Putting On and Removing Personal Protective Equipment

Ortega, Rafael; Bhadelia, Nahid; Obanor, Osamede; Cyr, Kyle L.; Yu, Priscilla; McMahon, Maureen; Gotzmann, Dahlia

doi:10.1056/nejmvcm1412105

Cited by 25 publications

(20 citation statements)

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“…For prevention and control of infectious disease in healthcare settings, healthcare workers should place a high value on safely putting on, removing and disposing PPE [29]. When removing contaminated PPE such as gowns, gloves, medical masks, and face shield in high-risk settings, it is necessary to follow strict safety regulations to prevent further contamination and spread of infection [29]. However, we found that only half of the medical interns in KSA attended training on wearing and removing face mask (or N95 mask) and gloves safely during the COVID-19 pandemic.…”

Section: Practicesmentioning

confidence: 99%

“…A study with healthcare workers in China suggests that careful removal of PPE is positively associated with higher education level and work experience [20]. Therefore, hospital administration should arrange repetitive training and demonstrated competency in putting on and removing PPE for healthcare workers [29], specially targeting novices like medical interns.…”

Section: Practicesmentioning

confidence: 99%

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Knowledge, Attitudes, and Practices of Medical Interns Toward COVID-19 in Saudi Arabia: A Cross-Sectional Survey, April-May 2020

Alnohair¹,

Mahmud²,

Alshehri³

et al. 2020

Preprint

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Background: COVID-19 is a highly infectious, rapidly spreading disease without any proven vaccine or treatment. Poor knowledge, attitude and practices (KAP) toward COIVD-19 prevention measures among healthcare workers may lead to further transmission of the disease. Lack of attention towards non-frontline healthcare workers may put them at higher risk of infection from undetected cases. Here, we evaluate medical interns’ KAP toward COVID-19 prevention measures in the Kingdom of Saudi Arabia (KSA). Methods: We conducted a cross-sectional online survey. We distributed a structured questionnaire to the medical interns through different social media. Data was collected between April and May 2020. We estimated the prevalence of good KAP toward COVID-19 prevention measures. We did T-test or ANOVA to investigate the mean differences in KAP between socio-demographic groups. In addition, we did multivariable logistic regression analysis to investigate the socio-demographic determinants of good KAP.Results: Of the total 250 participants, 60% were males, 64% were aged between 20 and 25 years, and 90% was Saudi. 24% interns are relying on social media, newspaper, television or friends as primary source of COVID-19 information, while others are relying on formal sources like official websites of national and international bodies. Overall, the prevalence of good knowledge, attitude and practices are 38% (95% CI: 32.2-44.2), 55.2% (48.9-61.3) and 24% (19.1-29.7), respectively. Graduating from government universities are associated with higher odds of good knowledge (aOR: 3.87; 95% CI: 1.05-14.22) and positive attitude (aOR: 4.84; 95% CI: 1.28-18.23) than private or foreign universities. While, practicing in the west region-Mecca and Medina (aOR: 2.35; 95% CI: 1.05-5.23); and the North region-Hail, Jouf, Tabuk & Northern borders (aOR: 3.2; 95% CI: 1.32-7.75) are associated to higher odds of moderate/good practice compared to practicing in the central region- Riyadh and Qassim. Conclusions: Our findings reveal gaps in KAP among medical interns. Medical interns in Saudi Arabia are not deployed as front-line health worker to combat COVID-19. However, community transmission of COVID-19 make it critical to improve KAP of medical interns toward COVID-19 prevention measures. Repeated training to improve KAP and competency of the medical interns in this regard are warranted.

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Section: Practicesmentioning

confidence: 99%

Section: Practicesmentioning

confidence: 99%

Knowledge, Attitudes, and Practices of Medical Interns Toward COVID-19 in Saudi Arabia: A Cross-Sectional Survey, April-May 2020

Alnohair¹,

Mahmud²,

Alshehri³

et al. 2020

Preprint

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“…Working with and handling of the protective equipment itself is difficult and the risk of crosscontamination is significant, especially during removal: In a simulation study, Myreen et al described that during removal of PPE, contamination of healthcare professionals' skin or clothing occurred in 46% of cases. 14,15 The use of a PIU substantially reduces this risk of contamination because the patient is completely isolated from the environment, regardless of how many HCW are caring for the patient at the same time. Main complaints when using the PIU in our study were the standardized one-sized gloves (often either too big or too small) and decreased and limited visibility through the plastic shield.…”

Section: Discussionmentioning

confidence: 99%

Emergency Airway Management in a Simulation of Highly Contagious Isolated Patients: Both Isolation Strategy and Device Type Matter

Plazikowski

Greif

Marschall

et al. 2018

Infect. Control Hosp. Epidemiol.

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OBJECTIVE To compare 6 airway-management devices in 3 isolation scenarios regarding their effect on airway management: portable isolation unit (PIU), personal protective equipment (PPE), and standard protection measures METHODS In total, 30 anesthesiologists working in emergency medical services performed airway management on mannequins in 3 isolation settings using 6 different airway management devices (in random order): (1) standard Macintosh laryngoscope; (2) Airtraq SP-video-laryngoscope; (3) i-gel; (4) LMA-Fastrach; (5) Ambu fiberoptic-aScope; and (6) Melker cricothyrotomy-set. Each was assessed regarding time-to-ventilate (primary outcome) and rating of difficulty handling the device. RESULTS In 86% (standard protection) and 85% (PPE) of attempts, airway management was achieved in <60 seconds, irrespective of the device used. In the PIU setting, only 69% of attempts succeeded within this time frame (P<.05). Median time-to-ventilate was shorter for standard protection (23 seconds) and PPE (25 seconds) compared to the PIU (38 seconds; P<.001). In the PIU setting, the fiberscope took the longest (median, 170 seconds), while i-gel was the quickest (median, 13 seconds). The rating of difficulty (visual analogue scale [VAS], 0-100) differed significantly between the isolation scenarios: Airway management was most difficult with PIU (VAS, 76), followed by PPE (VAS, 35), and standard protection (VAS, 9) (P<.01). CONCLUSION Wearing PPE produced similar times-to-ventilate as standard protection among anesthesiologists, but it was subjectively rated more difficult. The portable isolation unit permitted acceptable times-to-ventilate when excluding fiberscope and cricothyrotomy. Supraglottic airway devices allowed the fastest airway management in all isolation scenarios, thus being highly recommendable if a portable isolation unit is used and emergency airway management becomes necessary. Infect Control Hosp Epidemiol 2018;39:145-151.

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“…Personal protective equipment dressing steps (1). A, B and C: Hand washing with antiseptic soap and single use surgical brush, then towel-drying (in case of first disinfection) D: Surgical mask removing E and F: Friction of the hands with a hydroalcoholic solution G and H: Putting on a non-sterile apron I, J, K and L: the correct way to wear a headgear with a high covering and adjusting power application of the hydroalcoholic solution, the right hand is positioned on the back of the left hand, the fingers interwined and vice versa [8]. It is also necessary to perform regular desinfection of the work environment with an appropriate cleaning solution.…”

Section: Personal Protective Equipment (Ppe) Dressingmentioning

confidence: 99%

“…In the light of previous studies about other infectious diseases (Ebola epidemic) and with current description by the american CDC (Centers for Disease Control and Prevention) [8,9], we propose to describe the dressing and undressing procedures before and after a gynaecological or obstetric surgery. These precautions should be applied in the same way as a situation similar to emerging biological risks.…”

Section: Introductionmentioning

confidence: 99%

Technics to put on and remove personal protective equipment before surgical or obstetrical procedure in suspected or infected COVID-19 patients (with video)

Nohuz

Atallah

Cerruto

et al. 2020

Journal of Gynecology Obstetrics and Human Reproduction

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Putting On and Removing Personal Protective Equipment

Cited by 25 publications

References 0 publications

Knowledge, Attitudes, and Practices of Medical Interns Toward COVID-19 in Saudi Arabia: A Cross-Sectional Survey, April-May 2020

Knowledge, Attitudes, and Practices of Medical Interns Toward COVID-19 in Saudi Arabia: A Cross-Sectional Survey, April-May 2020

Emergency Airway Management in a Simulation of Highly Contagious Isolated Patients: Both Isolation Strategy and Device Type Matter

Technics to put on and remove personal protective equipment before surgical or obstetrical procedure in suspected or infected COVID-19 patients (with video)

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