Dataset Information

Non-exposure procedure to aerosols during a tracheostomy under biosafety isolation in SARS CoV-2.

ABSTRACT: A tracheostomy performed on patients infected with SARS CoV-2 is one of the procedures with the highest risks of aerosolization. Safety recommendations for carrying out this procedure are not suitable for implementation in every hospital. Despite the use of Personal Protection Equipment, the suit leaves the submental area unprotected, and even the face mask may not provide a full seal. The use of additional biosafety isolation equipment increases safety, thus preventing exposure to infecting particles and allowing the surgeon to perform the technique with the use of the available equipment; it reduces the risks of further trans-surgical complications and increases the possibilities of handling them in case they arise.

SUBMITTER: Mejia FJM

PROVIDER: S-EPMC7365079 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Non-exposure procedure to aerosols during a tracheostomy under biosafety isolation in SARS CoV-2.

Mejía Francisco Javier Mancilla FJM Salinas Laura Serrano LS Mundo Abraham Hernández AH Saucedo Luis Miguel Méndez LMM Rodríguez Edgar Alejandro García EAG

Operative techniques in otolaryngology--head and neck surgery 20200716 4

A tracheostomy performed on patients infected with SARS CoV-2 is one of the procedures with the highest risks of aerosolization. Safety recommendations for carrying out this procedure are not suitable for implementation in every hospital. Despite the use of Personal Protection Equipment, the suit leaves the submental area unprotected, and even the face mask may not provide a full seal. The use of additional biosafety isolation equipment increases safety, thus preventing exposure to infecting par ...[more]

PMID: 32837126

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Project description:On March 16, 2020, 198,000 dentists in the United States closed their doors to patients, fueled by concerns that aerosols generated during dental procedures are potential vehicles for transmission of respiratory pathogens through saliva. Our knowledge of these aerosol constituents is sparse and gleaned from case reports and poorly controlled studies. Therefore, we tracked the origins of microbiota in aerosols generated during ultrasonic scaling, implant osteotomy, and restorative procedures by combining reverse transcriptase quantitative polymerase chain reaction (to identify and quantify SARS-CoV-2) and 16S sequencing (to characterize the entire microbiome) with fine-scale enumeration and source tracking. Linear discriminant analysis of Bray-Curtis dissimilarity distances revealed significant class separation between the salivary microbiome and aerosol microbiota deposited on the operator, patient, assistant, or the environment (P < 0.01, analysis of similarities). We also discovered that 78% of the microbiota in condensate could be traced to the dental irrigant, while saliva contributed to a median of 0% of aerosol microbiota. We also identified low copy numbers of SARS-CoV-2 virus in the saliva of several asymptomatic patients but none in aerosols generated from these patients. Together, the bacterial and viral data encourage us to conclude that when infection control measures are used, such as preoperative mouth rinses and intraoral high-volume evacuation, dental treatment is not a factor in increasing the risk for transmission of SARS-CoV-2 in asymptomatic patients and that standard infection control practices are sufficiently capable of protecting personnel and patients from exposure to potential pathogens. This information is of immediate urgency, not only for safe resumption of dental treatment during the ongoing COVID-19 pandemic, but also to inform evidence-based selection of personal protection equipment and infection control practices at a time when resources are stretched and personal protection equipment needs to be prioritized.

Dataset Information

Non-exposure procedure to aerosols during a tracheostomy under biosafety isolation in SARS CoV-2.

Publications

Non-exposure procedure to aerosols during a tracheostomy under biosafety isolation in SARS CoV-2.

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