COVID-19 infection is related to differences in the use of personal protective equipment by orthopaedic specialist trainees caring for hip fracture patients during the second surge of COVID-19 in the North West of England.
COVID-19
FFP3
Nosocomial covid
Surgical facemasks
Journal
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie
ISSN: 1432-1068
Titre abrégé: Eur J Orthop Surg Traumatol
Pays: France
ID NLM: 9518037
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
received:
26
01
2021
accepted:
11
05
2021
pubmed:
11
6
2021
medline:
20
7
2021
entrez:
10
6
2021
Statut:
ppublish
Résumé
Personal protective equipment (PPE) may protect health-care workers from COVID-19 infection and limit nosocomial spread to vulnerable hip fracture patients. We performed a cross-sectional survey amongst orthopaedic trainees to explore PPE practice in 19 hospitals caring for hip fracture patients in the North West of England. During the second wave of the pandemic, 14/19 (74%) hospitals experienced an outbreak of COVID-19 amongst staff or patients on the orthopaedic wards. An FFP3 respirator mask was used by doctors in only 6/19 (32%) hospitals when seeing patients with COVID-19 and a cough and in 5/19 (26%) hospitals when seeing asymptomatic patients with COVID-19. A COVID-19 outbreak was reported in 11/13 (85%) orthopaedic units where staff wore fluid resistant surgical masks compared to 3/6 (50%) units using an FFP3 respirator mask (RR 1.69, 95% CI 0.74-3.89) when caring for symptomatic patients with COVID-19. Similarly, a COVID-19 outbreak was reported in more orthopaedic units caring for asymptomatic patients with COVID-19 where staff wore fluid resistant surgical masks (12/14 (86%)) as compared to an FFP3 respirator mask (2/5 (40%)) (RR 2.14, 95% CI 0.72-6.4). Urgent re-evaluation of PPE use is required to reduce nosocomial spread of COVID-19, amongst highly vulnerable patients with hip fracture.
Identifiants
pubmed: 34110468
doi: 10.1007/s00590-021-03006-z
pii: 10.1007/s00590-021-03006-z
pmc: PMC8191442
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
989-993Références
Ong SWX, Tan YK, Chia PY, Lee TH, Ng OT, Wong MSY, Marimuthu K (2020) Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient. JAMA 323(16):1610–1612
doi: 10.1001/jama.2020.3227
Mastan S, Cash T, Malik RA, Charalambous CP (2020) COVIDHipFracture study group. limited implementation of measures to reduce nosocomial spread of COVID-19 in hip fracture patients in the North West of England. J Hosp Infect 108:90–93
doi: 10.1016/j.jhin.2020.11.007
Shah AVS, Wood R, Gribben C, Caldwell D, Bishop J, Weir A et al (2019) Risk of hospital admission with coronavirus disease, in healthcare workers and their households: nationwide linkage cohort study. The BMJ 2020:371. https://doi.org/10.1136/bmj.m3582
doi: 10.1136/bmj.m3582
Heneghan C, Howdon D, Oke J, Jefferson T. The Ongoing Problem of UK Hospital Acquired Infections. The Centre for Evidence-Based Medicine. Accessed 17 December 2020 https://www.cebm.net/covid-19/the-ongoing-problem-of-hospital-acquired-infections-across-the-uk/
Clement ND, Ng N, Simpson CJ, Patton RFL, Hall AJ, Simpson AHRW, Duckworth AD (2020) The prevalence, mortality, and associated risk factors for developing COVID-19 in hip fracture patients: a systematic review and meta-analysis. Bone Joint Res 9(12):873–883
doi: 10.1302/2046-3758.912.BJR-2020-0473.R1
Narang A, Chan G, Aframian A, Ali Z, Carr A, Goodier H et al (2020) Thirty-day mortality following surgical management of hip fractures during the COVID-19 pandemic: findings from a prospective multi-centre UK study. Int Orthop. https://doi.org/10.1007/s00264-020-04739-y
doi: 10.1007/s00264-020-04739-y
pubmed: 32970201
Jackson T, Deibert D, Wyatt G, Durand-Moreau Q, Adisesh A, Khunti K et al (2020) Classification of aerosol-generating procedures: a rapid systematic review. BMJ Open Resp Res. https://doi.org/10.1136/bmjresp-2020-000730
doi: 10.1136/bmjresp-2020-000730
pubmed: 33040021
pmcid: 7549490
Rational use of personal protective equipment (PPE) for coronavirus disease (COVID-19). World Health Orgnisation. Accessed 17 December 2020 https://apps.who.int/iris/bitstream/handle/10665/331498/WHO-2019-nCoV-IPCPPE_use-2020.2-eng.pdf
Use Personal Protective Equipment (PPE) When Caring for Patients with Confirmed or Suspected COVID-19. CDC. Accessed 17 December 2020 https://www.cdc.gov/coronavirus/2019-ncov/downloads/A_FS_HCP_COVID19_PPE.pdf
Zheng C, Hafezi-Bakhtiari N, Cooper V, Davidson H, Habibi M, Riley P et al (2020) Characteristics and transmission dynamics of COVID-19 in healthcare workers at a London teaching hospital. J Hosp Infect 106:325–329. https://doi.org/10.1016/j.jhin.2020.07.025
doi: 10.1016/j.jhin.2020.07.025
pubmed: 32730771
pmcid: 7384992
Offeddu V, Yung CF, Low MSF et al (2017) Effectiveness of masks and respirators against respiratory infections in healthcare workers: a systematic review and meta-analysis. Clin Infect Dis 65(11):1934–1942
doi: 10.1093/cid/cix681
Jefferson T, Del Mar CB, Dooley L, Ferroni E, Al-Ansary LA, Bawazeer GA, van Driel ML, Jones MA, Thorning S, Beller EM, Clark J, Hoffmann TC, Glasziou PP, Conly JM (2020) Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev 11:CD006207
pubmed: 33215698
Kim M-C, Bae S, Kim JY, Park SY, Lim JS, Sung M et al (2020) Effectiveness of surgical, KF94, and N95 respirator masks in blocking SARS-CoV-2: a controlled comparison in 7 patients. Infect Dis (Lond) 52:908–912. https://doi.org/10.1080/23744235.2020.1810858
doi: 10.1080/23744235.2020.1810858
Cochrane Central Register of Controlled Trials (CENTRAL), Date Added to CENTRAL:31 March 2020 Issue Added to CENTRAL:2020 Issue 03
‘Postcode lottery’ of PPE, survey of surgeons finds. Royal College of Surgeons of England. 2020 Accessed 17 December 2020