Overview of the User Experience for Snorkeling Mask Designs during the COVID-19 Pandemic

The Usability of Face Coverings Used to Prevent the Spread of COVID-19

OBJECTIVE

To describe the perceived usability and usability problems associated with face coverings used to prevent the spread of COVID-19.

BACKGROUND

Since public health experts have now identified the appropriate use of facemasks as one of the critical elements in an effective COVID mitigation strategy, understanding how people use and care for them has become important.

METHOD

Data were collected via a survey that was shared on social media to which 2148 people responded. Participants were asked to identify the category class of the face covering they most often wear, rate its usability, answer demographic information, and questions about their mask use and hygiene, and identify issues they may suffer in relation to face cover use.

RESULTS

Overall, users appear to perceive their face coverings favorably from a usability and satisfaction standpoint, even though almost two-thirds of users indicated that they experienced discomfort and problems with glasses fogging with the most popular mask types. When considering demographic information, users' political party affiliation appears related to how they perceive the usability of their face covering.

CONCLUSION

Designers should work to improve the fit and comfort properties of protective masks; evidence suggests the System Usability Scale may be a useful tool in those efforts.

APPLICATION

Understanding mask design and behavioral issues related to their use can help in the development of masks and will maximize their acceptance and effectiveness in the field.

Does the use of a diving mask adapted for non-invasive ventilation in hypoxemic acute respiratory failure in individuals with and without COVID-19 increase the ratio of arterial oxygen partial pressure to fractional inspired oxygen? A randomized clinical trial

Non-invasive ventilation (NIV) can be used in acute hypoxemic respiratory failure (AHRF); however, verifying the best interface for its use needs to be evaluated in the COVID-19 pandemic scenario. The objective of this study was to evaluate the behavior of the ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2 ratio) in patients with AHRF with and without COVID-19 undergoing NIV with the conventional orofacial mask and the adapted diving mask. This is a randomized clinical trial in which patients were allocated into four groups: i) group 1: COVID-19 + adapted mask (n=12); ii) group 2: COVID-19 + conventional orofacial mask (n=12); iii) group 3: non-COVID-19 + adapted mask (n=2); iv) group 4: non-COVID-19 + conventional orofacial mask (n=12). The PaO2/FiO2 ratio was obtained 1, 24, and 48 hours after starting NIV, and the success of NIV was evaluated. This study followed the norms of the Consolidated Standards of Reporting Trials statement and was registered in the Brazilian Registry of Clinical Trials under registration RBR-7xmbgsz. Both the adapted diving mask and the conventional orofacial mask increased the PaO2/FiO2 ratio. The interfaces differed in terms of the PaO2/FiO2 ratio in the first hour [309.66 (11.48) and 275.71 (11.48), respectively] (p=0.042) and 48 hours [365.81 (16.85) and 308.79 (18.86), respectively] (p=0.021). NIV success was 91.7% in groups 1, 2, and 3, and 83.3% in group 4. No adverse effects related to interfaces or NIV were observed. NIV through the conventional orofacial mask interfaces and the adapted diving mask was effective in improving the PaO2/FiO2 ratio; however, the adapted mask presented a better PaO2/FiO2 ratio during use. There was no significant difference between interfaces regarding NIV failure.

Aerosol containment device design considerations and performance evaluation metrics

BACKGROUND

Spurred by the Coronavirus infectious disease 2019 pandemic, aerosol containment devices (ACDs) were developed to capture infectious respiratory aerosols generated by patients at their source. Prior reviews indicated that such devices had low evidence of effectiveness, but did not address how ACDs should be evaluated, how well they should perform, nor have clearly defined performance standards. Towards developing design criteria for ACDs, two questions were posed: 1) What characteristics have guided the design of ACDs? 2) How have these characteristics been evaluated?

METHODS

A scoping review was performed consistent with PRISMA guidelines. Data were extracted with respect to general study information, intended use of the device, device design characteristics and evaluation.

RESULTS

Fifty-four articles were included. Evaluation was most commonly performed with respect to device aerosol containment (n = 31, 61%), with only 5 (9%), 3 (6%) and 8 (15%) formally assessing providing experience, patient experience and procedure impact, respectively. Nearly all of the studies that explored provider experience and procedure impact studied intubation. Few studies provided a priori performance criteria for any evaluation metric, or referenced any external guidelines by which to bench mark performance.

CONCLUSION

With respect to aerosol containment, ACDs should reduce exposure among HCP with the device compared with the absence of the device, and provide ≥90% reduction in respirable aerosols, equivalent in performance to N95 filtering facepiece respirators, if the goal is to reduce reliance on personal protective equipment. The ACD should not increase awkward or uncomfortable postures, or adversely impact biomechanics of the procedure itself as this could have implications for procedure outcomes. A variety of standardized instruments exist to assess the experience of patients and healthcare personnel. Integration of ACDs into routine clinical practice requires rigorous studies of aerosol containment and the user experience.

Impact of the First Phase of the COVID-19 Pandemic on the Acquisition of Goods and Services in the Italian Health System

The emergency caused by the escalation in the COVID-19 pandemic, which became widespread starting on 31 January 2020, put a strain on the Italian National Health System and forced purchasing centres to deviate from the ordinary general principles dictated by current legislation. The aim of this paper is to describe how Spedali Civili Hospital in Brescia challenged the crisis, structured itself optimally, followed simplified procedures, launched new processes, and opened up more Intensive Care Unit beds to accommodate the high number of COVID cases. From an analysis of the equipment variation in terms of increased purchases, subsequent installations, and tests carried out compared with the pre-pandemic period, we report the difficulties that hospitals had to face in the first phase of the pandemic and how they were able to respond to their needs. Our data clearly displayed how the pandemic situation led to a deep internal reorganisation and that the drafting of simpler, effective, and adaptable procedures represents a first key element to ensure receptivity and responsiveness in the management of ordinary and non-ordinary events such as this pandemic condition.

Noninvasive ventilation in patients with COVID-19 from the perspective of the risk of contamination: a narrative review

INTRODUCTION

noninvasive ventilation (NIV) can be a useful resource to treat acute respiratory failure (ARF), which occurs in patients with COVID-19. However, it is important to consider that there are still no clinical studies that have verified the safety of its use in increase of contamination.

AREAS COVERED

Given the potential benefits and simultaneous concerns over the use of NIV in patients with COVID-19, further inquiry is necessary to reach a clinical consensus and provide recommendations for safe use, avoiding contamination. In this context, this narrative review, which included articles published in the Embase, SciELO, PEDro, PubMed and Cochrane up to August 2021, is focused to evaluate available studies related to interfaces, types of circuits, recommended filters, cares for the environment and protective factors for NIV use in patients with COVID-19.

EXPERT OPINION

The studies analyzed recommend that the use of NIV can be safe: 1) with equipment that allows the use of the helmet as a safer interface; 2) with double circuit and antimicrobial filter in the expiratory branch; 3) in an environment that allows negative pressure, reducing the dispersion of aerosol particles in the environment; 4) the health team must use the recommended PPE to avoid contamination.