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Prevention and Containment
Published in Joseph R. Masci, Elizabeth Bass, Ebola, 2017
Joseph R. Masci, Elizabeth Bass
This guidance was subsequently updated to Expand the rationale for respiratory protection.Clarify that the trained observer should not serve as an assistant for doffing PPE.Suggest that a designated doffing assistant or buddy might be helpful, especially in doffing with the powered air purifying respirator (PAPR) option.Modify the PAPR doffing procedure to make the steps clearer.Change the order of boot cover removal. Boot covers should now be removed after the gown or coverall.Clarify the types of gowns and coveralls that are recommended and provide a link to considerations for gown and coverall selection.Emphasize the importance of frequent cleaning of the floor and work surfaces in the doffing area.
The Role of Infection Control and Hospital Epidemiology in the Optimization of Antibiotic Use
Published in Robert C. Owens, Paul G. Ambrose, Charles H. Nightingale, Antibiotic Optimization, 2004
Multidrug-resistant tuberculosis is a globally important problem and a major concern of infection control. Known or suspected cases should be managed using airborne precautions. Negative-pressure rooms and the use of N95 masks or powered air-purifying respirators (PAPRs) protect other patients and employees. High-risk patients (those with HIV, immunocompromised patients) with pneumonias of unknown etiology should be placed on precautions until Mycobacterium tuberculosis is ruled out (140).
Personal Protective Equipment (PPE): Practical and Theoretical Considerations
Published in Brian J. Lukey, James A. Romano, Salem Harry, Chemical Warfare Agents, 2019
The powered air-purifying respirator (PAPR or PAPPER) employed in Level C has many advantages, including (1) minimal mobility restrictions, (2) small size, (3) easy maintenance because of few parts, (4) minimal cardiovascular effect, (5) easy storage in small spaces, (6) lightweight (only a few pounds without the blower, which can be worn on the belt), (7) cheaper cost per unit than atmosphere (air)-supplied respirators, (8) far less complicated design than atmosphere (air)-supplied respirators (since they lack a high-pressure tank, hoses, and high-pressure reduction valves), and (9) relative simplicity in use. They characteristically filter at least 4–6 cfm of air (113–170 L/min) (3M Instruction Manuals, 2004; Scott Safety C420 Brochure, 2005), and depending on the filters and blowers used, rates as high as 9 cfm/min (254.85 L/min) are obtainable (Minnesota Mining and Manufacturing [3M] Technical Assistance, 2006, personal communication via telephone 800-243-4630, accessed April 10, 2006). Regulations emphasize that blowers of PAPRs employing a tight mask-like facepiece must be capable of producing at least 4 cfm airflow, whereas those of loose-fitting hood-like facepieces must be capable of producing at least 6 cfm. The greatly increased volume of flow of filtered air created within the facepiece of the respirator by the blower would create an outward flow (from the respirator’s facepiece to the surrounding contaminated atmosphere) of air should a faceseal leak occur. This outward flow of filtered air would significantly decrease the possibility of inhalation of any significant amount of unfiltered toxic atmospheric air, especially in the hooded variety of respirators, since no faceseal exists within many models with this type of respirator. Hence, all PAPRs (both tight-fitting facepiece and hood variations) are considered positive-pressure respirators by OSHA.
Measures against COVID-19 pandemic – a single tertiary center experience
Published in Journal of Obstetrics and Gynaecology, 2022
Orkun Ilgen, Bahadır Saatli, Tunc Timur, Hakan Kula, Selim Kandemir, Sefa Kurt, Erkan Cagliyan
The use of PPE is one of the most important precautions for individuals to protect themselves especially from asymptomatic patients. All staff was trained on the use and store the PPE. Staff who failed to fit the N95 masks to their face may use positive air pressure respirators (PAPR). However, there was not enough PAPRs in our institution. Therefore, staff who failed to use N95 masks were relocated to sections, where non-COVID-19 patients were treated (Lee et al. 2004). Goggles were provided to each member of staff against conjunctival transmission (Chang et al. 2020; Li et al. 2020). The staff were requested to use their N95 masks were used repeatedly with an additional surgical mask covering it, in order to extend the usage of the N95 mask up to three days and reduce the risk of running out of them. Equipment shortage concerning PPE has been a global issue, especially at the beginning of the pandemic. According to a survey, 73% of healthcare professionals worldwide reported equipment shortage (Yánez Benítez et al. 2021). Although extended use of the N95 mask is defined as wearing the same mask while close contact with several COVID-19 patients without getting the mask off, the duration usually is not more than 4 to 5 h in practice because of the need for eating or drinking (Fisher and Shaffer 2014). Re-use is defined as wearing the same N95 mask when encountering several patients with getting the mask off between the patients. The Association for Professionals in Infection Control and Epidemiology position papers recommend extended use more than re-use (Fisher and Shaffer 2014).
Personal protective equipment (PPE) during the COVID-19 pandemic for oculofacial plastic and orbital surgery
Published in Orbit, 2021
Patrick Daigle, Victoria Leung, Vivian Yin, Evan Kalin-Hajdu, Navdeep Nijhawan
With regard to PPE in the general clinical context, physicians should follow universal droplet precautions as per their hospital protocols for COVID-19 infection control. Most centers recommend fit testing for N95 masks every 2 years. Proper PPE fit and use are essential for effective protection. The highest risk of self-contamination is at doffing. Surgeons should review their local donning and doffing videos prior to use,35 and infrequent users of N95 masks should have a partner spot them. A powered air-purifying respirator (PAPR) is an air-purifying respirator that uses a blower to force air through filter cartridges or canisters and into the breathing zone of the wearer. PAPRs can also be used for protection when there is a risk of aerosolized pathogens. However, they are less commonly available than N95 respirators, require formal training for use, as well as stringent disinfection and sanitization procedures after each use, and are similarly subject to risks of self-contamination. Eye protection with goggles and/or a face shield has generally been recommended by most surgical centers.
Turbulent Airflow Costume Compromises Occupational Safety and Infection Control: A Hospital Risk Management Case Report
Published in Journal of Legal Medicine, 2021
Background: Air-powered costumes use a small motor to create positive pressure within the costume. This mechanism is similar to Powered Air Purifying Respirator (PAPR).1 However, unlike a PAPR the air-powered costume does not filter the incoming air through a HEPA filter. Nor does it capture the air inside a contained space and filter it before it is released into the environment. The affect is that droplets from the person in the costume or from air that is drawn into the costume, which would normally be too heavy to travel farther than 6 feet, are aerosolized by traveling through the turbulent blower. These small particles can easily penetrate the thin fabric that makes the costume. This creates an infection control problem by aerosolizing the particles and then propelling them with the force of positive pressure.2