Spread of Respiratory Droplets in a Simulated Ophthalmic Surgery

Felfeli, Tina; Amrit, S.; Braga-Mele, Rosa; Mandelcorn, Efrem D.; Hatch, Wendy; Rai, Amandeep

doi:10.1016/j.ophtha.2020.09.043

Cited by 9 publications

(9 citation statements)

References 8 publications

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“…Whenever possible, surgery should be performed under local anesthesia to avoid the generation of aerosols during general anesthesia procedures; otherwise, exposure should be minimized during intubation and extubation [ 49 ]. For minimizing the spread of respiratory droplets in procedures performed under monitored sedation, a patient's mask with a tight seal of the surgical drape could be used [ 47 , 55 ]. For suspected or confirmed patients full PPE, airborne isolation in the room with negative pressure, assigning an experienced surgeon, and using the most familiar methods to shorten the time of surgery as much as possible must be considered [ 49 ].…”

Section: Resultsmentioning

confidence: 99%

A Systematic Literature Review and Bibliometric Analysis of Ophthalmology and COVID-19 Research

Forouhari

Mansouri

Safi

et al. 2022

Journal of Ophthalmology

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This review is proposed to summarize the updates on COVID-19 and ophthalmology along with the bibliometric features of articles that have been published since the beginning of the COVID-19 outbreak. The databases, including PubMed, Scopus, and Web of Science, were searched using “Coronavirus,” “COVID-19,” “SARS-CoV-2,” “pandemic,” “ophthalmology,” “ophthalmic,” and “eye” keywords. All published articles except commentaries, errata, and corrigenda up to April 2021 were included. Titles and abstracts were screened, and ophthalmology-focused articles were collected. The bibliographic information of the articles, such as the name and country of the first author, type of study, date of publication, language, and journal name, were extracted. Included studies were assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. After systematic searching, 2,669 distinct articles were screened by title/abstract, and 1,174 ophthalmology-focused articles were selected to be reviewed. Ophthalmology-focused publications accounted for less than 0.5 percent of the total COVID-19-related articles. Most of the articles were published in the Indian Journal of Ophthalmology, and the main publication type was “original article.” Almost 88% of the publications were in English. There was a decline in the publication rate during the initial months of 2021 compared with the middle and last months of 2020. Most of the publications were affiliated with the United States of America. However, Singapore and the United Kingdom were the countries with the highest number of publications after population adjustment. Furthermore, a comprehensive review on major topics including SARS-CoV-2 ocular tropism, ophthalmic manifestations, ocular complications due to COVID-19 treatment strategies, the pandemic effect on ophthalmology care and operations, myopia progression during the pandemic, and telemedicine was conducted.

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Section: Resultsmentioning

confidence: 99%

A Systematic Literature Review and Bibliometric Analysis of Ophthalmology and COVID-19 Research

Forouhari

Mansouri

Safi

et al. 2022

Journal of Ophthalmology

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“…Multiple studies have used similar methods for assessing droplet and aerosol spread by using fluorescence dye and then quantifying the area of distribution. [ 19 20 23 24 ] Liquid detergent was used in this study as a cost-effective alternative to fluorescent dye. However, the validity of liquid detergent to simulate respiratory particles is unknown.…”

Section: Discussionmentioning

confidence: 99%

“…for use during airway procedures in COVID-19 patients. [ 20 ] The “aerosol box” was criticized for being bulky, heavy to carry and position in emergency settings and for being rigid restricting the hand movements. Barriers that use plastic sheets were preferred for its versatility and flexibility.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of “Resuscitation Cover All” in Minimizing COVID-19 Transmission to Health-Care Workers during Cardiopulmonary Resuscitation

Ayyan

Raju

Anandhi

et al. 2022

Journal of Global Infectious Diseases

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Introduction: Coronavirus disease 2019 (COVID-19) is a highly contagious disease transmitted by contact, droplets, and aerosols. Front line health-care workers (HCWs), particularly emergency physicians and acute care providers, are vulnerable to being exposed while treating their sick patients. Despite appropriate personal protective equipment use, HCW gets infected, suggesting the need for multiple layers of protection such as barrier devices. Methods: We aimed to determine the effectiveness of our novel “Resuscitation Cover All”(RCA) in reducing the exposure of HCW to simulated respiratory particles and its feasibility during cardio pulmonary resuscitation (CPR). This was a pilot simulation-based study. Five CPR simulation sessions were performed in Standard and RCA protocols, individually. Exposures through contact, droplets, and aerosols were simulated using a standardized volume of liquid detergent. Under Wood's lamp illumination, exposures of participants were compared between the protocols. Rate and depth of chest compressions, time taken to intubate, interruptions in CPR, and first-pass success were analyzed. Results: Overall mean exposure in standard protocol was 4950.4 ± 1461.6 (95%confidence interval [CI]:3135.7–6765.2) sq.pixels and RCA protocol was 2203.6 ± 1499.0 (95%CI: 342.4–4064.9) sq.pixels ( P = 0.019). In standard, chest compressor had the highest exposure of 3066.6 ± 1419.2 (95%CI: 2051.3–4081.9) sq.pixels followed by defibrillator assistant 1166.4 ± 767.4 (95%CI: 617.4–1715.4) sq.pixels. Chest compressor of RCA had reduced exposure compared to that of standard ( P < 0.001). Hands were the most frequently exposed body part. Airway manager of RCA had no exposure over head and neck in any session. No significant difference in CPR performance metrics was observed. Conclusion: This pilot simulation-based study shows that the novel RCA device could minimize the exposure of HCW to simulated respiratory particles during CPR. Also, it might not alter the high-quality CPR performance metrics. We need more real-life evidence.

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“…They are summarized briefly in Table 1. Simulations in the ophthalmic office and operating theatre have suggested that these measures significantly decrease the likelihood of SARS‐CoV‐2 infection in ophthalmology practice 125‐129 …”

Section: Implications For the Ophthalmologistmentioning

confidence: 99%