What Workers Need to Know About Pandemic Flu: Protecting Workers During Pandemic Flu

[Excerpt] This fact sheet tells how to set up an infection control program that will make workplaces safer during a pandemic flu. A pandemic flu will have a huge impact on workers in the United States. During the worst part of a pandemic flu, 40% to 60% of workers may have to stay home. Some workers are more likely to get sick, like health care workers and those who respond to an emergency. Workers who have a lot of close contact with the public are also in danger. Whenever workers are at risk of getting the virus, employers must take steps to prevent it from spreading. This is called infection control

Rapid Response of an Academic Surgical Department to the COVID-19 Pandemic: Implications for Patients, Surgeons, and the Community.

BackgroundAs the coronavirus disease 2019 (COVID-19) pandemic continues to spread, swift actions and preparation are critical for ensuring the best outcomes for patients and providers. We aim to describe our hospital and Department of Surgery's experience in preparing for the COVID-19 pandemic and caring for surgical patients during this unprecedented time.Study designThis is a descriptive study outlining the strategy of a single academic health system for addressing the following 4 critical issues facing surgical departments during the COVID-19 pandemic: developing a cohesive leadership team and system for frequent communication throughout the department; ensuring adequate hospital capacity to care for an anticipated influx of COVID-19 patients; safeguarding supplies of blood products and personal protective equipment to protect patients and providers; and preparing for an unstable workforce due to illness and competing personal priorities, such as childcare.ResultsThrough collaborative efforts within the Department of Surgery and hospital, we provided concise and regular communication, reduced operating room volume by 80%, secured a 4-week supply of personal protective equipment, and created reduced staffing protocols with back-up staffing plans.ConclusionsBy developing an enabling infrastructure, a department can nimbly respond to crises like COVID-19 by promoting trust among colleagues and emphasizing an unwavering commitment to excellent patient care. Sharing principles and practical applications of these changes is important to optimize responses across the country and the world

Use of A New Inexpensive Powered Air-Purifying Device in Facilitating Safe Performance of Tracheostomy in COVID-19 Patients

Purpose: This retrospective cohort study describes use of novel PPE and technique to facilitate safe performance of tracheostomy in 9 patients requiring mechanical ventilation in a COVID-19 designated ICU. Materials and methods: Standard personal protective equipment - including double gloves, full body overall with hood, shoe covers, a single-use N95 mask and a face shield -was employed by all team members. In addition, a single use low cost powered air-purifying respirator (PAPR) was developed in order to increase safety, visibility, and comfort. This device was worn in addition to standard PPE, covered the entire head and upper torso and employed a belt-worn pump delivering approximately 150 l/min air via a viral filter to the user. Tracheostomy was performed by a 3-person otolaryngologist and critical care physician team using video laryngoscopy and a single stage dilation percutaneous tracheostomy kit. Mechanical ventilation was paused from after wire passage until dilation and placement of the tracheostomy tube. Results: No blood oxygen desaturation or other complications were noted during or after the procedure, with no procedure related mortality. No team members subsequently developed COVID-19. Conclusions: Using novel PPE tracheostomy can be performed safely for both patient and staff despite active COVID-19 infection

EVALUATION OF TRANSIENT COGNITIVE CHANGES FROM MAXIMAL EXERTION AND RESPIRATOR WEAR

A comprehensive occupational respiratory protection program is mandated by federal law to protect workers exposed to breathing hazardous atmospheres. Those wearing respirators and/or performing high-intensity physical work may endure physiological and/or psychological impairment from cardiorespiratory stress, respirator anxiety, and working in hazardous conditions. The effects of multiple stressors may impede or override physiological and psychological adaptation mechanisms, causing cognitive deterioration or disruption when clarity and speed of thought and action are crucial. This study examined transient cognitive differences due to activity, respirator, and gender wear through examination of archival data collected during two studies that evaluated the physiological effects of activity and respirator wear. Scores and response times from the Mini Mental State Examination (MMSE), a brief verbally administered assessment of cognitive function, were collected and archived in anticipation of developing this line of research. The sample of 18 active healthy college students (9 males and 9 females) performed the Wingate Anaerobic Test (WAnT), a cycle ergometry protocol requiring subjects to pedal as fast as possible for 30 seconds against a prescribed resistance. Subjects performed four discrete treatments—three immediately post-WAnT and one at rest. The MMSE was administered immediately after performance of the WAnT wearing no respirator (N), wearing a half face air-purifying respirator (P), and wearing a half face air-supplying respirator (S); and with the subject seated wearing no respirator (R). For each MMSE administration, the total and 11 sectional scores and response times were recorded for the required questions and tasks. A Minitab two-way ANOVA was performed on the total and sectional MMSE scores and times. Where treatment proved significant, Bonferroni 95% Confidence Intervals were calculated to identify important treatment comparisons. Statistically reliable differences (p \u3c .05) in total and select sectional scores and times relative to activity level, respirator usage, gender, and individual subject response variance were identified. Scores were assumed to represent thought clarity and times to represent response speed. It was concluded that cognitive function regarding thought clarity and response speed differs selectively from changes in activity level without respirator wear, respirator usage after maximal exertion, gender, and individual subject response variance

Pressure Optimized PowEred Respirator (PROPER): A miniaturized wearable cleanroom and biosafety system for aerially transmitted viral infections such as COVID-19

The authors of the paper would like to acknowledge Andreas Nilsson from Department of Computer Science, Electrical and Space Engineering of the Luleå University of Technology (LTU), Sweden.The supply of Personal Protective Equipment (PPE) in hospitals to keep the Health Care Professionals (HCP) safe taking care of patients may be limited, especially during the outbreak of a new disease. In particular, the face and body protective equipment is critical to prevent the wearer from exposure to pathogenic biological airborne particulates. This situation has been now observed worldwide during the onset of the COVID-19 pandemic. As concern over shortages of PPE at hospitals grows, we share with the public and makers’ community the Pressure Optimized PowEred Respirator (PROPER) equipment, made out of COTS components. It is functionally equivalent to a Powered Air Purifying Respirator (PAPR). PROPER, a hood-based system which uses open source and easily accessible components is low-cost, relatively passive in terms of energy consumption and mechanisms, and easy and fast to 3D print, build and assemble. We have adapted our experience on building clean room environments and qualifying the bioburden of space instruments to this solution, which is in essence a miniaturized, personal, wearable cleanroom. PROPER would be able to offer better protection than an N95 respirator mask, mainly because it is insensitive to seal fit and it shields the eyes as well. The PROPER SMS fabric is designed for single-use and not intended for reuse, as they may start to tear and fail but the rest of the parts can be disinfected and reused. We provide a set of guidelines to build a low-cost 3D printed solution for an effective PAPR system and describe the procedures to validate it to comply with the biosafety level 3 requirements. We have validated the prototype of PROPER unit for air flow, ISO class cleanliness level, oxygen and carbon-dioxide gas concentrations during exhalation, and present here these results for illustration. We demonstrate that the area inside the hood is more than 200 times cleaner than the external ambient without the operator and more than 175 times with the operator and in an aerosol exposed environment. We also include the procedure to clean and disinfect the equipment for reuse. PROPER may be a useful addition to provide protection to HCPs against the SARSCoV-2 virus or other potential future viral diseases that are transmitted aerially.Spanish State Research Agency (AEI) Project No. MDM-2017-0737 Unidad de Excelencia ‘‘María de Maeztu”- Centro de Astrobiología (CSIC-INTA)Spanish Ministry of Science and Innovation project (ref. PID2019-104205 GB-C21

PRessure Optimized PowEred Respirator (PROPER) : a miniaturized wearable cleanroom and biosafety system for aerially transmitted viral infections such as COVID-19

Acknowledgements: The authors of the paper would like to acknowledge Andreas Nilsson from Department of Computer Science, Electrical and Space Engineering of the Luleå University of Technology (LTU), Sweden, for his support in the procurement of components. MPZ has been partially funded by the Spanish State Research Agency (AEI) Project No. MDM-2017-0737 Unidad de Excelencia “María de Maeztu”- Centro de Astrobiología (CSIC-INTA) and the Spanish Ministry of Science and Innovation project (ref. PID2019-104205GB-C21).Peer reviewedPublisher PD

Servo blower control for powered air purifying respirators

2012 Fall.Includes bibliographical references.Powered air purifying respirators (PAPRs) are a form of respiratory protection that uses a motor-coupled fan to provide filtered air to a user through a positive pressure mask. Three types of PAPR devices have been developed of which breath-responsive PAPRs are the most recent. The benefits of breath-responsive PAPRs have been identified and regulatory performance requirements have been put in place for these devices, however, no devices have been certified by any regulatory agencies. This study proposes a novel conceptual design for a breath-responsive PAPR and describes a dynamic simulation of the characteristics of this new PAPR compared to a constant flow design as exercised by a simulated breathing cycle. Additionally, this study describes a prototype of the breath-responsive concept with experimental evaluation of the prototype against regulatory requirements and conceptual design targets

Laminar Flow Face Shield

The scope of this project was to design a personal protective equipment (PPE) that protects the wearer from SARS-CoV-2 without inhibiting communication and was comfortable to wear for long periods of time. SARS-CoV-2, commonly known as COVID-19, is a contagious respiratory virus that spreads through droplets produced when someone who is infected by the virus coughs, sneezes, or talks. These droplets may land on the mouths or noses of nearby people or may be inhaled in the lungs, infecting those who come in contact with the virus. The current guidelines to help slow the spread of COVID-19 are to wear a mask that covers the mouth and nose when around others [1]. However, this causes the wearer\u27s voice to be muffled and be difficult to understand, covers the wearer\u27s facial expressions, inhibits others from picking up on important facial cues, and can become uncomfortable after long periods of wear. An alternative that meets these needs would be a powered air-purifying respirator (PAPR), which is currently sold by several companies in various forms. Many are quite comfortable and allow the user’s face to be seen, but the price is the biggest downfall, most costing over $1,000. Our goal was to design a comfortable, affordable, and effective powered air purifying respirator for Cal Poly professors. We were able to create a respirator that costs only$140, filters out 99.93% of COVID-19 sized particles, and is generally well received in functionality by the general public. This document comprises the results of the critical design process, including background research, specifications, concept development and final design, testing and manufacturing plans, and project timeline

Quantification of bacterial shedding from the respiratory tract of health care workers wearing PAPRs and other types of Air-Purifying Respirators on sterile conditions in a simulated Operating Rooms (ORs)

The role of powered air- purifying respirators (PAPRs) in healthcare settings during infectious diseases outbreaks and highly contagious pathogens (e.g., SARS, HINI, Ebola, COVID etc.) has attracted much interest based on the level of respiratory protection they provide and their many positive user features. A common practice among healthcare workers to minimize airborne contaminant exposure has been to use surgical masks or N95 filtering facepiece respirators (FFRs). Surgical masks have been shown to offer minimal respiratory protection and while N95 FFRs offer better respiratory protection, they are not comfortable to use for a prolonged period. With current PAPR designs, exhaled air from the wearer is not filtered at all before release to the environment. This design feature suggests a potential for biocontamination when using PAPRs in an operating room sterile field condition. The objective of this research is to evaluate the bacterial shedding from the respiratory tract of healthcare workers while wearing PAPRs and half-mask respirators on sterile conditions in operating rooms (ORs). A randomized, simulated workplace study was conducted to compare the bacterial shedding from respiratory tracts of 9 teams of 2 participants each wearing six different types of respiratory protection devices (RPD), including an FDA approved surgical mask (SM), and five different NIOSH certified respirators. The result showed that the bacterial contamination produced by a pair of subjects wearing the N95 FFR without exhalation valves, the PAPR with APF=25 and the PAPR with APF=1000 was not significantly different than the contamination resulting from wearing the SM. However, the bacterial contamination resulting from using the N95 FFR with exhalation valve and elastomeric half-mask respirator, EHMR with exhalation valve was found to be significantly higher than the bacterial contamination resulting from wearing the SM