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Coronavirus (COVID-19): We Want to Hear from You

Disasters Article   (15,685 Views | 130 Replies | 254 Words)

tnbutterfly - Mary is a BSN, RN and specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

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What reports have you had about the Wuhan Coronavirus in your area?

The Coronavirus/COVID-19 has made its appearance in the United States. Would you like to help us cover the news as it unfolds? You are reading page 10 of Coronavirus (COVID-19): We Want to Hear from You. If you want to start from the beginning Go to First Page.

MunoRN has 10 years experience as a RN and specializes in Critical Care.

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6 hours ago, Gampopa said:

Isn't a pt who is actively coughing producing aerosolized droplets? I would want to be wearing an N95 into a COVID 19 room regardless of what procedure I'm performing.

I agree that the CDC's rationale behind identifying an increased risk of transmission specific to Aerosol Generating Procedures (AGPs) but not spontaneous coughing makes no sense.  

The rationale for using a higher level of respiratory protection during AGPs is that it's likely to make the patient cough, yet they don't appear to consider a spontaneous cough to carry the risks, which is dumb.

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S84 has 28 years experience as a ASN and specializes in Pacu.

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I have a question...based on what I heard in his speech " activation on hospitals emergency management plan and limiting visitations in nsg homes via Medicare putting out new rules"  .... can anyone interpret the  where ambulatory surgical care centers fall?..  I have concerns about ASC staying open. We can screen the patients pre calling but we have no information on who brings them to the facility. Most ASC centers are elective surgeries think a closure would be smart but I don't see any thing happening in my area presently. Patients may decide to cancell out cases but don't see any elective closures

What do you think?..

Edited by S84
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SummitRN has 8 years experience as a BSN, RN and specializes in ICU + Infection Prevention.

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11 hours ago, MunoRN said:

To clarify, that study doesn't show COVID-19 to be an airborne pathogen, droplet transmission occurs in the air and the droplet particles are airborne, but that is different from airborne transmission.

The CDC recommends using respirators / PAPRs when available because standard masks are not as effective in preventing droplet transmission, not because the virus is an airborne pathogen.  This is why the CDC prioritizes the use of airborne precautions (respirators and negative airflow rooms) to those circumstances most likely to involve the generation of droplets (aerosol generating procedures).

The study indicates aerosol and fomite viability of the virus after hours.

 

THAT IS THE DEFINITION OF AIRBORNE

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MunoRN has 10 years experience as a RN and specializes in Critical Care.

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17 minutes ago, SummitRN said:

The study indicates aerosol and fomite viability of the virus after hours.

 

THAT IS THE DEFINITION OF AIRBORNE

Airborne transmission refers to particles that are able to remain suspended in air for long periods of time, and remain viable.  This study utilized a Goldberg drum which is a contraption that keeps droplet nuclei airborne that would otherwise not remain airborne for an extended period of time.  So what the study found was that when COVID-19 is artificially maintained in an airborne state it remains viable for about 3 hours, but it didn't find that COVID-19 droplet nuclei can remain airborne for 3 hours.  

I would agree though that this difference is somewhat just semantics, aerosolized droplets can certainly remain in the air long enough for others to inhale them, and given the right conditions can travel some distance, no doubt farther than the commonly referenced 6 feet.  

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MunoRN has 10 years experience as a RN and specializes in Critical Care.

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31 minutes ago, SummitRN said:

The study indicates aerosol and fomite viability of the virus after hours.

 

THAT IS THE DEFINITION OF AIRBORNE

On a related note, we've been trying to figure out increased respiratory protection is recommended as a priority when doing Aerosol Generating Procedures, supposedly because it may cause the patient to cough, but not when the patient is spontaneously coughing.  It would seem to me that the physiology of the cough itself is the same, regardless of the trigger.  

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Gampopa has 10 years experience and specializes in Adult M/S.

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At our facility, to ration masks, we are going by WHO recommendations for using N95 only when aerosolization is likely. However, staff is using N95s with any suspected COVID19 pt even for routine care. My managers are adamant that N95s get passed out only to staff that need them d/t the very limited supply which I understand. But I also understand staff wanting to protect themselves and their families so as the House sup I look the other way.

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SummitRN has 8 years experience as a BSN, RN and specializes in ICU + Infection Prevention.

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5 minutes ago, Gampopa said:

At our facility, to ration masks, we are going by WHO recommendations for using N95 only when aerosolization is likely. However, staff is using N95s with any suspected COVID19 pt even for routine care. My managers are adamant that N95s get passed out only to staff that need them d/t the very limited supply which I understand. But I also understand staff wanting to protect themselves and their families so as the House sup I look the other way.

Your position is sympathetic, but eventually without rationing there will be no masks available for the high-risk procedures. This is only going to get worse. Look at Italy, but not late in the day otherwise you won't sleep.

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43 Posts; 132 Profile Views

Hey everyone. I hope someone can respond to this. I am a UAP at a major hospital but am per diem and I have no health insurance. I am applying for Obamacare soon but between now and when I get coverage I am concerned for my health. I have a propensity for having bronchitis multiple times per year for the past couple of years. So I am concerned I might get sick but have no coverage. I don't want to not go to work because I am needed at a time like this even though I am just a UAP.  I feel like if I bring this concern up to my bosses they will not care and I also do not want to seem dramatic. Please advise!

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43 Posts; 132 Profile Views

@NurseSpeedy My university ended up having all employees transition to telecommuting. This whole COVID-19 scenario is wild. I did not expect it to get this out of control. 

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CapeCodMermaid has 30 years experience as a RN and specializes in Gerontology, Med surg, Home Health.

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No SNF I’ve ever worked in had had N95 masks. We have stopped allowing visitors, check residents’ temps twice a day and employee temps when they arrive at work. Only one confirmed case in my county as of yesterday.

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1 hour ago, CapeCodMermaid said:

No SNF I’ve ever worked in had had N95 masks. We have stopped allowing visitors, check residents’ temps twice a day and employee temps when they arrive at work. Only one confirmed case in my county as of yesterday.

"But many nursing homes across the country can’t purchase N95 protective masks for their health workers because they have not bought them in the past, according to Premier. A system of `“allocation” in place among major distributors limits people to a historic purchase volume."

https://www.washingtonpost.com/business/2020/03/14/hospital-doctors-patients-coronavirus/

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jeanbeth has 6 years experience and specializes in Gerontology, Education.

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I teach at a private (for-profit) practical nursing program. The Governor's state of emergency declaration prohibits social groups above 250, the DPH prohibits LTC visitors (our clinical sites), and our accrediting body is requesting a plan if we have to close or go to on-line learning. None of these actions REQUIRE us to close our school. And so as of right now students and staff are required to be on campus Monday morning and we must dock our students their minutes if they are absent. Health and safety concerns?  Leadership? 

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