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Protection of health care workers from exhaled air of patients operated under local, regional, spinal or epidural anaesthesia during COVID 19 pandemic

By Kuldeep Atodaria, Mayank Singh, Vimalkumar S Prajapati, Kush Shaileshkumar Shahkush, Pradipkumar Raghuvirsinh Atodaria

Posted 02 Dec 2020
medRxiv DOI: 10.1101/2020.11.26.20192823

The SARS-CoV-2 (COVID-19) pandemic mandates the use of N-95/FFP-2 masks for healthcare workers, especially in operation room (OR) for surgical or aerosol producing pro-cedures. During pandemic, surgical interventions such as limb trauma, limb amputations, and limb malignancies continued to flow into the hospitals and are normally performed un-der local, regional or spinal anaesthesia. N-95/FFP-2 masks normally do not prevent escape of exhaled air to surrounding and to avoid the escape of exhaled unfiltered air, sealing masks by taping its edges to face possibly serves the purpose, but causes significant discomfort to patients. HEPA filters, high vacuum suction apparatus, and negative pressure operating-room may protect partially against the-risk of infection if patients exhaled air is infected. In order to reduce risk of transmission from patients exhaled air to the healthcare workers, a technique has been designed to divert the patients exhaled air to outside the-OR using a suction machine. This technique is easy, simple and cost-effective and trial has been per-formed with four-volunteers to see feasibility to breathe through N-95 mask sealed by stick-ing its edges to face using tape. The trial reflected reduction in SpO2, causing increased res-piratory-rate, tachycardia and hypertension, in-addition an un-acclimatized volunteers had difficulty in breathing through sealed N-95 masks, which was relieved by supplying oxygen to them. Attaching suction system to remove the-exhaled air aids to comfort levels. Treating exhaled-air with sodium-hypochlorite and diverting it externally to an open-space outside the-OR added to safety for the patients, surgical team and the hospital surroundings.

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