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Hi Fiona,
The thought of a negative pressure operating theatre is very scary – that they are positive pressure is to protect the patient from infection of an open wound. With negative pressure theatres they just become a sink for any bits of dust and bacteria and fungi floating around in the air. The risks to the patient are huge. What antibiotic prophylaxis would you use when you know you have unclean air flowing over the patient with an open wound on a table? How will this risk be communicated to the patient prior to surgery so they have informed choice about the risks of their surgery? Is there any point operating on the patient if they are then at high risk of overwhelming infection?
With proper airflow, the HEPA filtered air flows from the roof, past the staff and then to the patient and away across the floor to the exhausts. The air flow direction helps protect the staff, along with proper PPE.
Airflow in theatres is not changed for measles of TB patients, so why for COVID if this is based on a proper risk assessment rather than fear?
If your Facility Manager is a member of the Institute of Hospital Engineers Australia (IHEA), we have had two webinars on air conditioning during COVID with some very experienced air conditioning/theatre air supply specialists, including on negative pressure operating theatres that were recorded, and would be good for anyone contemplating this to listen to – any IHEA member will have access and probably wouldn’t mind you having a listen.
Regards,
Sarah Bailey MSc, PGDip Med Myc
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Hi All,
In response to COVID, and for future planning I have been asked to consider the creation of a negative pressure operating theatre for use in emergency surgery for a COVID positive case (e.g. C-section, post MVA).
I am aware that this is against the usual recommendations which are for positive pressure operating theatre to reduce risk of Surgical Site Infection. However it has been raised with me that the risk of unexpected intubation of a COVID positive patient in a positive pressure theatre puts staff at risk.
I am interested in how other facilities are responding to this issue and balancing risk to staff with risk to patient.
Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_control
IPCU – ‘By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms’
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