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To determine the extent that appropriate personal protective equipment (PPE), per CDC guidance, was used during the COVID-19 pandemic by health care personnel (HCP) in Louisiana in five clinical settings.
An online questionnaire was distributed to the LA Nursery registry. Appropriate use of PPE in each of the five clinical scenarios was defined by the authors based on CDC guidelines. The scenarios ranged from communal hospital space to carrying out Aerosol Generating Procedures (AGP). 1760 HCP participated between June-July 2020.
The average adherence in LA was lowest for carrying out AGPs scenario at 39.5% compliance and highest for patient contact when COVID-19 not suspected scenario at 82.8% compliance. Adherence among parishes varied widely. Commentary to suggest a shortage of PPE supply and the practice of re-using PPE was strong.
Use of appropriate PPE varied by setting. It was higher in scenarios where only face masks (or respirators) were the standard (i.e., community hospital or when COVID-19 not suspected) and lower in scenarios where additional PPE (e.g., gloves, eye protection, and isolation gown) were required.
As HCP are at the forefront of efforts to contain the coronavirus, the factors underlying variable adherence to CDC protocols in LA need to be further analyzed and addressed.
Protecting frontline health care workers with personal protective equipment (PPE) is critical during the coronavirus disease (COVID-19) pandemic. Through an online survey, we demonstrated variable adherence to the Centers for Disease Control and Prevention (CDC) PPE guidelines among health care personnel (HCP).
CDC guidelines for optimal and acceptable PPE usage in common situations faced by frontline health care workers were referenced to create a short online survey. The survey was distributed to national, statewide, and local professional organizations across the United States and to HCP, using a snowball sampling technique. Responses were collected between June 15 and July 17, 2020.
Responses totaling 2245 were received from doctors, nurses, midwives, paramedics, and medical technicians in 44 states. Eight states with n > 20 (Arizona, California, Colorado, Louisiana, Oregon, South Carolina, Texas, and Washington) and a total of 436 responses are included in the quantitative analysis. Adherence to CDC guidelines was observed to be highest in the scenario of patient contact when COVID-19 was not suspected (86.47%) and lowest when carrying out aerosol generating procedures (AGPs) (42.47%).
Further research is urgently needed to identify the reasons underlying variability between professions and regions to pinpoint strategies for maximizing adherence and improving the safety of HCPs.
Adenotonsillectomy is frequently performed for obstructive sleep apnoea, but is associated with post-operative respiratory morbidity. This study assessed the effect of paediatric Otrivine (0.05 per cent xylometazoline hydrochloride) on post-operative respiratory compromise.
Paediatric patients undergoing adenotonsillectomy for obstructive sleep apnoea were included. The control group (n = 24) received no intervention and the intervention group (n = 25) received intra-operative paediatric Otrivine during induction using a nasal patty. Post-operative outcomes included pain, respiratory distress signs and medical intervention level required (simple, intermediate and major).
Post-operative respiratory distress signs were exhibited by 4 per cent of the Otrivine group and 21 per cent of the control group. Sixty-eight per cent of the Otrivine group required simple medical interventions post-operatively, compared to 42 per cent of the control group. In the Otrivine group, 4 per cent required intermediate interventions; none required major interventions. In the control group, 12.5 per cent required both intermediate and major interventions. Fifty per cent of the control group reported pain post-operatively, compared with 40 per cent in the Otrivine group.
Intra-operative paediatric Otrivine may reduce post-operative respiratory compromise in paediatric patients undergoing adenotonsillectomy for obstructive sleep apnoea. A randomised controlled trial is required.
Ultrasound of the bladder is used in clinical practice as a non-invasive estimate of bladder volume when assessing post-void urinary residual. Two types of ultrasound equipment are dedicated bladder scanner and standard linear array transabdominal or transvaginal ultrasound. Ultrasound of the bladder neck can be used to assess urethral hypermobility. Increased bladder neck mobility is associated with stress urinary incontinence. The volume of the urethral sphincter can be measured using three-dimensional ultrasound. Measurement of the thickness of the bladder wall has been validated using the transvaginal, transperineal, translabial or transabdominal approach. The ultrasound is likely to be used increasingly to provide the anatomical parameters in conjunction with functional parameters provided by urodynamics. Two-dimensional and three-dimensional ultrasounds have been employed to statically and dynamically image the pelvic floor. The application of ultrasound in the identification of levator injury is currently being used as a research tool.
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