In this study, self-determined, ambulatory and casual blood pressure measurements were studied in patients with mild to moderate essential hypertension. 31 patients were studied during a 7-day period: casual blood pressures were taken on the 1st, 4th and 7th day. Pressure monitoring for 24 h using a noninvasive ambulatory blood pressure recorder was performed on the 1st and 7th day. Patients recorded blood pressure daily at home at least 3 times each day. On the 1st day, the mean casual blood pressure was significantly higher than either mean self-determined blood pressure or mean 24-hour ambulatory blood pressure. There was no significant difference between ambulatory daytime means and self-determined means. Casual blood pressures decreased from day 1 to day 7 significantly, while no significant difference in self-determined or ambulatory readings was observed. On the 7th day casual blood pressures were still significantly higher than self-determined measurements. Our results show that values obtained from daytime ambulatory measurements and self-determined measurements were equivalent. A fall in blood pressure with serial observations was found only in casual blood pressure, while no significant change occurred with either self-determined or ambulatory pressure. Since self-determined blood pressure measurements are easier and more economical to perform than ambulatory measurements, self-determined measurement is an excellent alternative to obtain representative blood pressure values for the diagnosis and treatment of hypertension.
Introduction
Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), is responsible for the coronavirus disease 2019 (COVID – 19) global pandemic. Similar coronavirus epidemics over the past years affected healthcare workers significantly. Aerosol generating procedures (AGPs) presented a unique risk to ear, nose and throat (ENT) Surgeons. We introduce various methods of reducing risk in ENT AGPs.
Recommendations
During trachesostomies we advocate the adoption of a specialist checklist based on ENT UK guidelines.
We also advise the use of a clear drape to create a clear barrier between the patient and staff.
For ear surgery we advise suturing 2 microscope pieces together end-to-end so that a clear drape can sperate the patient from surgeon.
During nasal and sinus surgery, we advise attaching a clear drape to the sterile camera drape used in rigid nasal endoscopy to create a barrier between patient and surgeon.
Discussion
Our recommendations will create an extra barrier between the patient and the rest of healthcare team. This should reduce the risks to theatre staff from AGPs.
Conclusions
COVID 19 is a serious health issue affecting healthcare workers, especially during AGPs in ENT surgery. We recommend several techniques to reduce risk. These can also be used during future epidemics.
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