Some medical procedures may increase the risk for healthcare professionals to develop COVID-19 and other respiratory illnesses. For these high-risk procedures, it is important that the healthcare provider has access to personal protective equipment (PPE) such as the N95 mask. However, not all procedures that appear to be at high risk have that designation.
For example, vaginal delivery is not currently considered a high-risk or aerosol-producing procedure by the World Health Organization and the US Centers for Disease Control and Prevention.As a result, the N95 mask is currently deprecated Health care workers In all labor and delivery medical settings.
However, new UCLA-led research Obstetrics and gynecology Due to the involvement of faculty members from the Department of Obstetrics and Gynecology at UCLA Health and the Department of Mechanical and Aerospace Engineering (MAE) at the Faculty of Engineering at UCLA Samueli, respiratory emissions generated during work Vaginal delivery The process can increase the risk of infection with respiratory illness.
This is the first study to show labor and respiratory excretion during labor and data explaining how these excretion move faster and potentially farther than a simple cough.
Dr. Rashmi Rao, an assistant professor of obstetrics and gynecology at the University of California, Los Angeles School of Medicine and author of the corresponding study, discussed the study and its impact on supporting labor and delivery staff’s PPE requirements. ..
What makes vaginal delivery a high-risk setting for healthcare providers?
The act of labor and vaginal delivery involves strenuous breathing and repeated Valsalva maneuvers. This is a breathing and extrusion technique used in the second stage of labor, release Of respiratory particles. These particles move at high speeds far away and remain suspended in the air. During active work, complex gas clouds (respiratory emissions containing gas and particles) can move at an average speed of 1.8 meters per second. This is about 30% faster than the gas cloud moving during normal breathing and at least 6% faster than gas. Clouds form when you cough.
How could the patient’s respiratory release be measured?
A colleague at UCLA Samueli’s Faculty of Mechanical and Aerospace Engineering studied respiratory release using background-oriented Schlieren imaging. This is a technique for visualizing the invisible warm gas and cold ambient air flow. It has been shown that the patient’s breathing becomes progressively faster as the patient progresses from early labor to Valsalva, becoming more active in the second stage of labor.
How can I use these results to change the PPE protocol in the delivery room?
This study requires that all delivery units provide staff with complete PPE (with N95 mask) by encouraging the designation of vaginal delivery as a procedure that can produce aerosols at high risk. It can be used as support.
This result underscores the importance of providing adequate PPE to healthcare professionals in the field of obstetrics and gynecology, especially when caring for suspected or identified patients with COVID-19. ..
What is the next stage of research?
Studies show how fast and far the respiratory particles were generated Labor When delivery You can travel. In the next phase of the study, we would like to demonstrate that aerosols, which are infectious viral particles that can float or drift in the air, are actually present in these respiratory emissions.
Thalia Mok et al, Assessment of respiratory release during labor and during labor, Obstetrics and gynecology (2021). DOI: 10.1097 / AOG.0000000000004533
University of California, Los Angeles
Quote: The risk of COVID-19 infection is increased during the patient’s breathing hard work (September 14, 2021).
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COVID-19 transmission risks rise during labor with patients’ heavier breathing Source link COVID-19 transmission risks rise during labor with patients’ heavier breathing