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https://www.readbyqxmd.com/read/29669616/comparison-of-thermal-manikin-modeling-and-human-subjects-response-during-use-of-cooling-devices-under-personal-protective-ensembles-in-the-heat
#1
Tyler Quinn, Jung-Hyun Kim, Yongsuk Seo, Aitor Coca
IntroductionPersonal protective equipment (PPE) recommended for use in West Africa during the Ebola outbreak increased risk for heat illness, and countermeasures addressing this issue would be valuable.Hypothesis/ProblemThe purpose of this study was to examine the physiological impact and heat perception of four different personal cooling devices (PCDs) under impermeable PPE during low-intensity exercise in a hot and humid environment using thermal manikin modeling and human testing. METHODS: Six healthy male subjects walked on a treadmill in a hot/humid environment (32°C/92% relative humidity [RH]) at three metabolic equivalents (METs) for 60 minutes wearing PPE recommended for use in West Africa and one of four different personal cooling devices (PCDs; PCD1, PCD2, PCD3, and PCD4) or no PCD for control (CON)...
April 19, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29527297/incorporating-health-workers-perspectives-into-a-who-guideline-on-personal-protective-equipment-developed-during-an-ebola-virus-disease-outbreak
#2
Saskia Den Boon, Constanza Vallenas, Mauricio Ferri, Susan L Norris
Background: Ebola virus disease (EVD) health facility transmission can result in infection and death of health workers. The World Health Organization (WHO) supports countries in preparing for and responding to public health emergencies, which often require developing new guidance in short timelines with scarce evidence. The objective of this study was to understand frontline physicians' and nurses' perspectives about personal protective equipment (PPE) use during the 2014-2016 EVD outbreak in West Africa and to incorporate these findings into the development process of a WHO rapid advice guideline...
2018: F1000Research
https://www.readbyqxmd.com/read/29480365/-west-africa-ebola-outbreak-immediate-and-hands-on-formation-the-pre-deployment-training-program-for-frontline-aid-workers-of-the-german-red-cross-other-aid-organizations-and-the-german-armed-forces-wuerzburg-germany-2014-15
#3
REVIEW
Maximilian Gertler, Sven Loik, Christian Kleine, Alexa Matuschek, Norbert Gresser, Mario di Gennaro, Andreas Fabricius, Thomas Kratz, August Stich, Joost Butenop
BACKGROUND: In September 2014, the German government mandated the German Red Cross (GRC) and the German Armed Forces to support the international efforts to stop the epidemic of Ebola virus disease (EVD) in West-Africa. The GRC requested specific training from the Medical Mission Institute Wuerzburg (MI). OBJECTIVES: We describe and discuss the development, strategy, results, and evaluation of the program to formulate conclusions and recommendations for similar emergencies...
February 26, 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/29471475/assessing-viral-transfer-during-doffing-of-ebola-level-personal-protective-equipment-in-a-biocontainment-unit
#4
Lisa M Casanova, Kimberly Erukunuakpor, Colleen S Kraft, Joel M Mumma, Francis T Durso, Ashley N Ferguson, Christina L Gipson, Victoria L Walsh, Craig Zimring, Jennifer DuBose, Jesse T Jacob
Background: Personal protective equipment (PPE) protects healthcare workers (HCWs) caring for patients with Ebola virus disease (EVD), and PPE doffing is a critical point for preventing viral self-contamination. We assessed contamination of skin, gloves, and scrubs after doffing Ebola-level PPE contaminated with surrogate viruses: bacteriophages MS2 and Φ6. Methods: In a medical biocontainment unit, HCWs (n = 10) experienced in EVD care donned and doffed PPE following unit protocols that incorporate trained observer guidance and alcohol-based hand rub (ABHR)...
February 17, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29471368/human-factors-risk-analyses-of-a-doffing-protocol-for-ebola-level-personal-protective-equipment-mapping-errors-to-contamination
#5
Joel M Mumma, Francis T Durso, Ashley N Ferguson, Christina L Gipson, Lisa Casanova, Kimberly Erukunuakpor, Colleen S Kraft, Victoria L Walsh, Craig Zimring, Jennifer DuBose, Jesse T Jacob
Background: Doffing protocols for personal protective equipment (PPE) are critical for keeping healthcare workers (HCWs) safe during care of patients with Ebola virus disease. We assessed the relationship between errors and self-contamination during doffing. Methods: Eleven HCWs experienced with doffing Ebola-level PPE participated in simulations in which HCWs donned PPE marked with surrogate viruses (ɸ6 and MS2), completed a clinical task, and were assessed for contamination after doffing...
February 17, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29393841/the-infectious-disease-network-idn-development-and-use-for-evaluation-of-potential-ebola-cases-in-georgia
#6
Alezandria K Turner, Robert K Wages, Kelly Nadeau, Laura Edison, Peki F Prince, Earnest R Doss, Cherie Drenzek, Patrick O'Neal
In response to the 2014 Ebola virus disease (EVD) outbreak in West Africa, the Georgia Department of Public Health developed the Infectious Disease Network (IDN) based on an EVD preparedness needs assessment of hospitals and Emergency Medical Services (EMS) providers. The network consists of 12 hospitals and 16 EMS providers with staff specially trained to provide a coordinated response and utilize appropriate personal protective equipment (PPE) for the transport or treatment of a suspected or confirmed serious communicable disease patient...
February 2, 2018: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/29149432/ebola-in-the-netherlands-2014-2015-costs-of-preparedness-and-response
#7
Anita W M Suijkerbuijk, Corien M Swaan, Marie-Josee J Mangen, Johan J Polder, Aura Timen, Wilhelmina L M Ruijs
The recent epidemic of Ebola virus disease (EVD) resulted in countries worldwide to prepare for the possibility of having an EVD patient. In this study, we estimate the costs of Ebola preparedness and response borne by the Dutch health system. An activity-based costing method was used, in which the cost of staff time spent in preparedness and response activities was calculated based on a time-recording system and interviews with key professionals at the healthcare organizations involved. In addition, the organizations provided cost information on patient days of hospitalization, laboratory tests, personal protective equipment (PPE), as well as the additional cleaning and disinfection required...
November 17, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/29058966/high-level-isolation-unit-infection-control-procedures
#8
Jocelyn J Herstein, Paul D Biddinger, Shawn G Gibbs, Aurora B Le, Katelyn C Jelden, Angela L Hewlett, John J Lowe
The 2014-2016 Ebola outbreak in West Africa prompted a select group of US hospitals to establish high-level isolation units equipped with advanced engineering controls, trained staff, and stringent protocols to safely treat highly infectious disease patients. This survey details the comprehensive infection control protocols developed by these units, including for decontamination of units, post-mortem management, liquid waste disposal, and personal protective equipment (PPE) use. In spring 2016, a survey was electronically distributed to the 56 original Centers for Disease Control and Prevention (CDC)-designated high-level isolation units...
September 2017: Health Security
https://www.readbyqxmd.com/read/28937795/using-mystery-patient-drills-to-assess-hospital-ebola-preparedness-in-new-york-city-2014-2015
#9
Mary Foote, Roshni Daver, Celia Quinn
In response to the Ebola virus disease (EVD) outbreak in West Africa, rapid measures were taken to ensure readiness at frontline New York City (NYC) healthcare facilities, including mandating monthly EVD mystery patient drills to test screening protocols. This study analyzed after-action reports to describe the use of mystery patient drills to test rapid identification and isolation of potential EVD cases in NYC emergency departments. NYC hospitals were required to develop protocols for EVD screening and isolation, and to conduct drills with an actor presenting to the emergency department with symptoms suggestive of EVD...
September 2017: Health Security
https://www.readbyqxmd.com/read/28673681/the-association-between-self-perceived-proficiency-of-personal-protective-equipment-and-objective-performance-an-observational-study-during-a-bioterrorism-simulation-drill
#10
Itay Fogel, Osant David, Chaya H Balik, Arik Eisenkraft, Lion Poles, Omri Shental, Michael Kassirer, Tal Brosh-Nissimov
BACKGROUND: The recent Ebola virus disease outbreak emphasized the potential misuse of personal protective equipment (PPE) by health care workers (HCWs) during such an event. We aimed to compare self-perceived proficiency of PPE use and objective performance, and identify predictors of low compliance and PPE misuse. METHODS: An observational study combined with subjective questionnaires were carried out during a bioterror simulation drill. Forty-two observers evaluated performance under PPE...
June 30, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28663587/challenge-of-liquid-stressed-protective-materials-and-environmental-persistence-of-ebola-virus
#11
Aidan M Nikiforuk, Todd A Cutts, Steven S Theriault, Bradley W M Cook
After the largest Ebola virus outbreak in history, experts have attempted to answer how the Zaire ebolavirus species emerged in West Africa and caused chains of human-to-human transmission. The widespread and untimely infection of Health Care Workers (HCW) in the affected countries accelerated spread of the virus within the community. Among the reasons attributed to this trend, it must be considered that HCW were exposed to the virus in their occupational environment. The contribution of environmental conditions to the spread of Ebola in West Africa was examined by investigating the effect of temperature/humidity on the virus's environmental persistence and by modeling if saturation (liquid stress) allows for penetration of Ebola virus through personal protective equipment (PPE)...
June 29, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28636443/personal-protective-equipment-supply-chain-lessons-learned-from-recent-public-health-emergency-responses
#12
Anita Patel, Maryann M D'Alessandro, Karen J Ireland, W Greg Burel, Elaine B Wencil, Sonja A Rasmussen
Personal protective equipment (PPE) that protects healthcare workers from infection is a critical component of infection control strategies in healthcare settings. During a public health emergency response, protecting healthcare workers from infectious disease is essential, given that they provide clinical care to those who fall ill, have a high risk of exposure, and need to be assured of occupational safety. Like most goods in the United States, the PPE market supply is based on demand. The US PPE supply chain has minimal ability to rapidly surge production, resulting in challenges to meeting large unexpected increases in demand that might occur during a public health emergency...
May 2017: Health Security
https://www.readbyqxmd.com/read/28606192/assessment-of-healthcare-worker-protocol-deviations-and-self-contamination-during-personal-protective-equipment-donning-and-doffing
#13
Jennie H Kwon, Carey-Ann D Burnham, Kimberly A Reske, Stephen Y Liang, Tiffany Hink, Meghan A Wallace, Angela Shupe, Sondra Seiler, Candice Cass, Victoria J Fraser, Erik R Dubberke
OBJECTIVE To evaluate healthcare worker (HCW) risk of self-contamination when donning and doffing personal protective equipment (PPE) using fluorescence and MS2 bacteriophage. DESIGN Prospective pilot study. SETTING Tertiary-care hospital. PARTICIPANTS A total of 36 HCWs were included in this study: 18 donned/doffed contact precaution (CP) PPE and 18 donned/doffed Ebola virus disease (EVD) PPE. INTERVENTIONS HCWs donned PPE according to standard protocols. Fluorescent liquid and MS2 bacteriophage were applied to HCWs...
June 13, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28601946/clinical-management-of-patients-with-ebola-virus-disease-in-high-resource-settings
#14
G Marshall Lyon, Aneesh K Mehta, Bruce S Ribner
Like most viral illnesses in humans, supportive care of the patient is the mainstay of clinical care for patients with Ebola virus disease (EVD). The goal is to maintain and sustain the patient until a specific immune response develops and clears the viral infection. Clearly, antiviral therapy may eventually help speed recovery, but supportive care will likely always be the centerpiece of care of the patient with EVD. While terrible in terms of human suffering and loss, the EVD outbreak of 2014-2016 provided an unheralded opportunity to advance our understanding in the care of patients (WHO 2016)...
2017: Current Topics in Microbiology and Immunology
https://www.readbyqxmd.com/read/28588978/improving-ebola-infection-prevention-and-control-in-primary-healthcare-facilities-in-sierra-leone-a-single-group-pretest-post-test-mixed-methods-study
#15
Ruwan Ratnayake, Lara S Ho, Rashid Ansumana, Hannah Brown, Matthias Borchert, Laura Miller, Thomas Kratz, Shannon A McMahon, Foday Sahr
BACKGROUND: Accomplishing infection prevention and control (IPC) in health facilities in Sub-Saharan Africa is challenging. Owing to poor IPC, healthcare workers (HCWs) were frequently infected during Sierra Leone's Ebola epidemic. In late 2014, IPC was rapidly and nationally scaled up. We carried out workshops in sampled facilities to further improve adherence to IPC. We investigated HCW experiences and observed practice gaps, before and after the workshops. METHODS: We conducted an uncontrolled, before and after, mixed-methods study in eight health facilities in Bo and Kenema Districts during December 2014 and January 2015...
November 2016: BMJ Global Health
https://www.readbyqxmd.com/read/28573636/ebola-virus-field-sample-collection
#16
Brian R Amman, Amy J Schuh, Jonathan S Towner
Sampling wildlife for ebolaviruses presents the researcher with a multitude of challenges, foremost of which is safety. Throughout the methods described in this chapter, personal safety and personal protective equipment (PPE) will be reiterated for each methodology. The methods described here are those used to successfully detect and isolate marburgviruses from their natural reservoir, Rousettus aegyptiacus, and therefore should be applicable for diagnostic testing for ebolaviruses via RT-PCR, ELISA, and IHC techniques...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28493945/ebola-virus-rna-detection-on-fomites-in-close-proximity-to-confirmed-ebola-patients-n-zerekore-guinea-2015
#17
Romain Palich, Leonid M Irenge, Eric Barte de Sainte Fare, Augustin Augier, Denis Malvy, Jean-Luc Gala
OBJECTIVE: Health care workers (HCWs) in contact with patients with Ebola virus disease (EVD) are exposed to a risk of viral contamination. Fomites contaminated with the patient's blood or body fluids represents this risk. Our study aims to detect Ebola virus (EBOV) RNA within the high- and low-risk areas of an Ebola treatment unit (ETU) located in inland Guinea during the 2014-2015 West African Ebola epidemics. For samples from patients' immediate vicinity, we aim to seek an association between viral RNA detectability and level of plasma viral load of patients (intermediate to high, or very high)...
2017: PloS One
https://www.readbyqxmd.com/read/28420487/personal-protective-equipment-solution-for-uk-military-medical-personnel-working-in-an-ebola-virus-disease-treatment-unit-in-sierra-leone
#18
P Reidy, T Fletcher, C Shieber, J Shallcross, H Towler, M Ping, L Kenworthy, N Silman, E Aarons
The combination of personal protective equipment (PPE) together with donning and doffing protocols was designed to protect British and Canadian military medical personnel in the Kerry Town Ebola Treatment Unit (ETU) in Sierra Leone. The PPE solution was selected to protect medical staff from infectious risks, notably Ebola virus, and chemical (hypochlorite) exposure. PPE maximized dexterity, enabled personnel to work in hot temperatures for periods of up to 2h, protected mucosal membranes when doffing outer layers, and minimized potential contamination of the doffing area with infectious material by reducing the requirement to spray PPE with hypochlorite...
May 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28303774/physiological-evaluation-of-personal-protective-ensembles-recommended-for-use-in-west-africa
#19
Aitor Coca, Tyler Quinn, Jung-Hyun Kim, Tianzhou Wu, Jeff Powell, Raymond Roberge, Ronald Shaffer
OBJECTIVE: Personal protective equipment (PPE) provides health care workers with a barrier to prevent human contact with viruses like Ebola and potential transmission of the disease. However, PPE can also introduce an additional physiological burden from potentially increased heat stress. This study evaluated the human physiological and subjective responses to continuous light exercise within environmental conditions similar to those in West Africa while wearing 3 different, commonly used PPE ensembles (E1, E2, and E3)...
October 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28303772/physiological-evaluation-of-cooling-devices-in-conjunction-with-personal-protective-ensembles-recommended-for-use-in-west-africa
#20
Tyler Quinn, Jung-Hyun Kim, Amanda Strauch, Tianzhou Wu, Jeffery Powell, Raymond Roberge, Ronald Shaffer, Aitor Coca
OBJECTIVE: Cooling devices (CDs) worn under personal protective equipment (PPE) can alleviate some of the heat stress faced by health care workers responding to the Ebola outbreak in West Africa. METHODS: Six healthy, young individuals were tested while wearing 4 different CDs or no cooling (control) under PPE in an environmental chamber (32°C/92% relative humidity) while walking (3 METs, 2.5 mph, 0% grade) on a treadmill for 60 minutes. Exercise was preceded by a 15-minute stabilization period and a 15-minute donning period...
March 17, 2017: Disaster Medicine and Public Health Preparedness
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