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Bronchoscopy safety precautions for diagnosing COVID‐19 associated pulmonary aspergillosis—A simulation study
Author(s) -
Koehler Philipp,
Cornely Oliver A.,
Kochanek Matthias
Publication year - 2021
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.13183
Subject(s) - bronchoscopy , medicine , personal protective equipment , contamination , covid-19 , aerosol , aerosolization , outbreak , intensive care medicine , radiology , surgery , pathology , disease , infectious disease (medical specialty) , anesthesia , chemistry , ecology , organic chemistry , biology , inhalation
Objectives With the outbreak of coronavirus disease 2019 (COVID‐19), clinicians have used personal protective equipment to avoid transmission of severe acute respiratory syndrome coronavirus 2. However, they still face occupational risk of infection, when treating COVID‐19 patients. This may be highest during invasive diagnostic procedures releasing aerosols and droplets. Thereby, the use of diagnostic procedures for Covid‐19 associated aspergillosis may be delayed or impeded, as use of bronchoscopy has been discouraged. This leads to avoidance of a crucial procedure for diagnosing invasive aspergillosis. We intent to visualise aerosol and droplet spread and surface contamination during bronchoscopy and address which measures can avoid exposure of health‐care workers. Methods We created a simulation model to visualise aerosol and droplet generation as well as surface contamination by nebulising fluorescent solution detected by using ultraviolet light‐ and slow‐motion capture. We repurposed covers for ultrasound transducers or endoscopic cameras to prevent surface and ambient air contamination. Results In our bronchoscopy simulation model, we noticed extensive aerosol generation, droplet spread and surface contamination. Exposure of health‐care workers and contamination of surfaces can be efficiently reduced by repurposing covers for ultrasound transducers or endoscopic cameras to seal the tube opening during bronchoscopy in mechanically ventilated patients. Conclusion Adequate personal protective equipment and safety strategies allow to minimise contamination during bronchoscopy in mechanically ventilated COVID‐19 patients.