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More on Barrier Enclosure during Endotracheal Intubation.更多关于气管插管期间的屏障隔离
N Engl J Med. 2020 May 21;382(21):e69. doi: 10.1056/NEJMc2012960. Epub 2020 May 5.
4
Barrier Enclosure during Endotracheal Intubation.气管插管时的屏障隔离罩
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Consensus guidelines for managing the airway in patients with COVID-19: Guidelines from the Difficult Airway Society, the Association of Anaesthetists the Intensive Care Society, the Faculty of Intensive Care Medicine and the Royal College of Anaesthetists.COVID-19 患者气道管理共识指南:困难气道学会、麻醉师协会、重症监护学会、重症监护医学学院和皇家麻醉师学院指南。
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6
Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1.与严重急性呼吸综合征冠状病毒1(SARS-CoV-1)相比,严重急性呼吸综合征冠状病毒2(SARS-CoV-2)在气溶胶和表面的稳定性
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用于 COVID-19 大流行期间插管的气溶胶隔离和过滤帐篷。

An Aerosol Containment and Filtration Tent for Intubation During the COVID-19 Pandemic.

机构信息

Division of Emergency Medicine, 266111University of Utah Hospita and Clinics, Salt Lake City, USA.

Center for Medical Innovation, 7060University of Utah Health, Salt Lake City, USA.

出版信息

Surg Innov. 2021 Apr;28(2):226-230. doi: 10.1177/1553350621999976. Epub 2021 Mar 12.

DOI:10.1177/1553350621999976
PMID:33710929
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8685586/
Abstract

Exposure to infectious droplets confers a high risk for infection transmission by the SARS-CoV-2 coronavirus. Aerosolizing procedures pose particular concern for increasing healthcare workers' (HCWs) risks of infection. Multiple creative personal protective equipment solutions have been utilized to minimize exposure to infectious particles; however, the overall benefit of many of these devices is limited by a number of factors. We designed an intubation tent consisting of a metal frame and a clear plastic sheet. The flexible walls of our tent offer increased maneuverability & access, although the efficacy in reducing risk of transmission to HCWs remained unclear. Using an atomizer, particle generator, and matchstick smoke, we simulated the generation of infectious respiratory droplets and aerosols and tested whether our device effectively decreased the concentration of these particles to which a provider might be exposed. Finally, we tested whether the addition of a vacuum fan fit with a high efficiency particulate air filter designed to evacuate contaminated air would influence particle concentrations inside and outside the tent. Droplet dispersion tests with the tent in place showed that the simulated droplet distribution was limited to surfaces within the tent. Aerosol testing under a variety of circumstances consistently showed only a minor rise in particle concentration in the air outside the tent despite an initial peak of particle concentration during generation within. All testing demonstrated declining inside concentrations over time. Our simulations suggest our device has the potential to effectively decrease HCWs' exposure to infectious droplets and aerosolized viral particles.

摘要

暴露于传染性飞沫会使 SARS-CoV-2 冠状病毒感染的传播风险很高。气溶胶化操作特别令人关注,因为它会增加医护人员(HCWs)感染的风险。已经采用了多种创造性的个人防护设备解决方案来最大程度地减少对传染性颗粒的暴露;但是,许多这些设备的整体效果受到多种因素的限制。

我们设计了一个由金属框架和透明塑料片组成的插管帐篷。我们帐篷的柔性墙壁提供了更大的机动性和可操作性,尽管其降低 HCWs 感染风险的效果尚不清楚。我们使用雾化器、颗粒发生器和火柴烟模拟了传染性呼吸道飞沫和气溶胶的产生,并测试了我们的设备是否可以有效地降低提供者可能暴露于的这些颗粒的浓度。最后,我们测试了装有高效微粒空气过滤器的真空风扇的添加是否会影响帐篷内外的颗粒浓度。

在帐篷就位的情况下进行的液滴扩散测试表明,模拟的液滴分布仅限于帐篷内的表面。在各种情况下进行的气溶胶测试均表明,尽管在产生过程中有初始的颗粒浓度峰值,但帐篷外空气中的颗粒浓度仅略有上升。所有测试均表明内部浓度随时间呈下降趋势。

我们的模拟表明,我们的设备有可能有效地降低 HCWs 暴露于传染性飞沫和雾化病毒颗粒。