Overuse/Abuse of the Definition of "Aerosol-Generating Procedures" to Limit Mask Use

Re-evaluating our language when reducing risk of SARS-CoV-2 transmission to healthcare workers: Time to rethink the term, “aerosol-generating procedures”

The term, "aerosol-generating procedures” (AGPs), was proposed during the prior SARS-CoV-1 epidemic in order to maximise healthcare worker and patient protection. The concept of AGPs has since expanded to include routine therapeutic processes such as various modes of oxygen delivery and non-invasive ventilation modalities. Evidence gained during the SARS-CoV-2 pandemic has brought into question the concept of AGPs with regard to intubation, airway management, non-invasive ventilation and high flow nasal oxygen delivery. Although encounters where these procedures occur may still be associated with increased risk of infectious transmission, this is a function of the clinical context and not because the procedure itself is aerosol-generating.

Personal Protective Equipment Efficiency in Healthcare Emergencies: A Single-Center Experience

Coronavirus disease 2019 (COVID-19) has dramatically shifted the healthcare landscape since 2020. Measures against it includes universal masking in the healthcare areas and the community, viral testing before aerosolizing procedures, and ambulatory elective surgical procedures. Some hospitals have had mandated viral testing policies even before admission to the hospital. Healthcare workers (HCWs) have been cautiously modifying all pertinent practices to avoid the transmission of the virus.

Personal protective equipment (PPE), including gowns, gloves, eye protection, and properly fitted N95 respirator or powered air-purifying respirators (PAPR) while treating the suspected and confirmed COVID-19 patients were made mandatory. Similarly, we changed our aerosol-generating procedures (AGPs) protocols based on available limited data. We amended our approach to in-hospital cardiopulmonary resuscitation (basic life support (BLS)/advanced cardiovascular life support (ACLS)), given the risk of aerosol generation and transmission during the process. This article shares our experience and outcomes of PPE use in healthcare emergencies at our tertiary care academic center.

Knowledge about the effects of electrosurgery smoke among operating room nurses during COVID-19 Pandemic: A Cross-Sectional Study

Background

Electrosurgery smoke is the smoke emitted from tissue cauterization when using the electrosurgery device. Accordingly, in this smoke, more than 80 harmful toxins have been discovered. In the current study, we aimed to investigate the level of knowledge reported by the operating room nurses on the effects of electrosurgery smoke during the current COVID-19 pandemic.

Methods

This descriptive, survey-based cross-sectional study was performed on 533 OR nurses in all the referring hospitals of COVID-19 infection. The required information were collected using a questionnaire regarding the knowledge on the side effects of electrosurgery smoke. The obtained data were then analyzed using t-test and ANOVA by SPSS software.

Results

Most of the included participants (93.6%) had a low level of awareness and only a small number of them (0.4%) had a good level of knowledge on the effects of electrosurgery smoke. As well, a significant relationship (P˂0.05) was found between the level of knowledge reported by the OR nurses and the type of hospital (educational or private). Most of the studied hospitals used no electrosurgery smoke reduction equipment during electrosurgery.

Conclusion

The level of knowledge reported by the OR nurses was generally poor. It is recommended that managers and health officials try to increase the level of awareness of OR nurses during the COVID-19 pandemic by providing standard and protective equipment as well as holding some well-organized and related training courses.