Personal protective equipment for reducing the risk of respiratory infection among healthcare workers involved in emergency trauma surgery (search on 27 July 2020)
Citation: Griswold DP, Gempeler A, Kolias A, et al. Personal protective equipment for reducing the risk of COVID-19 infection among health care workers involved in emergency trauma surgery during the pandemic: An umbrella review. Journal of Trauma and Acute Care Surgery. 2021;90(4):e72-e80.
Language: Abstract and full text only available in EN.
Free to view: Yes
Funding sources: National Institute for Health Research Global Health Research Group on Neurotrauma, UK.
What is this? Preventing the transmission of infectious diseases among healthcare workers is important to the building of resilient health systems, especially during epidemics and pandemics. Various types of personal protective equipment (PPE) are used to help achieve this.
In this overview of reviews, the authors searched for systematic reviews of experimental and observational studies (and experimental or observational studies if not included in systematic reviews) with a particular focus on healthcare workers caring for trauma surgery patients. They restricted their searches to articles published in English and Spanish and did the search on 27 July 2020. They included 17 systematic reviews and 1 qualitative evidence synthesis, covering studies from 35 countries. Six of the systematic reviews included outcome data for COVID-19 infection and four evaluated other respiratory pathogens such as seasonal influenza, SARS, H1N1 and MERS.
What was found: Use of N95 respirators and surgical masks is associated with a reduced risk of COVID-19 when compared with no mask use (high certainty evidence).
In moderate- to high-risk environments, N95 respirators are associated with a further reduction in the risk of COVID-19 infection when compared with surgical masks.
Eye protection reduces the risk of infection of healthcare workers caring for trauma surgery patients.
Decontamination of masks and respirators with ultraviolet germicidal irradiation, vaporous hydrogen peroxide or dry heat is effective and does not affect the performance or fit of PPE.
Implications: The authors of this review recommended that, when caring for a trauma patient with suspected or unknown COVID-19 status, healthcare workers should use at least N95 respirators or equivalents and that decontamination with ultraviolet light, hydrogen peroxide and dry heat should be made available.
Other considerations: The authors of the review discussed their findings in the context of place of residence.
This summary was prepared by Jayne Chamberlain and edited and finalized by Mike Clarke.