The COVID-19 Airway Management Isolation Chamber (CAMIC) for Ears.
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ABSTRACT:
SUBMITTER: Tolisano AM
PROVIDER: S-EPMC7361893 | biostudies-literature | 2020 Nov
REPOSITORIES: biostudies-literature
Publications
The COVID-19 Airway Management Isolation Chamber (CAMIC) for Ears.
Tolisano Anthony M AM Blood Timothy C TC Riley Charles A CA Ruhl Douglas S DS Hong Steven S SS
The Laryngoscope 20200820 11
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Project description:ObjectiveDuring the coronavirus pandemic (COVID-19), health care workers are innovating patient care and safety measures. Unfortunately, many of these are not properly tested for efficacy. The objective of this study was to determine the efficacy of the novel COVID-19 Airway Management Isolation Chamber (CAMIC) to contain and evacuate particulate.Study designMulti-institutional proof-of-concept study.SettingTwo academic institutions: Walter Reed National Military Medical Center (WRNMMC) and Madigan Army Medical Center (MAMC).Subjects and methodsSmoke, saline nebulizer, and simulated working port models were developed to assess the efficacy of the CAMIC to contain and remove ultrafine particles. Particulate counts were collected at set time intervals inside and outside the system.ResultsWith the CAMIC on, smoke particulate counts inside the chamber significantly decreased over time: r(18) = -0.88, P < .001, WRNMMC; r(18) = -0.91, P < .001, MAMC. Similarly, saline nebulizer particulate counts inside the chamber significantly decreased over time: r(23) = -0.82, P < .001, WRNMMC; r(23) = -0.70, P < .001, MAMC. In the working port model, particulate counts inside the chamber significantly decreased over time: r(23) = -0.95, P < .001, WRNMMC; r(23) = -0.85, P < .001, MAMC. No significant leak was detected in the smoke, saline nebulizer, or working port model when the CAMIC was turned on.ConclusionsThe CAMIC system appears to provide a barrier that actively removes particles from within the chamber and limits egress. Further studies are necessary to determine clinical applicability. The CAMIC may serve as an adjunct to improve health care worker safety and patient outcomes.
| S-EPMC7361124 | biostudies-literature
Project description:The unique resource constraints, urgency, and virulence of the coronavirus disease 2019 pandemic has sparked immense innovation in the development of barrier devices to protect healthcare providers from infectious airborne particles generated by patients during airway management interventions. Of the existing devices, all have shortcomings which render them ineffective and impractical in out-of-hospital environments. Therefore, we propose a new design for such a device, along with a pragmatic evaluation of its efficacy. Must-have criteria for the device included: reduction of aerosol transmission by at least 90% as measured by pragmatic testing; construction from readily available, inexpensive materials; easy to clean; and compatibility with common EMS stretchers. The Patient Particle Containment Chamber (PPCC) consists of a standard shower liner draped over a modified octagonal PVC pipe frame and secured with binder clips. 3D printed sleeve portals were used to secure plastic sleeves to the shower liner wall. A weighted tube sealed the exterior base of the chamber with the contours of the patient's body and stretcher. Upon testing, the PPCC contained 99% of spray-paint particles sprayed over a 90s period. Overall, the PPCC provides a compact, affordable option that can be used in both the in-hospital and out-of-hospital environments.
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Project description: Not available
| S-EPMC7937356 | biostudies-literature
Project description:Molecular changes underlying the persistent health effects after SARS-CoV-2 infection remain poorly understood. To discern the gene regulatory landscape in the upper respiratory tract of COVID-19 patients, we performed enzymatic DNA methylome and single-cell RNA sequencing in nasal cells of COVID-19 patients (n=19, scRNA-seq n=14) and controls (n=14, scRNA-seq n=10). In addition, we re-sampled a subset of these patients for transcriptome analyses at 3 (n=7) and 12 months (n=5) post-infection and followed the expression of differentially regulated genes over time. Genome-wide DNA methylation analysis revealed 3,112 differentially methylated regions between COVID-19 patients and controls. Hypomethylated regions affected immune regulatory genes, while hypermethylated regions were associated with genes governing ciliary function. These genes were not only downregulated in the acute phase of disease but sustained repressed up to 12 months post-infection in ciliated cells. Validation in an independent cohort collected 6 months post-infection (n=15) indicated a symptom-dependent transcriptional repression of ciliary genes. We therefore propose that hypermethylation observed in the acute phase may exert a long-term effect on gene expression, possibly contributing to post-acute COVID-19 sequelae.
| S-SCDT-10_1038-S44321-025-00215-5 | biostudies-other
Project description:Importance:The COVID-19 pandemic is characterized by high transmissibility from patients with prolonged minimally- or asymptomatic periods, with a particularly increased risk of spread during aerosol-generating procedures, including endotracheal intubation. Observations:All patients presenting with upper airway obstruction due to angioedema during this time should be carefully managed in a way that is safest for both patient and provider. Conclusions:For patients requiring emergent airway management during the COVID-19 pandemic, minimization of aerosols while taking the necessary precautions to protect healthcare workers should are critical principles for their management.
| S-EPMC7274586 | biostudies-literature
Project description: Not available
| S-EPMC7200124 | biostudies-literature
Project description:BackgroundDuring the COVID-19 outbreak, healthcare providers might have avoided droplet/aerosol-generating procedures, such as non-invasive ventilation (NIV) and high-flow nasal cannula (HFNC) due to the concern of themselves being infected. We hypothesized that this change of practice could have also occurred to other non-COVID-infected patients in the Emergency Department (ED).MethodsA retrospective analytic study was conducted in the ED of Siriraj Hospital, Bangkok, Thailand, including adult patients presenting with signs and symptoms of respiratory distress between 1 March and 30 April 2020 (the COVID period). A comparison group using the same inclusion criteria was retrieved from 1 March to 30 April 2019 (the pre-COVID period). The primary outcome was rate of NIV and HFNC use. The secondary outcomes were rate of intubation, failure of NIV and HFNC, complications, and mortality.ResultsA total of 360 and 333 patients were included during the pre-COVID and COVID periods, respectively. After adjusting for baseline differences, patients in the COVID period were less likely to receive either NIV or HFNC than the pre-COVID period (adjusted OR 0.52 [95%CI 0.29-0.92]). Overall, intubation rate was similar between the two study periods. However, patients in respiratory distress with pulmonary edema had a relatively higher intubation rate in the COVID period. There were higher failure rates of NIV and HFNC, more infectious complications, and a higher rate of mortality in the pre-COVID period.ConclusionDuring the COVID-19 pandemic, the overall usage of NIV and HFNC in emergency non-COVID patients decreased. Although not affecting the overall intubation rate, this change of practice could have affected some groups of patients. Therefore, treatment decisions based on a balance between the benefits to the patients and the safety of healthcare providers should be made.
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Project description: Not available
| S-EPMC7283688 | biostudies-literature
Project description:A previously healthy 42-year-old male developed a fever and cough shortly after returning to Canada from overseas. Initially, he had mild upper respiratory tract infection symptoms and a cough. He was aware of the coronavirus disease-2019 (COVID-19) and the advisory to self-isolate and did so; however, he developed increasing respiratory distress over several days and called 911. On arrival at the emergency department (ED), his heart rate was 130 beats/min, respiratory rate 32 per/min, and oxygenation saturation 82% on room air. As per emergency medical services (EMS) protocol, they placed him on nasal prongs under a surgical mask at 5 L/min and his oxygen saturation improved to 86%.
| S-EPMC7203167 | biostudies-literature
Project description:The whole world at present is dealing with the COVID 19 pandemic. As per studies worldwide SARS-CoV-2 by sequencing analysis is 95% homogenous similar to the bat coronavirus and almost 70% similar to the SARS-CoV-1. SARS CoV 2 is a respiratory problem which in its worst form of disease causes ARDS and hampers the patient's ability to breathe on his own and has to be put on Ventilator. As per WHO (World Health Organization) guidelines, sanitization is an effective way of prevention from the infection. The proper sanitization being not feasible and time consuming in certain cases, faster and effective alternatives of sanitization processes are necessary. As per recently published study by researchers in Beijing, China, it was observed that with each degree rise in temperature and percent humidity, the contagiousness of the disease caused by the Coronavirus, named COVID 19 goes down significantly. R-naught or RO can be referred as the average number of people that gets infected from one sick person among a population which is not immune to the virus. The closer to zero an RO value the better the results indicating less spread of the disease. A lower RO means the outbreak is slowing or declining while a higher one means its swelling or growing at faster rate. The RO of the coronavirus hovers between 2 and 2.5 as per World Health Organization or WHO meaning that each new person spreads the disease to about 2.2 people on an average. The chamber being developed is aimed at lowering the Ro value so that the infection rate slows down. RO is not a fixed value, it changes depending on various factors such as proximity among people, the environmental surroundings and climatic conditions. The higher temperatures (38 °C) at 80-90% relative humidity decreases the virus activity within 24 h. Moreover, in a condition where the virus that was dried was stored at higher temperature (>38 °C) and high relative humidity (>95%), there was observed an additional degradation in virus activity at each point in time. Taking into consideration the above research, we developed a COVID De-Incubator chamber to disinfect the clothes and commonly used daily wear items. Our results were exciting as the disinfection proved to be effective at temperatures of 75 °C-80 °C and humidity levels at 80%-90%. Moreover, the chamber was developed at significantly lower costs. In this study, an attempt has been made to fabricate a chamber with temperature and humidity-controlled environment to disinfect daily used material. Using fins and momentum source, a homogenous environment is created inside the chamber for better results, with the help of numerical simulation to decide the optimum angle for the inclination of fins and location of the momentum source.
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