COVID-19: Biosafety in the Intensive Care Unit

Abstract

Purpose of Review COVID-19 is a new, highly transmissible disease to which healthcare workers (HCWs) are exposed, especially in the intensive care unit (ICU). Information related to protection mechanisms is heterogeneous, and the infected HCWs’ number is increasing. This review intends to summarize the current knowledge and practices to protect ICU personnel during the patient management process in the context of the current pandemic. Recent Findings The transmission mechanisms of SARS-CoV-2 are mainly respiratory droplets, aerosols, and contact. The virus can last for a few hours suspended in the air and be viable on surfaces for several days. Some procedures carried out in the ICU can generate aerosols. The shortage of respirators, such as the N95, has generated an increase in the demand for other protective equipment in critical care settings. Summary The probability of transmission depends on the characteristics of the pathogen, the availability of quality personal protective equipment, and the human factors associated with the performance of health workers. It is necessary to have knowledge of the virus and availability of the best possible personal protection equipment, develop skills for handling equipment, and develop non-technical skills during all intensive care process; this can be achieved through structured training.

Sources of healthcare workers’ COVID‑19 infections and related safety guidelines

“…Although the practice of frequent doffing inside the patient area in the wards might increase the risk of infection, the UK guideline is to use the same mask for a session of work, and the infection rate for HCWs is even higher [8,22]. With other viral infections, contamination while doing D&D has been observed [23], marking the importance of assisted D&D and training [24]. Based on data presented by the authors, only <40% of the participants had been trained in D&D, thus the prevention of possible contamination during D&D needs more attention.…”

Adverse Effects of Personal Protective Equipment Among Intensive Care Unit Healthcare Professionals During the COVID-19 Pandemic: A Scoping Review

“…In this scoping review, we collected and systemically charted the available literature on PPE-related AEs and identified gaps in the existing knowledge. We found that nurses and other HCWs working in the ICU are at a high risk of infection as aerosol-generating procedures are more frequent (D ıaz-Guio et al, 2020). Moreover, HCWs in the ICU are required to wear PPE in the patient room as well as in the patient area (World Health Organization, 2020).…”

A Prospective, Longitudinal Evaluation of SARS-CoV-2 COVID-19 Exposure, Use of Protective Equipment and Social Distancing in a Group of Community Physicians

“…The additional risk of COVID-19 exposure would also likely occur in healthcare workers in the COVID-19 intensive care unit. Physicians performing procedures such as intubation, bronchoscopy and care of patients during a cardiorespiratory arrest are known to be exposed to high viral burdens [ 30 , 31 ].…”