2
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      A survey of personal protective equipment use among US otolaryngologists during the COVID-19 pandemic

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objective

          Describe current practices and challenges in personal protective equipment (PPE) use among US otolaryngologists during the COVID-19 pandemic.

          Study design

          Online survey.

          Setting

          Academic and non-academic healthcare institutions.

          Subjects and methods

          Subjects included US otolaryngology physicians. Emails were sent on April 17, 2020 to program coordinators at 121 residency programs, who were requested to forward the email to program directors for distribution. Further recruitment occurred through snowball recruitment. The survey was closed on June 15, 2020.

          Results

          Sixty-one participants completed the survey. 95.1% reported routine access to full PPE (N95 ± powered air purifying respirator [PAPR], gown, gloves, eye protection) for aerosol-generating procedures (AGPs) in COVID-19 patients, while 68.9% had routine access to full PPE for AGPs in patients without confirmed COVID-19. 88.5% had routine access to full PPE for potential aerosol-generating procedures (pAGPs) in COVID patients, while 80.3% had routine access to full PPE for pAGPs in patients without confirmed COVID. All participants felt that they “always” or “usually” had necessary PPE to safely perform procedures and surgeries on COVID patients. 83.6% received N95 fitting in the past year, and 93.4% reported adequate PPE training.

          Conclusion

          The majority of participants reported routine access to full PPE for AGPs and pAGPs in all patients, regardless of COVID status. There was a high perception of security, as well as adequate N95 fitting and PPE training. Areas for improvement include: optimizing PPE availability for AGPs in patients without confirmed COVID and wider recognition of otolaryngologic procedures as high risk for aerosolization.

          Related collections

          Most cited references2

          • Record: found
          • Abstract: found
          • Article: found

          Stability issues of RT‐PCR testing of SARS‐CoV‐2 for hospitalized patients clinically diagnosed with COVID‐19

          Abstract In this study, we collected a total of 610 hospitalized patients from Wuhan between February 2, 2020, and February 17, 2020. We reported a potentially high false negative rate of real‐time reverse‐transcriptase polymerase chain reaction (RT‐PCR) testing for SARS‐CoV‐2 in the 610 hospitalized patients clinically diagnosed with COVID‐19 during the 2019 outbreak. We also found that the RT‐PCR results from several tests at different points were variable from the same patients during the course of diagnosis and treatment of these patients. Our results indicate that in addition to the emphasis on RT‐PCR testing, clinical indicators such as computed tomography images should also be used not only for diagnosis and treatment but also for isolation, recovery/discharge, and transferring for hospitalized patients clinically diagnosed with COVID‐19 during the current epidemic. These results suggested the urgent needs for the standard of procedures of sampling from different anatomic sites, sample transportation, optimization of RT‐PCR, serology diagnosis/screening for SARS‐CoV‐2 infection, and distinct diagnosis from other respiratory diseases such as fluenza infections as well.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Airborne Aerosol Generation During Endonasal Procedures in the Era of COVID-19: Risks and Recommendations

            Objective In the era of SARS-CoV-2, the risk of infectious airborne aerosol generation during otolaryngologic procedures has been an area of increasing concern. The objective of this investigation was to quantify airborne aerosol production under clinical and surgical conditions and examine efficacy of mask mitigation strategies. Study Design Prospective quantification of airborne aerosol generation during surgical and clinical simulation. Setting Cadaver laboratory and clinical examination room. Subjects and Methods Airborne aerosol quantification with an optical particle sizer was performed in real time during cadaveric simulated endoscopic surgical conditions, including hand instrumentation, microdebrider use, high-speed drilling, and cautery. Aerosol sampling was additionally performed in simulated clinical and diagnostic settings. All clinical and surgical procedures were evaluated for propensity for significant airborne aerosol generation. Results Hand instrumentation and microdebridement did not produce detectable airborne aerosols in the range of 1 to 10 μm. Suction drilling at 12,000 rpm, high-speed drilling (4-mm diamond or cutting burs) at 70,000 rpm, and transnasal cautery generated significant airborne aerosols (P < .001). In clinical simulations, nasal endoscopy (P < .05), speech (P < .01), and sneezing (P < .01) generated 1- to 10-μm airborne aerosols. Significant aerosol escape was seen even with utilization of a standard surgical mask (P < .05). Intact and VENT-modified (valved endoscopy of the nose and throat) N95 respirator use prevented significant airborne aerosol spread. Conclusion Transnasal drill and cautery use is associated with significant airborne particulate matter production in the range of 1 to 10 μm under surgical conditions. During simulated clinical activity, airborne aerosol generation was seen during nasal endoscopy, speech, and sneezing. Intact or VENT-modified N95 respirators mitigated airborne aerosol transmission, while standard surgical masks did not.
              Bookmark

              Author and article information

              Journal
              Am J Otolaryngol
              Am J Otolaryngol
              American Journal of Otolaryngology
              Published by Elsevier Inc.
              0196-0709
              1532-818X
              18 September 2020
              18 September 2020
              : 102735
              Affiliations
              [a ]Northwestern University Feinberg School of Medicine, Department of Otolaryngology – Head and Neck Surgery, 676 N. St. Clair St., Suite 1325, Chicago, IL 60611, United States of America
              [b ]Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of University of Southern California, 1540 Alcazar St., Suite 204M, Los Angeles, CA 90033, United States of America
              [c ]Emory University School of Medicine, Department of Otolaryngology – Head and Neck Surgery, 550 Peachtree St. NE, Atlanta, GA 30308, United States of America
              [d ]Northwestern University Feinberg School of Medicine, Institute for Public Health and Medicine, Center for Healthcare Studies, 420 E. Superior St., 9th Floor, Chicago, IL 60611, United States of America
              Author notes
              [* ]Corresponding author at: Northwestern University Feinberg School of Medicine, Department of Otolaryngology, Head and Neck Surgery, 676 N. St. Clair St., Suite 1325, Chicago, IL 60611, United States of America.
              Article
              S0196-0709(20)30429-4 102735
              10.1016/j.amjoto.2020.102735
              7499145
              965d485c-6e8e-40f2-a6d3-203533a50bc3
              © 2020 Published by Elsevier Inc.

              Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

              History
              : 8 September 2020
              Categories
              Article

              agp, aerosol-generating procedure,pagp, potential aerosol-generating procedure,ppe, personal protective equipment,papr, powered air purifying respirator,covid-19,sars-cov-2,personal protective equipment

              Comments

              Comment on this article