Aerosolization of COVID-19 and Contamination Risks During Respiratory Treatments

Cassandra D Benge; John Alan Barwise

Aerosolization of COVID-19 and Contamination Risks During Respiratory Treatments

Fed Pract. 2020 Apr;37(4):160-163.

Authors

Cassandra D Benge¹, John Alan Barwise¹

Affiliation

¹ is a Clinical Pharmacy Specialist, and is a Staff Physician and Medical Director of the Surgical Intensive Care Unit, both at VA Tennessee Valley Healthcare System in Nashville. John Barwise is Associate Professor of Clinical Anesthesiology at Vanderbilt University Medical Center in Nashville.

PMID: 32322146
PMCID: PMC7173638

Abstract

Background: Aerosolized medications are frequently administered across the health care continuum to acutely ill patients. During viral pandemics, the World Health Organization and the Centers for Disease Control and Prevention advise the application of airborne precautions when performing aerosol-generating medical procedures, such as aerosolized medications.

Observations: Appropriate personal protective equipment (PPE), including fit-tested particulate respirators should be worn when administering nebulized medications to patients. These PPEs have been in short supply in the US during early phases of the COVID-19 pandemic, which is increasing the risk faced by health care workers (HCWs) who are treating patients using aerosolized medications. Despite taking appropriate precautions, HCWs are becoming infected with COVID-19. This may be related to secondary exposure related to viral longevity in fugitive emissions and viability on fomites.

Conclusions: We have expanded on non-US public health recommendations to provide guidance to frontline HCWs to enhance collaboration between clinicians, who are often siloed in their clinical practices, and ultimately to protect the federal workforce, which cannot sustain a significant loss of frontline HCWs.