Abstract
The COVID-19 pandemic has strained the healthcare system. It has led to the use of temporary isolation systems and less-then-optimum patient placement configurations because of inadequate number of isolation rooms, both of which can compromise provider safety. Three key elements require special attention to reduce the maximum and average aerosolized contaminant concentration exposure to a healthcare worker in any isolation system: flow rate; air changes per hour; and patient placement. This is important because concentration exposures of aerosolized contaminants to healthcare workers in hospitals using temporary isolation systems can reach levels 21–30 times greater than a properly engineered negative pressure isolation room. A working knowledge of these three elements can help create a safer environment for healthcare workers when isolation rooms are not available.
Highlights
Controlling both the droplet component and the aerosol component of an infectious process is critical to stopping the spread of an infection
SUMMARY There are three key physical elements to understand when working with isolation systems
The magnitude of the air changes per hour (ACH) determines the time the isolation system will reach 99% of its steady state value (T99%)
Summary
Controlling both the droplet component and the aerosol component of an infectious process is critical to stopping the spread of an infection. The interior of some common barrier devices can create unsafe, contaminated air [21-30] times higher than inside a standard negative pressure isolation room (NPIR) when an aerosol is present. Healthcare providers need to be aware of two potentially dangerous situations when using temporary isolation devices by considering the role of the droplet component and the role the aerosol component plays in the potential to spread infections. Consider if prior to intubation, a provider needed to attend to a patient inside a portable isolation box to access their central line for example. Assuming the provider is not wearing a powered air purifying respirator (PAPR), if their face is near or inside the opening of the isolation device their N-95 mask has to filter air [21-30] times more contaminated when wearing the N-95 mask in a standard NPIR. The use of an isolation box in a hallway could expose this highly contaminated air to other patients or visitors in the hallway
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