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2.
Antimicrob Resist Infect Control ; 9(1): 88, 2020 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-32552867

RESUMO

INTRODUCTION: Transmission of SARS-CoV-2 to health care workers (HCW) poses a major burden in the current COVID-19 pandemic. Unprotected exposure to a COVID-19 patient is a key risk factor for HCWs. Transmission mainly occurs by droplet transmission, or by aerosol generating procedures. Respirators such as filtering face piece masks (FFP2), also called respirators, are required to prevent transmission during aerosol generating procedures, as part of the personal protective equipment (PPE) for HCWs. However, many HCW were infected due to lack of PPE, or failure to use them. Therefore, the worldwide shortage of respirators triggered the development of reprocessing used FFP2 respirators or N95 respirators as standard in the US. Our proposal with H2O2 plasma sterilization for decontamination allows to reprocess FFP2, while they still meet the filtration efficiency required by EN 149. The protocol is simple, uses available resources in hospitals and can be rapidly implemented to decrease the shortage of respirators during this crisis. The goal of the study was the evaluate if respirators can be reprocessed and still fulfill the requirements for filtration efficiency outlined by EN 149. METHODS: Used FFP2 respirators - Model 3 M Aura™ 1862+ - were sterilized using a low temperature process hydrogen peroxide (H2O2), V-PRO® maX Low Temperature, a FDA (Food and Drug Administration) approved method to decontaminate FFP2 respirators. Decontaminated respirators were further checked for residual peroxide by a single-gas detector for H2O2. The total inward leakage of the protective respirators was quantitatively tested with 10 test persons in an atmosphere charged with paraffin aerosol according to the European Standard EN 149. The fit factor was calculated as the inverse of the total inward leakage. RESULTS: Ten new and ten decontaminated FFP2 respirators were tested for filtration efficiency. None of the respirators exceeded the maximum acceptable concentration of peroxide. More than 4000 respirators have been reprocessed so far, at cost of approximately 0.3 Euro/piece. CONCLUSIONS: FFP2 respirators can be safely reprocessed once after decontamination with plasma peroxide sterilization, whereafter they still fulfill EN 149 requirements. This allows to almost double the current number of available FFP2 respirators.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/instrumentação , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Máscaras/normas , Pandemias/prevenção & controle , Equipamento de Proteção Individual/normas , Pneumonia Viral/prevenção & controle , Aerossóis , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Aprovação de Equipamentos , Desenho de Equipamento/normas , Dispositivos de Proteção dos Olhos , Humanos , Peróxido de Hidrogênio , Controle de Infecções/métodos , Controle de Infecções/normas , Teste de Materiais , Pneumonia Viral/epidemiologia , Fatores de Risco , Estados Unidos/epidemiologia
3.
Rev Col Bras Cir ; 47: e20202574, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32578696

RESUMO

The COVID-19 Pandemic has resulted in a high number of hospital admissions and some of those patients need ventilatory support in intensive care units. The viral pneumonia secondary to Sars-cov-2 infection may lead to acute respiratory distress syndrome (ARDS) and longer mechanical ventilation needs, resulting in a higher demand for tracheostomies. Due to the high aerosolization potential of such procedure, and the associated risks of staff and envoirenment contamination, it is necesseray to develop a specific standardization of the of the whole process involving tracheostomies. This manuscript aims to demonstrate the main steps of the standardization created by a tracheostomy team in a tertiary hospital dedicated to providing care for patients with COVID-19.


Assuntos
Infecções por Coronavirus/cirurgia , Procedimentos Cirúrgicos Eletivos/normas , Pneumonia Viral/cirurgia , Centros de Atenção Terciária/normas , Traqueostomia/normas , Aerossóis/efeitos adversos , Betacoronavirus , Brasil , Infecções por Coronavirus/prevenção & controle , Humanos , Salas Cirúrgicas/normas , Duração da Cirurgia , Pandemias/prevenção & controle , Equipamento de Proteção Individual/normas , Pneumonia Viral/prevenção & controle
4.
IEEE Pulse ; 11(3): 29-30, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32559165

RESUMO

As the global pandemic caused by the COVID-19 virus continues to spread, researchers from across the world are harnessing their skills and opening their labs to contribute to solutions for managing and addressing the health crisis. One area identified by hospitals and medical providers as a critical need has been the shortage of personal protective equipment (PPE), which is required to keep health care providers safe from exposure to the virus as they care for patients. In response, manufacturers such as 3M have promised to increase production in order to fulfill the extensive orders. However, medical providers may not see the bulk of these outputs for weeks even as current supplies are running low.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Desenho de Equipamento/métodos , Máscaras/provisão & distribução , Pandemias/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/prevenção & controle , Engenharia Biomédica , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Desenho de Equipamento/normas , Humanos , Máscaras/normas , Equipamento de Proteção Individual/normas , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão
5.
Rev Col Bras Cir ; 47: e20202576, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32491028

RESUMO

The World Health Organization recognized in March 2020 the existence of a pandemic for the new coronavirus that appeared in China, in late 2019, and whose disease was named COVID-19. In this context, the SBAIT (Brazilian Society of Integrated Care for Traumatized Patients) conducted a survey with 219 trauma and emergency surgeons regarding the availability of personal protective equipment (PPE) and the role of the surgeon in this pandemic by means of an electronic survey. It was observed that surgeons have been acting under inadequate conditions, with a lack of basic supplies as well as more specific equipment such as N95 masks and facial shields for the care of potential victims who may be contaminated. The latter increases the risk of contamination of professionals, resulting in potential losses in the working teams. Immediate measures must be taken to guarantee access to safety equipment throughout the country, since all trauma victims and/or patients with emergency surgical conditions must be treated as potential carriers of COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Serviços Médicos de Emergência/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/prevenção & controle , Traumatologia/normas , Brasil , Infecções por Coronavirus/epidemiologia , Humanos , Equipamento de Proteção Individual/normas , Pneumonia Viral/epidemiologia , Inquéritos e Questionários
6.
Clinics (Sao Paulo) ; 75: e1989, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555947

RESUMO

OBJECTIVES: The present coronavirus disease (COVID-19) pandemic has ushered in an unprecedented era of quality control that has necessitated advanced safety precautions and the need to ensure the adequate protection of healthcare professionals (HCPs). Endoscopy units, endoscopists, and other HCP may be at a significant risk for transmission of the virus. Given the immense burden on the healthcare system and surge in the number of patients with COVID-19, well-designed protocols and recommendations are needed. We aimed to systematically characterize our approach to endoscopic procedures in a quaternary university hospital setting and provide summary protocol recommendations. METHOD: This descriptive study details a COVID-19-specific protocol designed to minimize infection risks to patients and healthcare workers in the endoscopy unit. RESULTS: Our institution, located in São Paulo, Brazil, includes a 900-bed hospital, with a 200-bed-specific intensive care unit exclusively designed for patients with moderate and severe COVID-19. We highlighted recommendations for infection prevention and control during endoscopic procedures, including appropriate triage and screening, outpatient management and procedural recommendations, role and usage of personal protective equipment (PPE), and role and procedural logistics involving COVID-19-positive patients. We also detailed hospital protocols for reprocessing endoscopes and cleaning rooms and also provided recommendations to minimize severe acute respiratory syndrome coronavirus 2 transmission. CONCLUSION: This COVID-19-specific administrative and clinical protocol can be replicated or adapted in multiple institutions and endoscopy units worldwide. Furthermore, the recommendations and summary protocol may improve patient and HCP safety in these trying times.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Endoscopia/normas , Hospitais Universitários/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual/normas , Pneumonia Viral/prevenção & controle , Brasil , Infecções por Coronavirus/transmissão , Endoscopia/métodos , Pessoal de Saúde/normas , Humanos , Pneumonia Viral/transmissão , Guias de Prática Clínica como Assunto , Fatores de Risco
9.
Lima; IETSI; mayo 2020. ilus.
Não convencional em Espanhol | LILACS, BRISA/RedTESA | ID: biblio-1100098

RESUMO

GENERALIDADES: Objetivo y población: Objetivo: Brindar recomendaciones para la realización de procedimientos endoscópicos gastrointestinales en el contexto de la pandemia COVID-19. Población: Pacientes adultos que acuden a las IPRESS de EsSalud, para la realización de un procedimiento endoscópico gastrointestinal durante el periodo de la pandemia COVID-19. Usuarios y ámbito: Usuarios: Estas recomendaciones están dirigidas al personal de salud que participa en los procedimientos endoscópicos gastrointestinales durante el periodo de la pandemia COVID-19. Ámbito: El presente documento es de aplicación en las IPRESS de EsSalud que realicen procedimientos endoscópicos gastrointestinales. MÉTODOS: a. Búsqueda y selección de protocolos, guías de práctica clínica y documentos técnicos prévios El 28 de abril de 2020 se buscó protocolos de manejo, guías de práctica clínica, y documentos técnicos que aborden la realización de procedimientos endoscópicos gastrointestinales durante el periodo de la pandemia COVID-19; cuya versión a texto completo se encuentre en español o inglés. Formulación de recomendaciones: Para la formulación de recomendaciones se revisaron los lineamientos propuestos por los protocolos encontrados que describieron ampliamente el tema a tratar, los cuales fueron adaptados para el contexto de EsSalud. Además, se tomó en cuenta las revisiones realizadas por IETSI (EsSalud) sobre el tema, así como otra información científica encontrada en búsquedas no sistemáticas o recomendadas por los expertos clínicos, para temas puntuales. DESARROLLO DE LAS RECOMENDACIONES: Para un mejor entendimiento, las recomendaciones en el presente documento serán agrupadas de acuerdo a las tres fases de un procedimiento endoscópico, es decir, pre, intra y post endoscopia:. Recomendaciones previas al procedimiento endoscópico. Recomendaciones durante el procedimiento endoscópico. Recomendaciones al finalizar el procedimiento endoscópico.


Assuntos
Humanos , Endoscopia Gastrointestinal/normas , Infecções por Coronavirus/epidemiologia , Equipamento de Proteção Individual/normas , Peru/epidemiologia , Avaliação da Tecnologia Biomédica , Avaliação em Saúde
10.
Washington; Organización Panamericana de la Salud; mayo 20, 2020. 4 p.
Não convencional em Inglês, Espanhol | LILACS | ID: biblio-1096943

RESUMO

This technical note presents the main recommendations on personal protective equipment and its use. It is aimed at personnel in the area of ​​environmental sanitation, and covers individual hygiene precautions and how to properly handle tools and equipment. It also includes indications on best practices for the protection of workers' health, guidelines for the disposal of dangerous elements for the community, and a guide for preparing sodium hypochlorite solutions for use in 0.1% disinfection.


Asegurar que se aplique las medidas de protección para los trabajadores en el manejo de aguas residuales y desechos sólidos. SARS-COV-2 requiere la aplicación de las normas existentes para la protección de la salud de los trabajadores.


Assuntos
Humanos , Administração de Recursos Humanos/normas , Pneumonia Viral/prevenção & controle , Saúde do Trabalhador/normas , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual/normas , Betacoronavirus , Serviço Hospitalar de Limpeza/normas
12.
World J Emerg Surg ; 15(1): 33, 2020 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-32414390

RESUMO

BACKGROUND: A novel coronavirus pneumonia outbreak began in Wuhan, Hubei Province, in December 2019; the outbreak was caused by a novel coronavirus previously never observed in humans. China has imposed the strictest quarantine and closed management measures in history to control the spread of the disease. However, a high level of evidence to support the surgical management of potential trauma patients during the novel coronavirus outbreak is still lacking. To regulate the emergency treatment of trauma patients during the outbreak, we drafted this paper from a trauma surgeon perspective according to practical experience in Wuhan. MAIN BODY: The article illustrates the general principles for the triage and evaluation of trauma patients during the outbreak of COVID-19, indications for emergency surgery, and infection prevention and control for medical personnel, providing a practical algorithm for trauma care providers during the outbreak period. CONCLUSIONS: The measures of emergency trauma care that we have provided can protect the medical personnel involved in emergency care and ensure the timeliness of effective interventions during the outbreak of COVID-19.


Assuntos
Infecções por Coronavirus , Transmissão de Doença Infecciosa/prevenção & controle , Controle de Infecções/normas , Pandemias , Pneumonia Viral , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/terapia , Algoritmos , Anestesia/normas , China , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Emergências , Unidades Hospitalares/normas , Humanos , Pandemias/prevenção & controle , Assistência Perioperatória/normas , Equipamento de Proteção Individual/normas , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Procedimentos Cirúrgicos Operatórios/normas , Tomografia Computadorizada por Raios X/normas , Triagem/normas
13.
Clin Neurophysiol ; 131(7): 1589-1598, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32417701

RESUMO

On 31st December 2019, China notified the World Health Organization of an outbreak of atypical pneumonia from patients at a local seafood market in Wuhan, Hubei, China, responsible for a new coronavirus called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that caused COVID-19 disease, which spread rapidly around the world. WHO declared a state of pandemic (11th March, 2020), which has caused more than 1 million infected and more than 110,000 deaths; it was observed that up to 29% of those infected were health care personnel. The main route of transmission of SARS-CoV2 is through respiratory secretions and direct contact with contaminated surfaces and material. The pandemic induced an international saturation of health care services and a rupture in the supply chain of protective equipment for healthcare personnel, which poses a high occupational risk to all. Based on the different healthcare systems, human resources, infrastructure and medical emergencies that will warrant the conduct of clinical neurophysiology studies and the lack of a guide for the management of the situation, it was decided by an expert task force of the Latin American Chapter of the International Federation of Clinical Neurophysiology to carry out these guidelines for the protection of patient and healthcare professionals conducting clinical neurophysiological studies.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde/estatística & dados numéricos , Monitorização Neurofisiológica/normas , Doenças Profissionais/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Comitês Consultivos , Assistência Ambulatorial , Infecções por Coronavirus/transmissão , Desinfecção/métodos , Eletroencefalografia/métodos , Humanos , Higiene , Pacientes Internados , América Latina/epidemiologia , Magnetoencefalografia , Máscaras , Monitorização Neurofisiológica/métodos , Equipamento de Proteção Individual/normas , Pneumonia Viral/transmissão , Polissonografia , Fatores de Risco
15.
J Arthroplasty ; 35(7S): S23-S27, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32354536

RESUMO

Care for patients during COVID-19 poses challenges that require the protection of staff with recommendations that health care workers wear at minimum, an N95 mask or equivalent while performing an aerosol-generating procedure with a face shield. The United States faces shortages of personal protective equipment (PPE), and surgeons who use loupes and headlights have difficulty using these in conjunction with face shields. Most arthroplasty surgeons use surgical helmet systems, but in the current pandemic, many hospitals have delayed elective arthroplasty surgeries and the helmet systems are going unused. As a result, the authors have begun retrofitting these arthroplasty helmets to serve as PPE. The purpose of this article is to outline the conception, design, donning technique, and safety testing of these arthroplasty helmets being repurposed as PPE.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Dispositivos de Proteção da Cabeça , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Impressão Tridimensional , Centros Médicos Acadêmicos , Aerossóis , Infecções por Coronavirus/transmissão , Pessoal de Saúde , Humanos , Equipamento de Proteção Individual/normas , Pneumonia Viral/transmissão , Estados Unidos
17.
J Pediatr Gastroenterol Nutr ; 70(6): 751-754, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32443023

RESUMO

SARS-CoV-2, the novel coronavirus causing coronavirus disease 2019 (COVID-19), is now a global pandemic. Human-to-human transmission has been documented to occur through respiratory secretions, feces, aerosols, and contaminated environmental surfaces. Pediatric patients present a unique challenge as they may have minimal symptoms and yet transmit disease. Endoscopists face risk for infection with viruses like SARS-CoV-2, as the aerosol generating nature of endoscopy diffuses respiratory disease that can be spread via an airborne and droplet route. We describe our center's methodology for pediatric patient risk stratification to facilitate responsible use of endoscopic resources during this crisis. We also describe our recommendations for use of personal protective equipment by endoscopists, with the goal of ensuring the safety of ourselves, our anesthesiology and endoscopy staff, and our patients.


Assuntos
Infecções por Coronavirus/prevenção & controle , Endoscopia Gastrointestinal/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual/normas , Pneumonia Viral/prevenção & controle , Betacoronavirus , Criança , Protocolos Clínicos/normas , Infecções por Coronavirus/transmissão , Endoscopia Gastrointestinal/normas , Humanos , Pneumonia Viral/transmissão , Medição de Risco
18.
J Neurointerv Surg ; 12(7): 643-647, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32434798

RESUMO

BACKGROUND: Infection from the SARS-CoV-2 virus has led to the COVID-19 pandemic. Given the large number of patients affected, healthcare personnel and facility resources are stretched to the limit; however, the need for urgent and emergent neurosurgical care continues. This article describes best practices when performing neurosurgical procedures on patients with COVID-19 based on multi-institutional experiences. METHODS: We assembled neurosurgical practitioners from 13 different health systems from across the USA, including those in hot spots, to describe their practices in managing neurosurgical emergencies within the COVID-19 environment. RESULTS: Patients presenting with neurosurgical emergencies should be considered as persons under investigation (PUI) and thus maximal personal protective equipment (PPE) should be donned during interaction and transfer. Intubations and extubations should be done with only anesthesia staff donning maximal PPE in a negative pressure environment. Operating room (OR) staff should enter the room once the air has been cleared of particulate matter. Certain OR suites should be designated as covid ORs, thus allowing for all neurosurgical cases on covid/PUI patients to be performed in these rooms, which will require a terminal clean post procedure. Each COVID OR suite should be attached to an anteroom which is a negative pressure room with a HEPA filter, thus allowing for donning and doffing of PPE without risking contamination of clean areas. CONCLUSION: Based on a multi-institutional collaborative effort, we describe best practices when providing neurosurgical treatment for patients with COVID-19 in order to optimize clinical care and minimize the exposure of patients and staff.


Assuntos
Betacoronavirus , Infecções por Coronavirus/cirurgia , Infecções por Coronavirus/transmissão , Pessoal de Saúde/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Procedimentos Neurocirúrgicos/normas , Pneumonia Viral/cirurgia , Pneumonia Viral/transmissão , Humanos , Procedimentos Neurocirúrgicos/efeitos adversos , Salas Cirúrgicas/métodos , Salas Cirúrgicas/normas , Pandemias , Equipamento de Proteção Individual/normas
20.
Braz J Otorhinolaryngol ; 86(3): 273-280, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32371055

RESUMO

INTRODUCTION: We are facing a pandemic with a great impact worldwide, as a result of the rapid spread of the novel coronavirus (COVID-19). The medical community is still getting to know behavior of this virus and the consequences from a population point of view. All this knowledge is extremely dynamic, so some behaviors are still not well established. Otorhinolaryngologists have a central role in the management of this situation, in which they must assess the patient, avoid contamination to and by health professionals and other patients. Thus, the recommendations of the Brazilian Association of Otorhinolaryngology and Cervical-Facial Surgery (ABORL-CCF) have the main objective of reducing the spread of the new coronavirus during otorhinolaryngological care and assisting in the management of these patients. METHODS: Review of the main recommendations of national and international scientific societies, decisions by government agencies and class councils. The topics will be related to the general aspects of COVID-19, personal protective equipment, care in patient assistance, endoscopic exam routines and the management of sinonasal, otological and pediatric evaluations related to COVID-19. RESULTS: The use of personal protective equipment is considered crucial in routine ENT care. We recommend postponing appointments, exams and elective surgeries to reduce the spread of COVID-19. Similarly, we recommend changing routines in several areas of otolaryngology. Additionally, guidance is provided on the use of telemedicine resources during the pandemic period. CONCLUSIONS: We are still at the beginning of the COVID-19 pandemic and scientific evidence is still scarce and incomplete, so these ABORL-CCF recommendations for otorhinolaryngologists may be updated based on new knowledge and the pattern of the new coronavirus spread.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Otolaringologia/normas , Pandemias/prevenção & controle , Equipamento de Proteção Individual/normas , Pneumonia Viral/prevenção & controle , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Guias de Prática Clínica como Assunto , Padrões de Prática Médica , Sociedades Médicas
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