DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20204771

Modified office practice in COVID-19 pandemic - an otorhinolaryngologist perspective

Juhi Tripathi, Shweta Kumari, Shalabh Rastogi

Abstract


COVID-19 spreads through contact, minute droplets and aerosol from infected person which may be symptomatic or asymptomatic. Nose and throat had very high load of severe acute respiratory syndrome (SARS-CoV-2) virus. Otorhinolaryngologists by virtue of their work which requires close examination of these part are at very high risk of infection. Many studies are available for precautions to be taken in patient management related to COVID-19 in wards and surgical intervention in operation theaters but very little information is available regarding precautions in working in outpatient clinic setting. Our article highlights some changes we made in ear, nose and throat (ENT) outpatient clinics after going through various guidelines to make it safe in current scenario. These changes may inspire others to move toward safer work practices in their outpatient area to provide ENT consultations. The main changes were categorized into infrastructural changes, identification of frugal but effective personal protective equipment (PPE) for ENT, training for use of different level of PPE as per risk, new modus operandi, and new infection prevention measures. These changes had taken into account safety guidelines by Ministry of health and family welfare (MOHFW) government of India and various international associations specific to specialty. The modification and its advantages were presented.


Keywords


COVID-19, ENT outpatient clinics, PPE, Infection, Healthcare workers, ENT examination

Full Text:

PDF

References


Martinez RM. Clinical Samples for SARS-CoV-2 Detection: Review of the Early Literature. Clin Microbiol Newsl. 2020;42(15):121-7.

Acter T, Uddin N, Das J, Akhter A, Choudhury TR, Kim S. Evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as coronavirus disease 2019 (COVID-19) pandemic: A global health emergency. Science of the Total Environment. 2020;730:138996.

World Health Organization. Transmission of SARS-CoV-2: implications for infection prevention precautions: scientific brief, 09 July 2020. World Health Organization; 2020. Available at: https://www.who.int/publications/i/item/modes-of-transmission-of-virus-causing-covid-19-implications -for-ipc-precaution-recommendations. Accessed on: 25 July 2020.

Lammers MJ, Lea J, Westerberg BD. Guidance for otolaryngology health care workers performing aerosol generating medical procedures during the COVID-19 pandemic. J Otolaryngol Head Neck Surg. 2020;49(1):1-8.

Miller LE, Shaye DA, Lee LN. Considerations for the otolaryngologist in the era of COVID-19: a review of the literature. Curr Opin Otolaryngol Head Neck Surg. 2020; 28(4):228-34.

Kowalski LP, Sanabria A, Ridge JA, Ng WT, de Bree R, Rinaldo A, Takes RP, Mäkitie AA, Carvalho AL, Bradford CR, Paleri V. COVID‐19 pandemic: effects and evidence‐based recommendations for otolaryngology and head and neck surgery practice. Head neck. 2020;42(6):1259-67.

Xu J, Li Y, Gan F, Du Y, Yao Y. Salivary glands: potential reservoirs for COVID-19 asymptomatic infection. J Dent Res. 2020;99(8):989.

Hu Z, Song C, Xu C, Jin G, Chen Y, Xu X, et al. Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China. Sci China Life Sci. 2020;63(5):706-11.

GOV.UK (2020) COVID-19: infection prevention and control. Available at: https://www.gov.uk/ government/publications/wuhan-novel-coronavirus-infection-prevention-and-control. Accessed on: 27 March 2020.

MOHFW Guidelines for safe ENT practice in COVID 19. Available at: https://www.mohfw.gov.in /pdf/ENTCOVID0306.pdf. Accessed on: 27 March 2020.

Guidance for Return to Practice for Otolaryngology-Head and Neck Surgery Part One. American academy of otolaryngology- head and neck surgery. Available at: https://www.entnet.org/sites/default/files/uploads /guidance_for_return_to_practice_part_one_update_070120.pdf. Accessed on: 27 March 2020.

World Health Organization (WHO). Atlanta: Infection prevention and control during health care when COVID-19 is suspected. 2020. Available at: https://apps.who.int/iris/rest/bitstreams/1272420/retrieve. Accessed on: 10 May 2020.

McCool RR, Davies L. Where does telemedicine fit into otolaryngology? An assessment of telemedicine eligibility among otolaryngology diagnoses. Otolaryngol–Head Neck Surg. 2018;158(4):641-4.

Siwicki B. Telemedicine during COVID-19: Benefits, limitations, burdens, adaptation. In healthcareitnews.com. 2020. Available at: https://www.healthcareitnews.com/news/telemedicine-during-covid-19-benefits-limitations-burdens-adaptation. Accessed on: 10 May 2020.

Canelli R, Connor CW, Gonzalez M, Nozari A, Ortega R. Barrier enclosure during endotracheal intubation. N Engl J Med. 2020;382:1957-8.