N-95 mask shortage. Physician usage to examine COVID-19 patients.

1,295 Views | 6 Replies | Last: 5 yr ago by JJMt
Marcus Aurelius
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The PPE shortage is a terrible problem as you know especially in places like NYC. I have been examining the confirmed or PUI COVID-19 patients initially with full PPE, and then subsequently, occasionally or if there is a clinical change.

What are other's experiences / thoughts re this?

I think it's going to become a new reality in the care of these patients as PPE needs to be conserved, especially for RNs taking care of them.
TRADUCTOR
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Turn break rooms into a sterilization operation. Include wet paper towel with PPE

From the CDC


https://www.cdc.gov/infectioncontrol/guidelines/disinfection/sterilization/other-methods.html
Microwave

Microwaves are used in medicine for disinfection of soft contact lenses, dental instruments, dentures, milk, and urinary catheters for intermittent self-catheterization925-931. However, microwaves must only be used with products that are compatible (e.g., do not melt) 931. Microwaves are radio-frequency waves, which are usually used at a frequency of 2450 MHz. The microwaves produce friction of water molecules in an alternating electrical field. The intermolecular friction derived from the vibrations generates heat and some authors believe that the effect of microwaves depends on the heat produced while others postulate a nonthermal lethal effect932-934. The initial reports showed microwaves to be an effective microbicide. The microwaves produced by a "home-type" microwave oven (2.45 GHz) completely inactivate bacterial cultures, mycobacteria, viruses, and G. stearothermophilus spores within 60 seconds to 5 minutes depending on the challenge organism933, 935-937. Another study confirmed these resuIts but also found that higher power microwaves in the presence of water may be needed for sterilization932. Complete destruction of Mycobacterium bovis was obtained with 4 minutes of microwave exposure (600W, 2450 MHz)937. The effectiveness of microwave ovens for different sterilization and disinfection purposes should be tested and demonstrated as test conditions affect the results (e.g., presence of water, microwave power). Sterilization of metal instruments can be accomplished but requires certain precautions.926. Of concern is that home-type microwave ovens may not have even distribution of microwave energy over the entire dry device (there may be hot and cold spots on solid medical devices); hence there may be areas that are not sterilized or disinfected. The use of microwave ovens to disinfect intermittent-use catheters also has been suggested. Researchers found that test bacteria (e.g., E. coli, Klebsiella pneumoniae, Candida albicans) were eliminated from red rubber catheters within 5 minutes 931. Microwaves used for sterilization of medical devices have not been FDA cleared.
rebag00
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Use an autoclave perhaps? I believe there are autoclaves that could disinfect the PPE without destroying it.
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Ag In Ok
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sterrads. Not high volume but so far they looking like a solid option for processing PPE
jagvocate
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Treat it like war and find a way to re-use.

Soap, water, a disinfectant, and let it dry in the sunshine (obviously where available and it's the type of respirator that won't fall apart).

2PacShakur
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JJMt said:

Saw an article describing a Nebraska hospital that was using UV to sterilize masks for reuse.
Maybe this one: https://www.nytimes.com/2020/03/20/health/coronavirus-masks-reuse.html

Edit to add: https://www.nebraskamed.com/sites/default/files/documents/covid-19/n-95-decon-process.pdf
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