Conversion of operating theatre from positive to negative pressure environment

Chow, Tommy W. S.; Kwan, Alan; Lin, Zhang; Bai, Wei

doi:10.1016/j.jhin.2006.07.020

Cited by 99 publications

(85 citation statements)

References 9 publications

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“…Recommendations made by the WHO and CDC for personal protective equipment (PPE) are in agreement that standard, contact precautions with face mask, eye protection, gown, and gloves are necessary (51). converting such facilities to negative pressure isolation in the setting of COVID-19 (84). Guidance and recommendations in this space will be forthcoming from interventional communities, including the ACC and SCAI (51).…”

Section: Considerations For Health Care Workersmentioning

confidence: 99%

Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic

Driggin

Madhavan

Bikdeli

et al. 2020

Journal of the American College of Cardiology

1,875

1,931

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Section: Considerations For Health Care Workersmentioning

confidence: 99%

Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic

Driggin

Madhavan

Bikdeli

et al. 2020

Journal of the American College of Cardiology

1,875

1,931

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“…The operating rooms in our hospital were generally positive-pressure environments, and we had no permanent negative-pressure operating rooms. Because a negative-pressure operating room is the optimal environment to prevent airborne virus spreading to adjacent areas 13 , two of our 25 operating rooms in the main operating suite of the hospital were temporarily converted into negative-pressure operating rooms to perform surgical procedures on MERS-related patients. Operating rooms no.…”

Section: Resultsmentioning

confidence: 99%

“…Unlike SARS, ongoing small and large MERS outbreaks in the Arabian Peninsula foster potential future MERS outbreaks in non-endemic countries. However, there is likely to be a very limited number of hospitals that are prepared with negative-pressure operating rooms, except for a few hospitals in Hong Kong that experienced the 2003 SARS outbreak 13 . Almost all hospitals generally have positive-pressure operating rooms and they may experience an outbreak without facilities that are prepared for perioperative management of MERS patients, as our hospital did in 2015.…”

Section: Discussionmentioning

confidence: 99%

Infection Prevention Measures for Surgical Procedures during a Middle East Respiratory Syndrome Outbreak in a Tertiary Care Hospital in South Korea

Park

Yoo

et al. 2020

Sci Rep

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In 2015, we experienced the largest in-hospital Middle East respiratory syndrome (MERS) outbreak outside the Arabian Peninsula. We share the infection prevention measures for surgical procedures during the unexpected outbreak at our hospital. We reviewed all forms of related documents and collected information through interviews with healthcare workers of our hospital. After the onset of outbreak, a multidisciplinary team devised institutional MERS-control guidelines. Two standard operating rooms were converted to temporary negative-pressure rooms by physically decreasing the inflow air volume (−4.7 Pa in the main room and −1.2 Pa in the anteroom). Healthcare workers were equipped with standard or enhanced personal protective equipment according to the MERS-related patient's profile and symptoms. Six MERS-related patients underwent emergency surgery, including four MERS-exposed and two MERS-confirmed patients. Negative conversion of MERS-CoV polymerase chain reaction tests was noticed for MERS-confirmed patients before surgery. MERS-exposed patients were also tested twice preoperatively, all of which were negative. All operative procedures in MERSrelated patients were performed without specific adverse events or perioperative MERS transmission. Our experience with setting up a temporary negative-pressure operation room and our conservative approach for managing MERS-related patients can be referred in cases of future unexpected MERS outbreaks in non-endemic countries.The Middle East respiratory syndrome (MERS) is a serious acute respiratory disease caused by the MERS coronavirus (MERS-CoV), and the mortality rates in infected patients are estimated at 20-40% 1 . Since the first case report in Saudi Arabia in 2012 2 , MERS outbreaks have occurred mainly in Middle Eastern countries and a small number of imported cases arose in Europe, Asia, United States, and Africa 3-7 . From May to July 2015, South Korea experienced the largest MERS outbreak outside the Arabian Peninsula 8,9 . The South Korean outbreak resulted in 186 laboratory-confirmed MERS cases, 92 of which were associated with our tertiary care hospital 10,11 . According to our institutional policy during the MERS outbreak, all elective surgeries for MERS-related patients were postponed when possible. However, several MERS-related patients inevitably required emergency operations under anesthesia. Two of the 92-MERS confirmed cases and four MERS-exposed patients underwent surgery. Although there is some literature regarding infection prevention during operative procedures for severe acute respiratory syndrome (SARS) coronavirus 12,13 , guidelines or references for MERS prevention during perioperative patient care were very limited. Therefore, we developed institutional guidelines for perioperative MERS infection prevention and we set up a temporary negative-pressure operating room.In this globalized era, along with small and large outbreaks that persist in the Arabian Peninsula, MERS outbreaks may recur in any other regions, especially if a super spreader i...

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“…Rapid advances in computer capacity have meant that the computational fluid dynamics (CFD) technique has become a powerful alternative for predicting the airflow field in enclosed environments. CFD is a branch of fluid mechanics that has been used extensively as a numerical tool to assess and visualize air movement, temperature distributions and particle concentrations [12,[21][22][23][24][25].…”

Section: Computational Fluid Dynamicsmentioning

confidence: 99%

Surgical clothing systems in laminar airflow operating room: a numerical assessment

Sadrizadeh

Holmberg

2014

Journal of Infection and Public Health

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This study compared two different laminar airflow distribution strategies - horizontal and vertical - and investigated the effectiveness of both ventilation systems in terms of reducing the sedimentation and distribution of bacteria-carrying particles. Three different staff clothing systems, which resulted in source strengths of 1.5, 4 and 5 CFU/s per person, were considered. The exploration was conducted numerically using a computational fluid dynamics technique. Active and passive air sampling methods were simulated in addition to recovery tests, and the results were compared. Model validation was performed through comparisons with measurement data from the published literature. The recovery test yielded a value of 8.1 min for the horizontal ventilation scenario and 11.9 min for the vertical ventilation system. Fewer particles were captured by the slit sampler and in sedimentation areas with the horizontal ventilation system. The simulated results revealed that under identical conditions in the examined operating room, the horizontal laminar ventilation system performed better than the vertical option. The internal constellation of lamps, the surgical team and objects could have a serious effect on the movement of infectious particles and therefore on postoperative surgical site infections.

show abstract

Conversion of operating theatre from positive to negative pressure environment

Cited by 99 publications

References 9 publications

Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic

Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic

Infection Prevention Measures for Surgical Procedures during a Middle East Respiratory Syndrome Outbreak in a Tertiary Care Hospital in South Korea

Surgical clothing systems in laminar airflow operating room: a numerical assessment

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