Use of personal protective equipment to care for patients with COVID-19: scoping review

OBJECTIVE

To summarize the knowledge about recommendations for the use of personal protective equipment necessary for the provision of care by health professionals to patients suspected or infected by the new coronavirus.

METHOD

Scoping review with search for primary studies, reviews and preprints articles in English, Portuguese and Spanish, in the last 20 years on the bases WOS/ISI, SCOPUS, MEDLINE/PuBMed, CINAHL, LILACS and SciELO. Unpublished studies in journals were surveyed on bioRxiv and SciELO preprints.

RESULTS

23 studies were eligible. Experiences with coronavirus prior to SARS-CoV-2 revealed that the equipment was an essential barrier in preventing transmission and followed the recommendations for standard precautions, contact, droplet and aerosol. In 13 (57%) studies, this equipment complied international recommendations and in 10 (45%) local recommendations.

CONCLUSION

The personal protective equipment used does not follow global standardization according to type, quality and adequate provision, exposing these professionals to the risk of contamination.

European consensus recommendations for neonatal and paediatric retrievals of positive or suspected COVID-19 patients

BACKGROUND

The 2020 novel coronavirus (SARS-Cov-2) pandemic necessitates tailored recommendations addressing specific procedures for neonatal and paediatric transport of suspected or positive COVID-19 patients. The aim of this consensus statement is to define guidelines for safe clinical care for children needing inter-facility transport while making sure that the clinical teams involved are sufficiently protected from SARS-CoV-2.

METHODS

A taskforce, composed of members of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC) Transport section and the European Society for Paediatric Research (ESPR), reviewed the published literature and used a rapid, two-step modified Delphi process to formulate recommendations regarding safety and clinical management during transport of COVID-19 patients.

RESULTS

The joint taskforce consisted of a panel of 12 experts who reached an agreement on a set of 17 recommendations specifying pertinent aspects on neonatal and paediatric COVID-19 patient transport. These included: case definition, personal protective equipment, airway management, equipment and strategies for invasive and non-invasive ventilation, special considerations for incubator and open stretcher transports, parents on transport and decontamination of transport vehicles.

CONCLUSIONS

Our consensus recommendations aim to define current best-practice and should help guide transport teams dealing with infants and children with COVID-19 to work safely and effectively.

IMPACT

We present European consensus recommendations on pertinent measures for transporting infants and children in times of the coronavirus (SARS-Cov-2 /COVID-19) pandemic. A panel of experts reviewed the evidence around transporting infants and children with proven or suspected COVID-19. Specific guidance on aspects of personal protective equipment, airway management and considerations for incubator and open stretcher transports is presented. Based on scant evidence, best-practice recommendations for neonatal and paediatric transport teams are presented, aiming for the protection of teams and patients. We highlight gaps in knowledge and areas of future research.

[Nursing care for controlling coronavirus infections in positive cases: a narrative review]

Objetivo

Esta revisión tiene como objetivo realizar un mapeado de evidencias científicas en cuidados enfermeros dirigidos a controlar infecciones por coronavirus.

Método

Se llevó a cabo una búsqueda bibliográfica en las bases de datos Medline, CINAHL, Scopus y en la colección principal de la WOS, sin límite de fecha y a través de las palabras clave «transmission», «infection», «contagious», «spreads», «coronavirinae», «coronavirus», «covid 19», «sars cov 2», «nurses» y «nursing». Inicialmente se identificaron 154 estudios y, tras seleccionarlos según criterios de elegibilidad, se incluyeron 16.

Resultados

Entre las recomendaciones principales, según la evidencia disponible, se encuentran el intercambio de aire en las habitaciones como medida para reducir el riesgo de contagio entre pacientes; el refuerzo de medidas en unidades de cuidados intensivos; seguimiento de contactos de casos positivos; y una adecuada formación de los profesionales.

Discusión y conclusiones

Los estudios incluidos en la revisión trataron sobre prácticas de prevención y control de contagios, analizando riesgos asociados a la exposición y enumerando acciones para evitar complicaciones en pacientes críticos. Se identificaron patrones de transmisión de casos, contactos y factores asociados. También se estudiaron los conocimientos y actitudes profesionales, mostrando la importancia de una buena formación para el control de infecciones, y de disponer de equipos suficientes y adecuadas infraestructuras.

Las enfermeras son vectores importantes de propagación. A pesar de que la evidencia disponible sobre la efectividad de cuidados para evitar el contagio por SARS-CoV-2 es escasa, los estudios publicados sobre la prevención y control ante brotes anteriores por coronavirus son de considerable utilidad.