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Keeping PPE barriers in COVID-19 wards while doing proper auscultation.

ABSTRACT: The emerging COVID-19 pandemic poses many difficulties to medical professionals. One of them is the need to use personal protective equipment (PPE) in order to protect themselves and their families, while not compromising their care. Physical examination is one of the cornerstones of medical assessment but parts of it are nearly impossible to do while wearing protective equipment. In this brief report we demonstrate a novel wireless stethoscope and its use for treating suspected and proven COVID-19 patients, as a representative to other infectious diseases.

SUBMITTER: Seidel E

PROVIDER: S-EPMC7724452 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Keeping PPE barriers in COVID-19 wards while doing proper auscultation.

Seidel Einat E Luski Shahar S Ribak Yaarit Y Nama Ahmed A Saraya Takeshi T Nishiyama Toshiaki T Oster Yonatan Y Nir-Paz Ran R

Antimicrobial resistance and infection control 20201209 1

The emerging COVID-19 pandemic poses many difficulties to medical professionals. One of them is the need to use personal protective equipment (PPE) in order to protect themselves and their families, while not compromising their care. Physical examination is one of the cornerstones of medical assessment but parts of it are nearly impossible to do while wearing protective equipment. In this brief report we demonstrate a novel wireless stethoscope and its use for treating suspected and proven COVID ...[more]

PMID: 33298120

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Project description:ObjectiveTo describe antimicrobial usage (AMU) trends before and during the coronavirus disease 2019 (COVID-19) pandemic, between COVID-19 and non-COVID-19 wards, and if there was any association with a COVID-19 order set.DesignQuasi-experimental retrospective interrupted time series analysis of AMU rates with a contemporaneous comparison of COVID-19 versus non-COVID-19 control wards. Analysis using incidence rate ratios (IRR) was conducted using a Poisson regression generalized linear model.SettingFive COVID-19 and 4 comparable non-COVID-19 wards and 6 intensive care units (ICUs) at 4 hospitals during pandemic waves 1-4.ParticipantsAll inpatients receiving systemic antimicrobials.InterventionThe COVID-19 checkbox antimicrobial order set was implemented in March 2020, to be used only if considered clinically indicated with modification in August 2021.Main outcomes and measuresThe primary outcome was a change in AMU rates (defined daily dose per 100 patient days per month) comparing pre- versus peri-pandemic periods and COVID-19 versus control non-COVID-19 wards. Secondary outcomes included antifungal usage rate in ICUs and assessing AMUs following implementation and modification of a COVID-19 order set.ResultsSignificantly greater rates of AMU (IRR[95%CI]) were observed on COVID-19 wards versus non-COVID-19 wards during waves 1-4 for all systemic antimicrobials (1.76[1.71-1.81], 1.10[1.07-1.13], 1.48[1.43-1.53], and 1.06[1.03-1.09]); for azithromycin (11.76[9.80-14.23], 10.96[9.49-12.74], 12.41[10.73-14.45], and 4.88[4.31-5.55]); and for ceftriaxone (2.39[2.16-2.65], 3.64[3.29-4.03], 2.94[2.67-3.23], and 1.62[1.49-1.76]).ConclusionsWe observed significantly increased AMU rates of all systemic agents during the first 4 waves of the pandemic and on COVID-19 wards compared with control wards for azithromycin and ceftriaxone. These agents saw a twofold reduction following order-set removal, suggesting that the clinical decision-support tool order set, as utilized, had influenced prescribing behavior.

Project description:During the COVID-19 pandemic, the world saw an exponential surge in the production of Personal Protective Equipment (PPE) kits, which eventually got discarded in the biomedical waste stream. In this study, thirteen different polymer samples from the PPE kit were collected and characterized using Fourier transform infrared spectrometer, thermogravimetric analysis, and analytical pyrolysis-gas chromatograph/mass spectrometry. The characterization data showed that about 94 % by mass of components were made of only three polymers, viz. polypropylene (PP, 75.6 wt %), polyethylene terephthalate (PET, 12.5 wt %), and polycarbonate (PC, 6 wt %). The analytical pyrolysis of the PPE coverall suit (PP) yielded mainly alkenes containing 2,4-dimethyl-1-heptene as the major compound with 17 wt % yield at 600 °C. The pyrolysates from face shield (PET) were rich in benzoic acid (5.8 wt %) and acetophenone (4.8 wt %), while those from safety goggles (PC) were rich in phenol (17.6 wt %) and p-cresol (12.4 wt %) at 600 °C. HZSM-5 and HY zeolites were used for the catalytic upgradation of pyrolysates especially from PP, PET and PC. The temperature and feed-to-catalyst ratio were optimized by performing catalytic fast pyrolysis experiments at 500 °C, 600 °C and 700 °C with different feed-to-catalyst ratios 1:2, 1:4, and 1:6 (w/w). The yield of aromatic hydrocarbons, viz., BTEX (benzene, toluene, ethylbenzene, xylenes) and naphthalene, was maximum (∼25.7 wt %) from PP coverall when HY catalyst was used at 600 °C and 1:6 (w/w) loading. In the case of PET face shield, the total yield of BTEX, naphthalene and biphenyl was maximum (27.9 wt %) at 600 °C and 1:4 (w/w) of HZSM-5, while in the case of PC goggles, it was maximum (18.6 wt %) at 700 °C and 1:4 (w/w) of HY. This study shows that the entire PPE kit can be valorized via catalytic fast pyrolysis to generate petrochemical products and platform molecules like monoaromatic hydrocarbons at high selectivities.

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Keeping PPE barriers in COVID-19 wards while doing proper auscultation.

Publications

Keeping PPE barriers in COVID-19 wards while doing proper auscultation.

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