención & control , Masculino , Pandemias , Equipo de Protección Personal , Estudios Prospectivos , Resultado del Tratamiento , Cicatrización de Heridas
6.
Artículo en Inglés | MEDLINE | ID: mdl-33567665

RESUMEN

BACKGROUND: During the SARS-CoV-2 pandemic, there was shortage of the standard respiratory protective equipment (RPE). The aim of this study was to develop a procedure to test the performance of alternative RPEs used in the care of COVID-19 patients. METHODS: A laboratory-based test was developed to compare RPEs by total inward leakage (TIL). We used a crossflow nebulizer to produce a jet spray of 1-100 µm water droplets with a fluorescent marker. The RPEs were placed on a dummy head and sprayed at distances of 30 and 60 cm. The outcome was determined as the recovery of the fluorescent marker on a membrane filter placed on the mouth of the dummy head. RESULTS: At 30 cm, a type IIR surgical mask gave a 17.7% lower TIL compared with an FFP2 respirator. At 60 cm, this difference was similar, with a 21.7% lower TIL for the surgical mask compared to the respirator. When adding a face shield, the TIL at 30 cm was further reduced by 9.5% for the respirator and 16.6% in the case of the surgical mask. CONCLUSIONS: A safe, fast and very sensitive test method was developed to assess the effectiveness of RPE by comparison under controlled conditions.


Asunto(s)
/prevención & control , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Máscaras/normas , Equipo de Protección Personal/normas , Dispositivos de Protección Respiratoria/normas , Aerosoles/efectos adversos , Humanos , Exposición Profesional/prevención & control , Ventiladores Mecánicos , Agua
7.
AORN J ; 113(2): 147-164, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33534156

RESUMEN

The evolution of SARS-CoV-2 from a zoonotic virus to a novel human pathogen resulted in the coronavirus disease 2019 (COVID-19) global pandemic. Health care delivery and infection prevention and control recommendations continue to evolve to protect the safety of health care personnel, patients, and visitors while researchers and policymakers learn more about SARS-CoV-2 and COVID-19. The perioperative setting is unique in that it exposes clinicians and personnel to increased risks through the invasive nature of surgical care. Using the Centers for Disease Control and Prevention's Hierarchy of Controls as a model, this article presents risk mitigation strategies for preventing the transmission of COVID-19 in the perioperative environment. The goals are to identify and eliminate potential exposure to SARS-CoV-2 when surgery is necessary for patients who are suspected or confirmed to have COVID-19 or who have an unknown infection status.


Asunto(s)
/transmisión , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Enfermería Perioperatoria , /enfermería , Humanos , Control de Infecciones
8.
Ann R Coll Surg Engl ; 103(2): e44-e47, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33559561

RESUMEN

Surgical tracheostomy is a high aerosol-generating procedure that is an essential aid to the recovery of patients who are critically ill with COVID-19 pneumonia. We present a single-centre case series of 16 patients with COVID-19 pneumonia who underwent tracheostomy. We recommend that the patient selection criteria for achieving a favourable outcome should be based on fraction of inspired oxygen together with prone-position ventilation. As with any challenging situation, the importance of effective communication is paramount. The critical modifications in the surgical steps are clearly explained. Timely tracheostomy also leads to an earlier freeing up of ventilator space during a period of a rapidly escalating pandemic. The outcomes in terms of swallow and speech function were also assessed. The study has also helped to remove the anxiety around open a tracheostomy in patients who are COVID-19 positive.


Asunto(s)
/terapia , Traqueostomía/métodos , Adulto , Anciano , Extubación Traqueal , /transmisión , Femenino , Humanos , Control de Infecciones , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Masculino , Persona de Mediana Edad , Equipo de Protección Personal , Respiración Artificial , Resultado del Tratamiento
9.
Sci Rep ; 11(1): 3179, 2021 02 04.
Artículo en Inglés | MEDLINE | ID: mdl-33542400

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected millions and killed more than 1.7 million people worldwide as of December 2020. Healthcare providers are at increased risk of infection when caring for patients with COVID-19. The mechanism of transmission of SARS-CoV-2 is beginning to emerge as airborne spread in addition to direct droplet and indirect contact as main routes of transmission. Here, we report on the design, construction, and testing of the BADGER (Box for Aerosol and Droplet Guarding and Evacuation in Respiratory Infection), an affordable, scalable device that contains droplets and aerosol particles, thus minimizing the risk of infection to healthcare providers. A semi-sealed environment is created inside the BADGER, which is placed over the head of the patient and maintains at least 12-air changes per hour using in-wall vacuum suction. Multiple hand-ports enable healthcare providers to perform essential tasks on a patient's airway and head. Overall, the BADGER has the potential to contain large droplets and small airborne particles as demonstrated by simulated qualitative and quantitative assessments to provide an additional layer of protection for healthcare providers treating COVID-19 and future respiratory contagions.


Asunto(s)
Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Equipos de Seguridad , Aerosoles , /transmisión , Humanos
10.
Ann Fam Med ; 19(1): 55-62, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33431393

RESUMEN

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has led at times to a scarcity of personal protective equipment, including medical masks, for health care clinicians, especially in primary care settings. The objective of this review was to summarize current evidence regarding the use of cloth masks to prevent respiratory viral infections, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), among health care clinicians. METHODS: We searched 5 databases, the Centers for Disease Control and Prevention website, and the reference lists of identified articles on April 3, 2020. All identified publications were independently screened by 2 reviewers. Two authors independently extracted data and graded the studies. Randomized control trials (RCTs) were graded using the Consolidated Standards of Reporting Trials (CONSORT) checklist, and observational and nonhuman subject studies were graded using 11 domains common across frequently used critical appraisal tools. All discrepancies were resolved by consensus. RESULTS: Our search identified 136 original publications. Nine studies met inclusion criteria. We performed a qualitative synthesis of the data from these studies. Four nonrandomized trials, 3 laboratory studies, 1 single-case experiment, and 1 RCT were identified. The laboratory studies found that cloth materials provided measurable levels of particle filtration but were less efficacious at blocking biologic material than medical masks. The RCT found that cloth masks were associated with significantly more viral infections than medical masks. CONCLUSIONS: The current literature suggests that cloth materials are somewhat efficacious in filtering particulate matter and aerosols but provide a worse fit and inferior protection compared to medical masks in clinical environments. The quality and quantity of literature addressing this question are lacking. Cloth masks lack evidence for adequate protection of health care clinicians against respiratory viral infections.


Asunto(s)
/prevención & control , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Máscaras/normas , Textiles , Diseño de Equipo , Humanos , Máscaras/provisión & distribución , Ensayo de Materiales , Equipo de Protección Personal/provisión & distribución , Estados Unidos
11.
Cir Cir ; 89(1): 4-11, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33498060

RESUMEN

Background: The coronavirus disease 2019 (COVID-19) outbreak have major implications in conventional surgical practice. As the number of patients with this diagnosis is rising, the infection risk for the surgical staff will be higher. Few publications have addressed the surgical management of patients diagnosed with COVID-19. Objective: To assess recommendations for care of patients and surgical team during the COVID-19 pandemic. Method: MEDLINE, Embase and the Cochrane Database of Systematic Reviews (April 2020) were searched the key words "COVID-19", "PROTOCOL" and "SURGERY". Relevant recommendations, guidelines and cases series were checked for the most accurate information for apply to our center. Results: We found 379 papers that included the key words. A total of 25 papers were included in the manuscript based in the pertinence of the recommendations. Three major topics were selected: perioperative, intraoperative and postoperative. Conclusion: As an attempt to regulate the surgical team approach, we present recommendations to preserve patients and surgical staff safety with high quality standards of care through reproducible strategies applicable in most hospital centers.


Asunto(s)
/prevención & control , Infección Hospitalaria/prevención & control , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/prevención & control , Pandemias , Aerosoles , Contaminación del Aire Interior , Citas y Horarios , Desinfección/métodos , Contaminación de Equipos/prevención & control , Humanos , México , Exposición Profesional , Quirófanos , Aislamiento de Pacientes , Atención Perioperativa , Equipo de Protección Personal , Personal de Hospital , Sala de Recuperación , Esterilización/métodos , Equipo Quirúrgico
12.
Air Med J ; 40(1): 16-19, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33455620

RESUMEN

Helmet-based noninvasive ventilation (NIV) is a viable option for the safe transport of potential or known coronavirus disease 2019 patients. Given the most likely modes of transmission through droplets, aerosols, and fomite contact, airway procedures such as endotracheal intubation place air medical crews and other health care providers at high risk for exposure. This, together with data that suggest that a large cohort of coronavirus disease 2019 patients have better outcomes if we can avoid intubating them, creates a need for a safe method of NIV or high-flow oxygen delivery during transport. Commonly used and successful in-hospital regimens for these patients are high-flow nasal cannula and continuous positive airway pressure or bilevel positive airway pressure. In some studies, helmet NIV has been shown to be a viable, if not superior, alternative to these therapies for patients with acute hypoxemic respiratory failure. Furthermore, because it is a sealed and closed space that completely isolates the patient's airway and breathing, it provides a very high degree of protection from exposure to pathogens transmitted through droplets or aerosols. This article discusses practical implementation of helmet NIV in air medical transport.


Asunto(s)
Ambulancias Aéreas , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Ventilación no Invasiva/instrumentación , /transmisión , Humanos , Ventilación no Invasiva/métodos
13.
Air Med J ; 40(1): 54-59, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33455627

RESUMEN

OBJECTIVE: The aeromedical transport of coronavirus patients presents risks to clinicians and aircrew. Patient positioning and physical barriers may provide additional protection during flight. This paper describes airflow testing undertaken on fixed wing and rotary wing aeromedical aircraft. METHODS: Airflow testing was undertaken on a stationary Hawker Beechcraft B200C and Leonardo Augusta Westland 139. Airflow was simulated using a Trainer 101 (MSS Professional A/S, Odense Sø, Syddanmark, Denmark) Smoke machine. Different cabin configurations were used along with variations in heating, cooling, and ventilation systems. RESULTS: For the Hawker Beechcraft B200C, smoke generated within the forward section of the cabin was observed to fill the cabin to a fluid boundary located in-line with the forward edge of the cargo door. With the curtain closed, smoke was only observed to enter the cockpit in very small quantities. For the Leonardo AW139, smoke generated within the cabin was observed to expand to fill the cabin evenly before dissipating. With the curtain closed, smoke was observed to enter the cockpit only in small quantities CONCLUSION: The use of physical barriers in fixed wing and rotary wing aeromedical aircraft provides some protection to aircrew. Optimal positioning of the patient is on the aft stretcher on the Beechcraft B200C and on a laterally orientated stretcher on the AW139. The results provide a baseline for further investigation into methods to protect aircrew during the coronavirus pandemic.


Asunto(s)
Ambulancias Aéreas , Aire Acondicionado/métodos , Movimientos del Aire , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Ventilación/métodos , Aire Acondicionado/instrumentación , Humanos , Ventilación/instrumentación
14.
Air Med J ; 40(1): 76-78, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33455633

RESUMEN

This short communication highlights the US Air Force's recent success with having their aeromedical evacuation crews use the Transportation Isolation System for the first time operationally to transport patients positive for coronavirus disease 2019.


Asunto(s)
Medicina Aeroespacial/métodos , Ambulancias Aéreas , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Medicina Militar/métodos , Personal Militar , Medicina Aeroespacial/instrumentación , Medicina Aeroespacial/tendencias , Humanos , Control de Infecciones/instrumentación , Control de Infecciones/tendencias , Medicina Militar/instrumentación , Medicina Militar/tendencias , Estados Unidos
15.
Am J Nurs ; 121(2): 40-45, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33470614

RESUMEN

ABSTRACT: The authors describe the personal protective equipment (PPE) clinicians require when involved in the care of patients with potential or confirmed exposure to highly infectious pathogens, such as the Ebola virus, multidrug-resistant organisms, or severe acute respiratory syndrome coronavirus 2, the cause of COVID-19. They discuss the communication challenges that arise with the various PPE required when caring for patients in high-containment clinical environments and how they and their colleagues in the National Institutes of Health's Special Clinical Studies Unit developed, field-tested, refined, and ultimately implemented policies and procedures that enabled clinicians to communicate effectively with other staff, patients, and external partners, such as governmental agencies, other specialized units, and nonprofit organizations.


Asunto(s)
Personal de Salud/organización & administración , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Relaciones Interprofesionales , Exposición Profesional/prevención & control , Equipo de Protección Personal/estadística & datos numéricos , /prevención & control , Brotes de Enfermedades/prevención & control , Humanos
16.
Respiration ; 100(1): 27-33, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33412544

RESUMEN

BACKGROUND: Bronchoscopic sampling of bronchoalveolar fluid (BAL) should be safe and effective. Current sampling practice risks loss of sample to the attached negative flow, aerosolisation, or spillage, due to repeated circuit breaks, when replacing sample containers. Such concerns were highlighted during the recent coronavirus pandemic. OBJECTIVES: Evaluation of an alternative integrated sampling solution, with the Ambu Bronchosampler with aScope 4, by an experienced bronchoscopist in ICU. METHODS: An observational study of 20 sequential bronchoscopic diagnostic sampling procedures was performed on mechanically ventilated patients with suspected ventilator-associated pneumonia. Mixed methods assessment was done. The predefined outcome measures were (1) ease of set up, (2) ease of specimen collection, (3) ease of protecting specimen from loss or spillage, and (4) overall workflow. The duration of the procedure and the % volume of sample retrieved were recorded. RESULTS: The mean (±standard deviation [SD]) time for collecting 1 sample was 2.5 ± 0.8 min. The mean (±SD) specimen yield for instilled miniBAL was 54.2 ± 17.9%. Compared with standard sampling, the set-up was much easier in 18 (90%), or easier in 2 (10%) of procedures, reducing the connection steps. It was much more intuitive to use in 14 (70%), more intuitive in 4 (20%), and no more intuitive to use in 2 (10%). The overall set-up and workflow was much easier in 69% of the 13 intraprocedural connections and easier or as easy in the remaining 31% procedures. All procedures where pre connection was established were much easier (7, 100%). The Ambu Bronchosampler remained upright in all procedures with no loss or spillage of sample. Obtaining a sample was much easier in 60%, easier in 10%, no different in 20%, and worse in 10%. The ability to protect a sample from start to finish compared to standard procedures was much easier in 80%, easier in 15%, and no different in 5% of procedures. Overall workflow was much easier in 14 (70%), easier in 4 (20%), and no different in 2 (10%) of procedures. CONCLUSIONS: The Ambu Bronchosampler unit was a reliable, effective, and possibly safer technique for diagnostic sampling in ICU. It may improve safety standards during the coronavirus pandemic. A randomized control trial against the standard sampling technique is warranted.


Asunto(s)
Broncoscopios , Broncoscopía/métodos , Equipos Desechables , Respiración Artificial , Manejo de Especímenes/métodos , Lavado Broncoalveolar/instrumentación , Lavado Broncoalveolar/métodos , Líquido del Lavado Bronquioalveolar , Broncoscopía/instrumentación , /transmisión , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Exposición Profesional/prevención & control , Aisladores de Pacientes , Equipo de Protección Personal , Neumonía Asociada al Ventilador/diagnóstico , Medición de Riesgo
17.
Pulm Med ; 2021: 8815925, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33510910

RESUMEN

Introduction: The rapidly spreading Novel Coronavirus 2019 (COVID-19) appeared to be a highly transmissible pathogen in healthcare environments and had resulted in a significant number of patients with respiratory failure requiring tracheostomy, an aerosol-generating procedure that places healthcare workers at high risk of contracting the infection. Instead of deferring or delaying the procedure, we developed and implemented a novel percutaneous dilatational tracheostomy (PDT) protocol aimed at minimizing the risk of transmission while maintaining favorable procedural outcome. Patients and Methods. All patients who underwent PDT per novel protocol were included in the study. The key element of the protocol was the use of apnea during the critical part of the insertion and upon any opening of the ventilator circuit. This was coupled with the use of enhanced personnel protection equipment (PPE) with a powered air-purifying respirator (PAPR). The operators underwent antibody serology testing and were evaluated for COVID-19 symptoms two weeks from the last procedure included in the study. Results: Between March 12th and June 30th, 2020, a total of 32 patients underwent PDT per novel protocol. The majority (80%) were positive for COVID-19 at the time of the procedure. The success rate was 94%. Only one patient developed minor self-limited bleeding. None of the proceduralists developed positive serology or any symptoms compatible with COVID-19 infection. Conclusion: A novel protocol that uses periods of apnea during opening of the ventilator circuit along with PAPR-enhanced PPE for PDT on COVID-19 patients appears to be effective and safe for patients and healthcare providers.


Asunto(s)
/complicaciones , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Insuficiencia Respiratoria/etiología , Insuficiencia Respiratoria/cirugía , Traqueostomía/métodos , Aerosoles , Dilatación , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Equipo de Protección Personal
19.
BMC Fam Pract ; 22(1): 22, 2021 01 16.
Artículo en Inglés | MEDLINE | ID: mdl-33453727

RESUMEN

BACKGROUND: Primary care physicians (PCPs) are first points-of-contact between suspected cases and the healthcare system in the current COVID-19 pandemic. This study examines PCPs' concerns, impact on personal lives and work, and level of pandemic preparedness in the context of COVID-19 in Singapore. We also examine factors and coping strategies that PCPs have used to manage stress during the outbreak. METHODS: Two hundred and sixteen PCPs actively practicing in either a public or private clinic were cluster sampled via email invitation from three primary care organizations in Singapore from 6th to 29th March 2020. Participants completed a cross-sectional online questionnaire consisting of items on work- and non-work-related concerns, impact on personal and work life, perceived pandemic preparedness, stress-reduction factors, and personal coping strategies related to COVID-19. RESULTS: A total of 158 questionnaires were usable for analyses. PCPs perceived themselves to be at high risk of COVID-19 infection (89.9%), and a source of risk (74.7%) and concern (71.5%) to loved ones. PCPs reported acceptance of these risks (91.1%) and the need to care for COVID-19 patients (85.4%). Overall perceived pandemic preparedness was extremely high (75.9 to 89.9%). PCPs prioritized availability of personal protective equipment, strict infection prevention guidelines, accessible information about COVID-19, and well-being of their colleagues and family as the most effective stress management factors. CONCLUSIONS: PCPs continue to serve willingly on the frontlines of this pandemic despite the high perception of risk to themselves and loved ones. Healthcare organizations should continue to support PCPs by managing both their psychosocial (e.g. stress management) and professional (e.g. pandemic preparedness) needs.


Asunto(s)
Actitud del Personal de Salud , Médicos de Atención Primaria/organización & administración , Atención Primaria de Salud/organización & administración , Instituciones de Atención Ambulatoria/organización & administración , Estudios Transversales , Brotes de Enfermedades/prevención & control , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Singapur
20.
Epidemiol Infect ; 149: e15, 2021 01 07.
Artículo en Inglés | MEDLINE | ID: mdl-33407965

RESUMEN

Health care workers (HCWs) are vulnerable to the risk of infections and could become vectors of onward transmission of coronavirus disease 2019 (COVID-19). Little is known about the factors which could contribute to increased COVID-19 infection among HCWs in Nigeria. We aimed at assessing the causes of COVID-19 infection among HCWs. We used a qualitative study design to conduct in-depth interview among 16 frontline HCWs participating in the COVID-19 response in Kwara State, Nigeria. Colaizzi's phenomenological method was used in the qualitative analysis of data. We found that HCWs were aware of their vulnerability to the COVID-19 infection, and the reasons attributed included poor knowledge of IPC measures for COVID-19, inadequate supply of personal protective equipment (PPE), poor political will and inadequate health facilities (HFs) management support. Improved political will and better involvement of HFs management teams in infection prevention and control (IPC) systems are needed to reduce the risk for COVID-19 infection among HCWs. We recommend scale-up training on IPC measures particularly hand washing and use of PPE as well as the development of effective points of care risk assessment with a high index of suspicion in HFs.


Asunto(s)
/prevención & control , Personal de Salud , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Adulto , Femenino , Recursos en Salud , Humanos , Masculino , Persona de Mediana Edad , Nigeria/epidemiología , Equipo de Protección Personal , Investigación Cualitativa , Medición de Riesgo
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