Articles: personal-protective-equipment.
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Describe current practices and challenges in personal protective equipment (PPE) use among US otolaryngologists during the COVID-19 pandemic. ⋯ The majority of participants reported routine access to full PPE for AGPs and pAGPs in all patients, regardless of COVID status. There was a high perception of security, as well as adequate N95 fitting and PPE training. Areas for improvement include: optimizing PPE availability for AGPs in patients without confirmed COVID and wider recognition of otolaryngologic procedures as high risk for aerosolization.
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The British Thoracic Society have published SPACES (Sharing Patient Assessments Cuts Exposure for Staff) guidance recommending the use of telecommunications as a means of inpatient clinical assessment during the COVID-19 pandemic. The aim of this audit was to reduce face-to-face exposure time during inpatient care of patients with suspected/confirmed COVID-19 using a telecommunications-based approach. 76 patients were included in the audit. 46 patients were included in cycle 1, which measured the average face-to-face time for clinical consultation per patient. 30 patients were included in cycle 2, whereby history-taking was conductedusing telecommunications and, if required, face-to-face physical examination. ⋯ No adverse events were noted. The audit confirms telecommunications can be integrated successfully into the daily inpatient ward round structure, reducing face-to-face exposure time while maintaining patient satisfaction and safety.
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Review
Methods for a Seamless Transition from Tracheostomy to Spontaneous Breathing in COVID-19 Patients.
The COVID-19 pandemic has profoundly affected health care delivery worldwide. A small yet significant number of patients with respiratory failure will require prolonged mechanical ventilation while recovering from the viral-induced injury. ⋯ In this paper, we review the procedures and methods to safely care for patients with COVID-19 who require tracheostomy, gastrostomy, weaning from mechanical ventilation, and final decannulation. The guiding principles consist of modifications in the methods of airway care to safely prevent iatrogenesis and to promote safety in patients severely affected by COVID-19, including mitigation of aerosol generation to minimize risk for health care workers.