First aid during the COVID-19 pandemic

Magnavita, Nicola; Sacco, Angelo; Nucera, Gabriella; Chirico, Francesco

doi:10.1093/occmed/kqaa148

Cited by 14 publications

(18 citation statements)

References 5 publications

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“…Moreover, the airborne transmission of SARS-CoV-2 can occur during medical procedures that generate aerosols (“aerosol-generating procedures”) [ 14 ]. Many aerosol-generating surgical procedures have been identified [ 15 , 16 , 17 , 18 , 19 , 20 ], and special preventive measures have been proposed [ 21 , 22 ]. The transmission capacity, and therefore the infectious power of the aerosols, also depends on the presence of airborne particulates.…”

Section: Introductionmentioning

confidence: 99%

Can Air-Conditioning Systems Contribute to the Spread of SARS/MERS/COVID-19 Infection? Insights from a Rapid Review of the Literature

Chirico

Sacco

Bragazzi

et al. 2020

IJERPH

Self Cite

110

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The airborne transmission of SARS-CoV-2 is still debated. The aim of this rapid review is to evaluate the COVID-19 risk associated with the presence of air-conditioning systems. Original studies (both observational and experimental researches) written in English and with no limit on time, on the airborne transmission of SARS-CoV, MERS-CoV, and SARS-CoV-2 coronaviruses that were associated with outbreaks, were included. Searches were made on PubMed/MEDLINE, PubMed Central (PMC), Google Scholar databases, and medRxiv. A snowball strategy was adopted to extend the search. Fourteen studies reporting outbreaks of coronavirus infection associated with the air-conditioning systems were included. All studies were carried out in the Far East. In six out the seven studies on SARS, the role of Heating, Ventilation, and Air Conditioning (HVAC) in the outbreak was indirectly proven by the spatial and temporal pattern of cases, or by airflow-dynamics models. In one report on MERS, the contamination of HVAC by viral particles was demonstrated. In four out of the six studies on SARS-CoV-2, the diffusion of viral particles through HVAC was suspected or supported by computer simulation. In conclusion, there is sufficient evidence of the airborne transmission of coronaviruses in previous Asian outbreaks, and this has been taken into account in the guidelines released by organizations and international agencies for controlling the spread of SARS-CoV-2 in indoor environments. However, the technological differences in HVAC systems prevent the generalization of the results on a worldwide basis. The few COVID-19 investigations available do not provide sufficient evidence that the SARS-CoV-2 virus can be transmitted by HVAC systems.

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Section: Introductionmentioning

confidence: 99%

Can Air-Conditioning Systems Contribute to the Spread of SARS/MERS/COVID-19 Infection? Insights from a Rapid Review of the Literature

Chirico

Sacco

Bragazzi

et al. 2020

IJERPH

Self Cite

110

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“…As a result, such systems might not be available for the majority of COVID−19 patients in the developing world, highlighting the need to better understand the risk of transporting – and attending to – a COVID−19−infected patient in a resource−limited environment. 22 …”

Section: Discussionmentioning

confidence: 99%

<p>Long−Distance Aeromedical Transport of Patients with COVID−19 in Fixed−Wing Air Ambulance Using a Portable Isolation Unit: Opportunities, Limitations and Mitigation Strategies</p>

Schwabe¹,

Kellner²,

Henkel³

et al. 2020

OAEM

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Introduction Aeromedical transport of patients with highly−infectious diseases, particularly over long distances with extended transport times, is a logistical, medical and organizational challenge. Following the 2014–2016 Ebola Crisis, sophisticated transport solutions have been developed, mostly utilizing large civilian and military airframes and the patient treated in a large isolation chamber. In the present COVID−19 pandemic, however, many services offer aeromedical transport of patients with highly−infectious diseases in much smaller portable medical isolation units (PMIU), with the medical team on the outside, delivering care through portholes. Methods We conducted a retrospective review of all transports of patients with proven or suspected COVID−19 disease, transported by Jetcall, Idstein, Germany, between April 1 and August 1, 2020, using a PMIU (EpiShuttle, EpiGuard AS, Oslo, Norway). Demographics and medical data were analyzed using the services’ standardized transport protocols. Transport−associated challenges and optimization strategies were identified by interviewing and debriefing all transport teams after each transport. Results Thirteen patients with COVID−19 have been transported in a PMIU over distances up to 7,400 kilometers (km), with flight times ranging from 02:15 hours to 11:10 hours. We identified the main limitations of PMIU transports as limited access to the patient and reduced manual dexterity when delivering care through the porthole gloves and disconnection of lines and tubes during loading and unloading procedures. Technical solutions such as bluetooth−enabled stethoscopes, cordless ultrasound scanners and communication devices, meticulous preparation of the PMIU and the patient following standardized protocols and scenario−based training of crew members can reduce some of the risks. Discussion Transporting a patient with COVID−19 or any other highly infectious disease in a PMIU is a feasible option even over long distances, but adding a significant layer of additional risk, thus requiring a careful and individualized risk−benefit analysis for each patient prior to transport.

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“…For this reason, ERC guidelines suggest that appropriate PPEs, such as gloves, masks and visor eye protection should we worn by rescuers, whereas the casualty should wear surgical mask. FFP masks, furthermore, must be made of filter material, cover the nose and mouth, and possibly also the chin (semi-mask) [4].…”

Section: To the Editormentioning

confidence: 99%

“…SARS-CoV-2 is a highly contagious virus and facial respirators could be insufficient to prevent the infection, because the "minimal infective dose" of the virus responsible for COVID-19 infection is unknown [4,9]. Therefore, adverse www.journals.viamedica.pl effects in HCWs caused by using respirators without EV should be carefully assessed and balanced with the risk of SARS-CoV-2 transmission to casualty.…”

Section: To the Editormentioning

confidence: 99%

“…In this evaluation, it should be noted that hospital HCWs wearing PPEs against COVID-19 (i.e., masks, respirators, gloves, and in hospitals where the contact with the infected and confirmed patient is direct, also gowns or body covers) can have many troubles to change their mask when it comes to perform lifesaving maneuvers. The level of protection, indeed, depends much on the ability to use the masks correctly, including if the rescuer has passed fit testing [4].…”

Section: To the Editormentioning

confidence: 99%

See 1 more Smart Citation

Proper Respirators Use Is Crucial for Protecting Both Emergency First Aid Responder and Casualty from COVID-19 and Airborne-Transmitted Infections

Chirico

Nucera

Sacco

et al. 2021

Advances in Respiratory Medicine

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First aid during the COVID-19 pandemic

Cited by 14 publications

References 5 publications

Can Air-Conditioning Systems Contribute to the Spread of SARS/MERS/COVID-19 Infection? Insights from a Rapid Review of the Literature

Can Air-Conditioning Systems Contribute to the Spread of SARS/MERS/COVID-19 Infection? Insights from a Rapid Review of the Literature

<p>Long−Distance Aeromedical Transport of Patients with COVID−19 in Fixed−Wing Air Ambulance Using a Portable Isolation Unit: Opportunities, Limitations and Mitigation Strategies</p>

Proper Respirators Use Is Crucial for Protecting Both Emergency First Aid Responder and Casualty from COVID-19 and Airborne-Transmitted Infections

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