Occupational hazards in anaesthesiology during the COVID-19 pandemic

Abstract

According to the Occupational Safety and Health Administration of the Department of Labor of the United States, the exposure risk for anaesthesiologists working with COVID-19 patients can be classified as high or very high. This is mostly due to fact that the anaesthesiologists work in close contact with patients’ airways, and the aerosol-generating nature of some procedures they perform. Fortunately, despite the occupational hazard, the incidence of COVID-19 among anaesthesiologists and intensivists remains relatively low. Current evidence suggests that the majority of SARS-CoV-2 infections in this group were either contracted outside of the work environment or can be attributed to personal protective equipment (PPE) malfunction. This article focuses on different aspects of anaesthesiologists’ safety, risks connected with different clinical scenarios and procedures, issues related to testing and screening, as well as modifiable and non-modifiable risk factors for severe illness or from COVID-19. This analysis is accompanied by a review of guidelines dedicated to mitigating said risks. Educating the personnel, introducing appropriate procedures, and proper utilisation of PPE are essential to the safety of all parties involved in hospital care, particularly those with significant exposure risk.

Occupational Risk Factors for SARS-CoV-2 Infection in Hospital Health Care Workers: A Prospective Nested Case-Control Study

“…Exposure to AGP was associated with a decreased risk of SARS-CoV-2 positivity at NPS (p = 0.02), although this result was not confirmed ay univariable and multivariable logistic regression analysis in the present study. Nevertheless, the latter finding has already been thoroughly investigated in the open literature [6][7][8][9]13,14,21,42]. AGPs are commonly associated with a high risk of respiratory viruses' infection [21]: a systematic review and meta-analysis on 17 studies reported an OR of SARS-CoV-2 infection of 6.69 for endotracheal intubation, 3.65 for Non-Invasive Ventilation and 10.03 for nebulized medications [9].…”

“…Nurses, HCWs working in hospitalization/emergency wards and infectious diseases personnel seem to have the highest risk of infection, with ob-gyn personnel and pediatrics personnel having the lowest risk [10][11][12]. By contrast, the evidence regarding anesthesiologist/intensivists is inconclusive [11][12][13][14][15].…”

“Ultrasound Derived Inferior Vena Cava Diameter and Collapsibility Index to Predict Central Venous Pressure Prior and After a Fluid Challenge in Spontaneous Breathing Preoperative Patients”

“…CVP should be monitored in cases of shock, circulatory failure, massive infusion or transfusion requirement, situations with massive bleeding risk, situations where careful fluid resuscitation is a must such as in paediatric patients or patients with cardiac problems. [5] CVP is a value indicating right atrial pressure or right ventricular filling pressure. It is an indicator of intravascular fluid status and right heart function.…”

“…Patients with left ventricular ejection fraction <40%, severe tricuspid regurgitation, mitral and aortic stenosis, pulmonary hypertension. 5. Patients with pericardial effusion and pleural effusion.…”