A Personal Respirator to Improve Protection for Healthcare Workers Treating COVID-19 (PeRSo)

Elkington, Paul; Dickinson, Alexander; Mavrogordato, Mark; Spencer, Daniel; Gillams, Richard J.; Grazia, Antonio De; Rosini, Sebastian; Garay‐Baquero, Diana J.; Diment, Laura; Mahobia, Nitin; Mant, Alexandra; Baynham, Tom; Morgan, Hywel

doi:10.3389/fmedt.2021.664259

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…Despite multiple testing of various masks, some staff continued to fail their fit‐tests, causing significant concern about potential increased infection risk. The advent of the locally designed Personal Respirator Southampton (PeRSo) hood provided a rapid alternative and reassurance to those who consistently failed mask fit‐testing (Elkington et al, 2021 ; Munro et al, 2021 ). As a department within a large hospital, we have fit tested more than 420 members of staff over 12 months, several staff members more than once.…”

Section: Preparationmentioning

confidence: 99%

“…The personal respirator Southampton (PeRSo) hood was introduced to all staff who were predominantly caring for COVID‐19 positive patients across the hospital. Following successful local design and development (Elkington et al, 2021 ), a PeRSo deployment team was assembled, including members from microbiology, PPE operations, health & safety, specialty divisional leads and the site manager. Training across the hospital was implemented with the help of training videos.…”

Section: Preparationmentioning

confidence: 99%

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Caring for COVID‐19 patients through a pandemic in the intensive care setting: A narrative review

Dushianthan

Griffiths

Hall

et al. 2022

WIREs Mechanisms of Disease

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Since the declaration of the novel SARS‐CoV‐2 virus pandemic, health systems/ health‐care‐workers globally have been overwhelmed by a vast number of COVID‐19 related hospitalizations and intensive care unit (ICU) admissions. During the early stages of the pandemic, the lack of formalized evidence‐based guidelines in all aspects of patient management was a significant challenge. Coupled with a lack of effective pharmacotherapies resulted in unsatisfactory outcomes in ICU patients. The anticipated increment in ICU surge capacity was staggering, with almost every ICU worldwide being advised to increase their capacity to allow adequate care provision in response to multiple waves of the pandemic. This increase in surge capacity required advanced planning and reassessments at every stage, taking advantage of experienced gained in combination with emerging evidence. In University Hospital Southampton General Intensive Care Unit (GICU), despite the initial lack of national and international guidance, we enhanced our ICU capacity and developed local guidance on all aspects of care to address the rapid demand from the increasing COVID‐19 admissions. The main element of this success was a multidisciplinary team approach intertwined with equipment and infrastructural reorganization. This narrative review provides an insight into the approach adopted by our center to manage patients with COVID‐19 critical illness, exploring the initial planning process, including contingency preparations to accommodate (360% capacity increment) and adaptation of our management pathways as more evidence emerged throughout the pandemic to provide the most appropriate levels of care to our patients. We hope our experience will benefit other intensive care units worldwide. This article is categorized under: Infectious Diseases > Genetics/Genomics/Epigenetics

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Section: Preparationmentioning

confidence: 99%

Section: Preparationmentioning

confidence: 99%

Caring for COVID‐19 patients through a pandemic in the intensive care setting: A narrative review

Dushianthan

Griffiths

Hall

et al. 2022

WIREs Mechanisms of Disease

View full text Add to dashboard Cite

show abstract

“…The CDC website provides detailed guidelines on the use of fit-tested N95 respirators and masks. Respiratory protective equipment (RPE) needs to be designed to improve healthcare professionals' protection against the inhalation of aerosol particles [159]. We further suggest considering advances in designing and manufacturing antimicrobial and antiviral functionalities on the fabric used to prepare PPE kits.…”

Section: Personal Protective Equipment (Ppe)mentioning

confidence: 99%

COVID-19 Pandemic: Public Health Risk Assessment and Risk Mitigation Strategies

Kim

Shinde

Lone

et al. 2021

JPM

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A newly emerged respiratory viral disease called severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is also known as pandemic coronavirus disease (COVID-19). This pandemic has resulted an unprecedented global health crisis and devastating impact on several sectors of human lives and economies. Fortunately, the average case fatality ratio for SARS-CoV-2 is below 2%, much lower than that estimated for MERS (34%) and SARS (11%). However, COVID-19 has a much higher transmissibility rate, as evident from the constant increase in the count of infections worldwide. This article explores the reasons behind how COVID-19 was able to cause a global pandemic crisis. The current outbreak scenario and causes of rapid global spread are examined using recent developments in the literature, epidemiological features relevant to public health awareness, and critical perspective of risk assessment and mitigation strategies. Effective pandemic risk mitigation measures have been established and amended against COVID-19 diseases, but there is still much scope for upgrading execution and coordination among authorities in terms of organizational leadership’s commitment and diverse range of safety measures, including administrative control measures, engineering control measures, and personal protective equipment (PPE). The significance of containment interventions against the COVID-19 pandemic is now well established; however, there is a need for its effective execution across the globe, and for the improvement of the performance of risk mitigation practices and suppression of future pandemic crises.

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Protection levels of N95-level respirator substitutes proposed during the COVID-19 pandemic: safety concerns and quantitative evaluation procedures

et al. 2021

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ObjectiveThe COVID-19 pandemic has precipitated widespread shortages of filtering facepiece respirators (FFRs) and the creation and sharing of proposed substitutes (novel designs, repurposed materials) with limited testing against regulatory standards. We aimed to categorically test the efficacy and fit of potential N95 respirator substitutes using protocols that can be replicated in university laboratories.SettingAcademic medical centre with occupational health-supervised fit testing along with laboratory studies.ParticipantsSeven adult volunteers who passed quantitative fit testing for small-sized (n=2) and regular-sized (n=5) commercial N95 respirators.MethodsFive open-source potential N95 respirator substitutes were evaluated and compared with commercial National Institute for Occupational Safety and Health (NIOSH)-approved N95 respirators as controls. Fit testing using the 7-minute standardised Occupational Safety and Health Administration fit test was performed. In addition, protocols that can be performed in university laboratories for materials testing (filtration efficiency, air resistance and fluid resistance) were developed to evaluate alternate filtration materials.ResultsAmong five open-source, improvised substitutes evaluated in this study, only one (which included a commercial elastomeric mask and commercial HEPA filter) passed a standard quantitative fit test. The four alternative materials evaluated for filtration efficiency (67%–89%) failed to meet the 95% threshold at a face velocity (7.6 cm/s) equivalent to that of a NIOSH particle filtration test for the control N95 FFR. In addition, for all but one material, the small surface area of two 3D-printed substitutes resulted in air resistance that was above the maximum in the NIOSH standard.ConclusionsTesting protocols such as those described here are essential to evaluate proposed improvised respiratory protection substitutes, and our testing platform could be replicated by teams with similar cross-disciplinary research capacity. Healthcare professionals should be cautious of claims associated with improvised respirators when suggested as FFR substitutes.

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A Personal Respirator to Improve Protection for Healthcare Workers Treating COVID-19 (PeRSo)

Cited by 5 publications

References 25 publications

Caring for COVID‐19 patients through a pandemic in the intensive care setting: A narrative review

Caring for COVID‐19 patients through a pandemic in the intensive care setting: A narrative review

COVID-19 Pandemic: Public Health Risk Assessment and Risk Mitigation Strategies

Protection levels of N95-level respirator substitutes proposed during the COVID-19 pandemic: safety concerns and quantitative evaluation procedures

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