Pilot study of directional airflow and containment of airborne particles in the size of Mycobacterium tuberculosis in an operating room

Olmsted, Russell N.

doi:10.1016/j.ajic.2007.10.028

Cited by 10 publications

(5 citation statements)

References 22 publications

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“…PAO aerosols generated in this manner contain particles from 0.1 to 10 μm, which corresponds to the size range of exhaled SARS-CoV-2 aerosolized droplets and is used as a laboratory surrogate of airborne pathogens. 6 , 8 , 10 , 11 , 12 , 13 We measured aerosolized PAO particulate concentrations inside and outside each enclosure with a calibrated PH-5 photometer (TEC Services Inc.). To quantify PAO concentrations outside of the rigid plastic barrier enclosures, we used the photometer to first measure the average concentration of PAO (upstream) within the enclosure, which served as the 100% reference to quantify aerosol penetration outside of the enclosure (downstream).…”

Section: Methodsmentioning

confidence: 99%

Improved Testing and Design of Intubation Boxes During the COVID-19 Pandemic

Turer

Good

Schilling

et al. 2021

Annals of Emergency Medicine

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Study objective Throughout the coronavirus disease 2019 pandemic, many emergency departments have been using passive protective enclosures (“intubation boxes”) during intubation. The effectiveness of these enclosures remains uncertain. We sought to quantify their ability to contain aerosols using industry standard test protocols. Methods We tested a commercially available passive protective enclosure representing the most common design and compared this with a modified enclosure that incorporated a vacuum system for active air filtration during simulated intubations and negative-pressure isolation. We evaluated the enclosures by using the same 3 tests air filtration experts use to certify class I biosafety cabinets: visual smoke pattern analysis using neutrally buoyant smoke, aerosol leak testing using a test aerosol that mimics the size of virus-containing particulates, and air velocity measurements. Results Qualitative evaluation revealed smoke escaping from all passive enclosure openings. Aerosol leak testing demonstrated elevated particle concentrations outside the enclosure during simulated intubations. In contrast, vacuum-filter-equipped enclosures fully contained the visible smoke and test aerosol to standards consistent with class I biosafety cabinet certification. Conclusion Passive enclosures for intubation failed to contain aerosols, but the addition of a vacuum and active air filtration reduced aerosol spread during simulated intubation and patient isolation.

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Section: Methodsmentioning

confidence: 99%

Improved Testing and Design of Intubation Boxes During the COVID-19 Pandemic

Turer

Good

Schilling

et al. 2021

Annals of Emergency Medicine

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“…66 Another study compared freestanding HEPA filter units placed inside the OR to a novel portable anteroom system with HEPA unit (PAS-HEPA) that is placed outside the OR, near the main entrance. 67 It was found that with the PAS-HEPA system, experimental smoke plumes were observed moving downward toward the main entry door. However, when freestanding HEPA units were placed on the patient bed inside the OR, smoke plumes were moving vertically upward toward the breathing zone of the OR personnel.…”

Section: Filtration In Healthcare Facilitiesmentioning

confidence: 99%

“…For example, during an HVAC system operations audit of 20 operating rooms in 10 different hospitals in the Hellenic Republic, the most common problems were poor maintenance of filters and nonexistent of air exhaust filters . Another study compared freestanding HEPA filter units placed inside the OR to a novel portable anteroom system with HEPA unit (PAS-HEPA) that is placed outside the OR, near the main entrance . It was found that with the PAS-HEPA system, experimental smoke plumes were observed moving downward and toward the main entry door.…”

Section: Filtration In Healthcare Facilitiesmentioning

confidence: 99%

COVID-19 Outbreak and Hospital Air Quality: A Systematic Review of Evidence on Air Filtration and Recirculation

Mousavi

Kananizadeh²,

Martinello

et al. 2020

Environ. Sci. Technol.

112

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The outbreak of SARS-CoV-2 has made us all think critically about hospital indoor air quality and the approaches to remove, dilute, and disinfect pathogenic organisms from the hospital environment. While specific aspects of the coronavirus infectivity, spread, and routes of transmission are still under rigorous investigation, it seems that a recollection of knowledge from the literature can provide useful lessons to cope with this new situation. As a result, a systematic literature review was conducted on the safety of air filtration and air recirculation in healthcare premises. This review targeted a wide range of evidence from codes and regulations, to peer-reviewed publications, and best practice standards. The literature search resulted in 394 publications, of which 109 documents were included in the final review. Overall, even though solid evidence to support current practice is very scarce, proper filtration remains one important approach to maintain the cleanliness of indoor air in hospitals. Given the rather large physical footprint of the filtration system, a range of short-term and long-term solutions from the literature are collected. Nonetheless, there is a need for a rigorous and feasible line of research in the area of air filtration and recirculation in healthcare facilities. Such efforts can enhance the performance of healthcare facilities under normal conditions or during a pandemic. Past innovations can be adopted for the new outbreak at low-to-minimal cost.

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“…Systems touted to lower SSIs include rooms with laminar airflow, filtered air exchange, and positive pressure 51. Some investigators advocate the placement of high-particulate air filters outside the OR to direct the contaminants toward the door 53. High flow of human traffic in and out of the OR has been shown to increase the number of bacterial colony-forming units in the room significantly, and thus should be limited 54…”

Section: Risk Reduction In Surgerymentioning

confidence: 99%

Reducing infection risk in implant-based breast-reconstruction surgery: challenges and solutions<div><br /></div>

Ooi

Song

2016

BCTT

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Implant-based procedures are the most commonly performed method for postmastectomy breast reconstruction. While donor-site morbidity is low, these procedures are associated with a higher risk of reconstructive loss. Many of these are related to infection of the implant, which can lead to prolonged antibiotic treatment, undesired additional surgical procedures, and unsatisfactory results. This review combines a summary of the recent literature regarding implant-related breast-reconstruction infections and combines this with a practical approach to the patient and surgery aimed at reducing this risk. Prevention of infection begins with appropriate reconstructive choice based on an assessment and optimization of risk factors. These include patient and disease characteristics, such as smoking, obesity, large breast size, and immediate reconstructive procedures, as well as adjuvant therapy, such as radiotherapy and chemotherapy. For implant-based breast reconstruction, preoperative planning and organization is key to reducing infection. A logical and consistent intraoperative and postoperative surgical protocol, including appropriate antibiotic choice, mastectomy-pocket creation, implant handling, and considered acellular dermal matrix use contribute toward the reduction of breast-implant infections.

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Pilot study of directional airflow and containment of airborne particles in the size of Mycobacterium tuberculosis in an operating room

Cited by 10 publications

References 22 publications

Improved Testing and Design of Intubation Boxes During the COVID-19 Pandemic

Improved Testing and Design of Intubation Boxes During the COVID-19 Pandemic

COVID-19 Outbreak and Hospital Air Quality: A Systematic Review of Evidence on Air Filtration and Recirculation

Reducing infection risk in implant-based breast-reconstruction surgery: challenges and solutions<div><br /></div>

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