Objective: Personal protective equipment (PPE) use is frequently construed as inconvenient and disturbing by healthcare professionals (HCPs). We hypothesized that new-onset symptoms among HCPs may be associated with extended use of PPE and aimed to investigate risk factors related with new-onset symptoms. In addition, the effects of new-onset symptoms on working performance were evaluated. Methods: In this cross-sectional study, 315 participants filled out a questionnaire that contains four main parts: 1) Demographics, 2) New-onset symptoms with PPE use, 3) PPE usage hours, 4) Personal opinion about the effect of sensed symptoms on working performance. Results: The mean age was 31.58 ± 4.6 years, and 50.5% (n=159) were female. New-onset symptom rate was 66% (n=208). The most common new-onset symptom was headache (n=115, 36.5%) followed by breathing difficulty-palpitation (n=79, 25.1%) and dermatitis (n=64, 20.3%). Extended use of PPE, smoking, and overweight were independently associated with developing new-onset symptoms. A clear majority of symptomatic participants pointed out impact on working performance (193/208, 92.7%). Conclusion: Hospitals should take the necessary precautions (e.g. shorter shifts and more often breaks) to prevent symptoms associated with PPE and ensure that HCPs comply with these precautions.
Knowledge of food allergy and anaphylaxis among primary care physicians was unsatisfactory. Provision or periodic educational programmes should be aimed at improving the standard of practice as acknowledged by the participants.
Introduction Cardiac compression is a cumbersome procedure. The American Heart Association suggests switching of cardiopulmonary resuscitation (CPR) provider every 2 min to prevent any decrease in resuscitation quality. High quality CPR is associated with improved outcomes. Previous studies have highlighted the difficulties in providing high quality CPR particularly while wearing personal protective equipment (PPE). This study aimed to evaluate the impact of personal protective equipment (PPE) use on CPR quality in prehospital cardiac arrest situations. Methods In this prospective simulation study, we compared the cardiac compression qualities and fatigue rates among prehospital health care professionals (HCPs) who were or were not using PPE. Results A total of 76 prehospital HCPs comprising 38 compression teams participated in this study. The mean compression rate was 117.71 ± 8.27/min without PPE and 115.58 ± 9.02/min with PPE (p = 0.191). Overall compression score was 86.95 ± 4.39 without PPE and 61.89 ± 14.43 with PPE (p < 0.001). Post-cardiac compression fatigue score was 4.42 ± 0.5 among HCPs who used their standard uniform and 7.74 ± 0.92 among those who used PPE (p < 0.001). The overall compression score difference between the two conditions was 25.05 ± 11.74 and the fatigue score difference was 3.31 ± 0.98. Discussion PPE use is associated with decreased cardiac compression quality and significantly higher fatigue rates than those associated with the use of standard uniforms. Routine use of mechanical compression devices should be considered when PPE is required for out-of-cardiac arrests.
This study was aimed to determine the risk factors, associated complications, opioid requirements, and mortality rates of rib fractures. Material and Method:Patients with rib fractures who were admitted to the emergency department between January 1, 2016, and December 31, 2020, were retrospectively analyzed. Patients' demographic data, rib fracture characteristics, trauma mechanism, associated complications, length of stay in the hospital, and inhospital mortality were recorded.Results: A total of 1074 patients were included in the study. Most of the patients were male (n=748, 69.6%) and the mean age was 53.89±15.31 years. The mean number of fractured ribs was 3.65±2.06. All patients with diaphragm laceration, atelectasis, pneumonia, ARDS, pneumomediastinum, lung herniation, flail chest, and empyema had six or more rib fractures. Comparison of died and survived patients showed statistically significant difference for age, gender, side of rib fracture, number of fractured ribs, and accompanying another organ injury. A moderate-strong correlation was found between the number of fractured ribs and pneumothorax, hemothorax, chest tube, opioid use, and length of stay in the hospital. Conclusion:Increased number of fractured ribs were associated with increased complications, opioid use, and length of stay in the hospital. The mortality rate was 8.8% in patients with 6 or more fractures. In-vehicle traffic accidents were the most common mechanism. Many of the rib fractures can be prevented if the measures are improved.
Background Several vaccines have been developed and approved for use against SARS-CoV-2; however, the use of personal protective equipment (PPE) and precautions against transmission remain important due to the lack of effective specific treatment and whole community immunity. Hydroxychloroquine sulfate (HCQ) was used as a treatment option in the early days of the pandemic; however, it was subsequently removed due to a lack of evidence as an effective treatment for COVID-19. Aim To evaluate the testing and infection characteristics of COVID-19 among health care professionals (HCPs) and determine the efficacy of prophylactic HCQ use to prevent transmission. Methods This retrospective cross-sectional study was carried out between 1 May and 30 September 2020. The HCPs included in the study were doctors, nurses, and paramedical personnel, such as secretaries or technical staff. The medical records of HCPs who had been tested for SARS-CoV-2 using polymerase chain reaction (PCR) were retrospectively analyzed. Student's t-test and Pearson's Chi-square test were used for inter-group comparisons. Results 508 HCPs were included in the study. A total of 152 (29.9%) HCPs were diagnosed with COVID-19. The positive PCR rate was 80.3% (n = 122). A comparison of infected and uninfected HCPs showed a significant difference in terms of age and occupation, and no significant difference in terms of gender, working area, and prophylactic HCQ use. Conclusion Protective measures in low-risk areas of our hospital require improvements. All HCPs should be trained on PPE usage. Furthermore, there was no evidence to support the efficacy of prophylactic HCQ against SARS-CoV-2 transmission.
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