Implementation of the Indoor Environmental Quality (IEQ) Model for the Assessment of a Retrofitted Historical Masonry Building

Achieving a satisfactory level for indoor environments of historical buildings is an ongoing problem that needs to be solved due to a large demand for deep retrofits in the whole of Europe. The implementation of the indoor environmental quality index (IEQ) to predict an occupant’s satisfaction in thermo-modernized historical buildings is a new concept which is a response to existing needs. In this article, a relevant study is provided with the intention to evaluate the indoor environmental performance of retrofitting effects in historical buildings dating back to the years 1873–1878. Considering the historical character of the buildings, some of the cellar spaces were fitted out with an innovative internal insulation system of mineral sheets based on calcium silicate to prevent water vapor condensation and effectively limit mold growth. The IEQ methodology was applied for retrofitted and non-retrofitted spaces as a comparison. Four essential components of indoor quality are investigated: thermal comfort, indoor air quality, acoustic comfort, and visual quality. The results of sub-component indexes are calculated based on the measured indoor parameters and the specific sensory functions. This paper discusses the results of an indoor environmental analysis including a mycological air quality assessment with the newly developed IAQindex (fungal air contamination index), total volatile organic compound concentration (TVOC), CO2, and formaldehyde (HCHO) assessment, the evaluation energy-related thermal comfort, acoustic, and visual quality, of modernized spaces. A questionnaire survey study was additionally carried out among a building’s users intentioned to compare the accounts of satisfaction before and after the retrofitting process and also to compare “subjective” results with the one’s based on in situ tests. The retrofitting approach was proven to be effective in limiting the presence of molds and a significant difference in indoor environmental quality between thermally insulated and uninsulated spaces was observed and discussed

A proposal of a cheap and simple method of medical personnel protection for endotracheal intubation of patients with a suspected or confirmed COVID-19 infection

ObjectivesThe COVID-19 pandemic has created additional risks to healthcare providers, especially those who perform aerosol generating procedures (AGPs) like endotracheal intubation. Endotracheal intubation is one of the procedures mostly generating aerosol and, therefore, requiring full protection of medical personnel against the infection.Material and MethodsIn this paper, basing on a literature review, the recommended intubation procedure is presented together with recommendations for personal protection during intubation. Additionally, a proposal of a simple and cheap protective barrier is described against spreading aerosol outside the intubation area. The aim was to propose a simple and cheap method to increase the safety of medical personnel performing AGPs in patients infected or suspected of being infected with COVID-19, which could be easily introduced into clinical practice.ResultsThe presented method is the authors’ own idea, based on their experience gathered from working in an operating room. Judging from their clinical experience, the presented method is effective and safe for patients.ConclusionsEndotracheal intubation is one of the most common AGPs and adequate actions must be taken in order to protect medical personnel against the infection and to prevent the spreading of aerosol around the intubation area. The proposed barrier is easy to set with disposable materials and standard equipment available in every operating room

An Evaluation of the Intubrite Laryngoscope in Simulated In-Hospital and Out-of-Hospital Settings by Individuals with No Clinical Experience: A Randomized, Cross-Over, Manikin Study

Introduction: The aim of the study was to compare the Intubrite laryngoscope and the standard Macintosh blade laryngoscope (MCL) used by persons with no clinical experience in simulated hospital and non-hospital conditions on a manikin model. Materials and methods: The study involved 50 students of Medical Rescue. The hospital conditions (intubation height 110 cm—high position) and those occurring at the scene (intubation of a manikin located at floor level-low position) were simulated. The analysis included: duration of intubation, visibility of the laryngeal opening by the Cormack–Lehane scale, the bioelectrical activity of the intubating muscles, comfort and subjective assessment of physical effort by the Borg scale (Borg’s scale of subjective feeling of effort). The statistical analysis was performed with Microsoft Excel and T-student tests for pairs with unequal variables. The statistical importance was set at p p p p p p > 0.05), while in the simulated out-of-hospital setting, it was significantly higher for the MCL (22% versus 8%, p p-value, values). The use of the Intubrite laryngoscope was associated with less effort than the MCL in high versus low positions. For MCL, intubation in a high position was associated with lower mean muscle activity than in a low position (+48.24 µV versus +58.25 µV, p-value). For the Intubrite laryngoscope, these values were at similar levels (+52.03 µV and +52.65 µV, p-value). Conclusions: The use of the Intubrite laryngoscope by people with no clinical experience shortens the time of intubation and improves the laryngeal view compared to the standard Macintosh laryngoscope, but it requires similar muscle work in simulated conditions

A pilot, prospective trial of IntuBrite® versus Macintosh direct laryngoscopy for paramedic endotracheal intubation in out of hospital cardiac arrest

Abstract Background Intubation in the case of out-of-hospital cardiac arrest (OHCA) is one of the most difficult procedures for Emergency Medical Services (EMS). The use of a laryngoscope with a dual light source is an interesting alternative to classic laryngoscopes. However, there are as yet no prospective data concerning the use of double light direct laryngoscopy (DL) by paramedics in traditional ground ambulance agencies in OHCA. Methods We performed a non-blinded trial in a single EMS in Poland within ambulances crews, comparing time and first pass success (FPS) for endotracheal intubation (ETI) in DL using the IntuBrite® (INT) and Macintosh laryngoscope (MCL) during cardiopulmonary resuscitation (CPR). We collected both patient and provider demographic information along with intubation details. The time and success rates were compared using an intention-to-treat analysis. Results Over a period of 40 months, a total of 86 intubations were performed using 42 INT and 44 MCL based on an intention-to-treat analysis. The FPS time of the ETI attempt (13.49 vs. 15.55 s) using an INT which was shorter than MCL was used (p < 0.05). First attempt success (34/42, 80.9% vs. 29/44, 64.4%) was comparable for INT and MCL with no statistical significance. Conclusions We found a statistically significant difference in intubation attempt time when the INT laryngoscope was used. Intubation first attempt success rates with INT and MCL were comparable with no statistical significance during CPR performed by paramedics. Trial Registration Trial was registered in Clinical Trials: NCT05607836 (10/28/2022

Air Enthalpy as an IAQ Indicator in Hot and Humid Environment—Experimental Evaluation

The authors studied the impact of indoor air humidity in the range of 60% to 90% on building user perception in the temperature range of 26 to 28 &deg;C. The research thesis was put forward that the impact of humidity on indoor air quality dissatisfaction of building users in a warm and humid indoor environment is greater than that indicated in thermal comfort models. The presented experiment examined the indoor air quality perception of n = 28 subjects in the test chamber of a nearly zero energy building under ten environmental conditions, together with a thermal comfort assessment. The authors developed an experimental relation for predicting building users&rsquo; satisfaction based on the Weber&ndash;Fechner law, where the predicted percentage of dissatisfied users (PD) is determined by means of air enthalpy (h), PD = f(h). The obtained results confirmed the sated thesis. Additionally, the intersection points of the experimental function and isotherms resulting from the Fanger model are presented, where the thermal comfort assessment starts to indicate lower user dissatisfaction results than experimental values. The authors recommend the experimental equation for humid air enthalpies in the range of 50 to 90 kJ/kg. The indoor air quality assessment based on the enthalpy value is simple and can be used to determine the overall Indoor Environmental Quality index of a building (IEQindex)

Experimental Confirmation of the Reliability of Fanger’s Thermal Comfort Model—Case Study of a Near-Zero Energy Building (NZEB) Office Building

Designing and constructing near zero energy buildings (NZEBs) is a challenge not only from a structural point of view, but also from the point of view of ensuring appropriate climate comfort for users. The standards describing how to ensure comfort were created in times when the challenges of building ZEB/NZEB were not yet explored and energy issues were not as important as they are today. Therefore, the assessment of the thermal and climatic comfort of people living and working in such buildings requires a new or revised approach to the methodology of thermal comfort assessment. In this article, the authors present the results of a thermal comfort study based on measurements and thermal sensory tests. Testing was carried out in an experimental office building (passive standard). The main goal of the experiment was to compare the thermal comfort measurement method based on the ISO-Fanger model with the actual comfort results obtained by the panellists in the model office condition. The tests allowed the lowest operating temperature providing thermal comfort (predicted mean vote (PMV) = 0 and &#8722;0.5) to be determined. Sensory tests were conducted using three types of questions. The results were compared to the other researchers&#8217; findings. It was noted that the panellists showed better thermal comfort sensation at lower temperatures than would result from the traditional Fanger distribution, so the authors proposed the experimental function of percentage of dissatisfied (PPD) = f(PMV). The authors hope that it contributed to the actual state of knowledge as a &#8220;small and specific scale&#8221; validation of the existing thermal comfort model. The results also revealed that the method of heating has an influence on the subjective thermal sensation