Coronavirus Discussion Thread

Carlos Danger

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Colorado has a law (PHEW) that states workers have a right to use their own PPE if it:
1. provides more protection that equipment provided at the workplace;
2. is recommended by a government health agency; and
3. does not make the worker unable to do the job

If you tried to do something like using the PAPR in the OR you'd get shut down for IP reasons, but otherwise, you'd be good to go in CO.
Why wouldn’t they let you use a PAPR in the OR?
 

Summit

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Why wouldn’t they let you use a PAPR in the OR?
The concern is sterile field contamination. Different models of PAPRs and cuff/hood configurations may offer increased/decreased risk over N95/surgical masks. A total join hood setup is obviously a risk mitigation solution. I personally think that there are ways to do it safely with more traditional PAPR products, and there are some studies that demonstrate this. However, many health systems do not permit PAPRs in the OR.
 

Carlos Danger

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The concern is sterile field contamination. Different models of PAPRs and cuff/hood configurations may offer increased/decreased risk over N95/surgical masks. A total join hood setup is obviously a risk mitigation solution. I personally think that there are ways to do it safely with more traditional PAPR products, and there are some studies that demonstrate this. However, many health systems do not permit PAPRs in the OR.
Interesting. I knew that was what you were going to say, though this is the first I’ve heard of it. Many anesthesia providers I know routinely wear PAPRs in the OR these days, though I do not.

I would never work for a system that did not allow PAPRs in the OR where they were indicated.
 
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Akulahawk

Akulahawk

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I have seen a PAPR hood covering thing that basically directed all outflow down and away from the sterile field. It seems to be a bit unwieldy but at least at a glance, it should alleviate the concern of sterile field contamination.

As far as using personally-owned PPE, I haven't yet seen anything similar to Colorado's law/regs in California... not that I haven't heard that such a beast exists, but that I haven't yet heard of actual law/regs/case law that would protect me should I start using my own compete PAPR system. What I have is at least as good, if not better, than what is currently provided.
 

Summit

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I really like the TR-300/600 series. Some place love MaxAir but they are loud because of the fan location.
 

Bullets

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As far as using personally-owned PPE, I haven't yet seen anything similar to Colorado's law/regs in California... not that I haven't heard that such a beast exists, but that I haven't yet heard of actual law/regs/case law that would protect me should I start using my own compete PAPR system. What I have is at least as good, if not better, than what is currently provided.
I thought that was an OSHA regulation, as long as approved by the employer? It is also the case in my state. While as an agency i have struggled with keeping N95s in stock, most of my staff have personally purchased EHFMs with P100 filters and wear them on respiratory or COVID concern calls. This has thankfully kept my N95 burn rate low. SUrgical masks were rough in the beginning but now i can buy them at 7-11 of all places so i or the crew pick up a box or three at the start of every shift. Ive got a good stock pile now
 
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Akulahawk

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I thought that was an OSHA regulation, as long as approved by the employer
That's the crux of the problem. If it's an OSHA reg, if the employer doesn't approve of it, then it's a no-go, even if the personal PPE is equivalent or superior to what's provided. I haven't found (yet) anything that would override employer approval if the personal PPE is equivalent or superior to provided PPE.
 

E tank

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The concern is sterile field contamination. Different models of PAPRs and cuff/hood configurations may offer increased/decreased risk over N95/surgical masks. A total join hood setup is obviously a risk mitigation solution. I personally think that there are ways to do it safely with more traditional PAPR products, and there are some studies that demonstrate this. However, many health systems do not permit PAPRs in the OR.
Another unsubstantiated "concern" just like cloth head coverings, non-bouffant caps and forced air warmers...surprised these places aren't drowning witches....
 

Chem2Do

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I watched an interesting youtube video on mask making from a doctor's wife using a HEPA filter vacuum bag (OSHA certified).
Here is the link
 

FiremanMike

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I was just now thinking back to the beginning of this.. When I decided to order 200 N95 masks "just in case"..

Ready for this to be done, can't believe it's gone on this long..
 

ffemt8978

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I was just now thinking back to the beginning of this.. When I decided to order 200 N95 masks "just in case"..

Ready for this to be done, can't believe it's gone on this long..
It will never be done. Even if we get past COVID, there will be another disease that threatens us unless we take drastic actions.
 

Summit

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It will never be done. Even if we get past COVID, there will be another disease that threatens us unless we take drastic actions.
Ya maybe sometime in the future when some dude chows down on another uncooked Pangolin.

But hopefully not for many decades
 

FiremanMike

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It will never be done. Even if we get past COVID, there will be another disease that threatens us unless we take drastic actions.
Maybe, but history would suggest that it’ll be awhile.. probably won’t see this again in our career or even lifetime..
 

ffemt8978

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How quickly we forget. The past 20 years have been full of claims of a pandemic that we need to take actions to stop. SARS, Swine Flu, Bird Flu, Monkeypox etc...

Yes, COVID-19 is extremely virulent...but that same claim was made about all those other diseases. COVID-19 has set the new baseline for all future pandemics, and when the next disease comes down the pike people will look to the actions we've taken as a starting point to contain the next one. For better or worse, we will never be done with this, nor will we ever go back to the "way it was".
 

FiremanMike

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How quickly we forget. The past 20 years have been full of claims of a pandemic that we need to take actions to stop. SARS, Swine Flu, Bird Flu, Monkeypox etc...

Yes, COVID-19 is extremely virulent...but that same claim was made about all those other diseases. COVID-19 has set the new baseline for all future pandemics, and when the next disease comes down the pike people will look to the actions we've taken as a starting point to contain the next one. For better or worse, we will never be done with this, nor will we ever go back to the "way it was".
I don’t forget those, I was a medic through all of them. None of them were as impactful nor did any of them require the same extreme measures to try to slow the spread.
 

ffemt8978

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I don’t forget those, I was a medic through all of them. None of them were as impactful nor did any of them require the same extreme measures to try to slow the spread.
In hindsight, that is correct. At the time, when we were still learning about them, there were a plethora of calls about how each disease was the next disaster. It turns out that this time, COVID-19 actually warranted those calls unlike the others.
 

PotatoMedic

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MERS is the one I'm afraid of if it ever became as infectious as COVID-19.
 
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Akulahawk

Akulahawk

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MERS is the one I'm afraid of if it ever became as infectious as COVID-19.
How about any of the viral hemorrhagic fevers... If they mutate to become easily droplet or airborne transmissible between humans...
 

Summit

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Exactly. Ebola isn't scary from a US pandemic potential in it's current corm, but it's a mutator

and the Reston strain showed possible airborne transmission, but it wasn't clear. Any successful mutation changing to a dominant airborne (or droplet) transmission mode in the wild is likely to become the dominant strain in short order. At least we have an Ebola vaccine now...
 

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