Are you a healthcare provider? Are you in charge of materials management for a clinic or hospital? Do you have employees who fear for their lives because of medical supply shortages?
Imagine that you are a nurse, doctor, respiratory therapist, or medical assistant in a hospital. Or you provide care in patient’s homes or work on an ambulance. You arrive to take care of a patient with a fever and symptoms of respiratory distress.
You reach in the box for gloves, and it’s empty. So is the box for masks. You can’t find a face shield.
You took an oath to care for your patients, but now you might be choosing to sacrifice yourself. What do you do?
The world first started hearing rumblings about a new virus in Wuhan, China, on December 31, 2019. Most Americans were not concerned at the time. On March 11, 2020, the World Health Organization declared a pandemic.
As of July 6, 2020, there are 2,982,928 confirmed cases of COVID-19 and 132,569 deaths in the United States. Supply chains across the world have become interrupted. Healthcare systems are becoming overwhelmed.
Reports keep circulating about shortages and the lack of needed supplies and equipment. Continue reading to learn more about this problem.
Latest Information About How SARS-CoV-2 (COVID-19) Spreads
The coronavirus is a positive sense, single-strand enveloped RNA virus. It belongs to the Coronaviridae family. This virus is often called the novel coronavirus or COVID-19. Now, the more current term is SARS-CoV-2.
A study approved on June 26, 2020, for publication in the Cell released its summary of findings. The authors report a new SARS-CoV-2 variant.
It carries the Spike protein amino acid called D614G. As of this publication date, this is the most prevalent form of the virus in the current pandemic.
This shift occurred in areas that first saw the D614 version before the D614G change emerged. This variant seems heartier and produces higher titers. The study reports that these patients have a higher upper respiratory tract viral loads.
SARS-CoV-2 spreads via respiratory droplets. Scientists are finding the virus in saliva and respiratory secretions. Up to 30% to 60% of asymptomatic people may shed the virus and cause others to become infected.
The evidence is unclear about the expected range of droplet transmission. Droplets may travel 6 feet or more. This is the reason for recommending universal mask use and physical distancing.
Understanding Droplet Transmission
Airborne transmission can occur via sneezing, coughing, speaking, breathing, and singing. The droplets may also attach to dust particles.
Coronavirus particles, or virions, are about 0.125 microns in diameter. Microorganisms smaller than 5 microns can float in the air.
Once these virions combine with dust particles, they’re carried by air currents. This may increase the chance that they’re inhaled by another person.
Some medical and surgical procedures can create aerosolized virions. This often happens with manipulations of the large airways. Examples of possible scenarios include the following:
- Bag-valve-mask ventilation
- Intubation
- Endotracheal suctioning
- Upper respiratory scope procedures
- Sputum induction
- Nebulizer treatments
- Positive pressure ventilations such as BIPAP or CPAP
Any type of surgery on the lungs or airway can release virions. This includes during autopsy procedures.
Containing SARS-CoV-2 in Medical Settings
Specific guidelines are now in place for healthcare providers caring for patients with known or suspected SARS-CoV-2. These patients should stay in an Airborne Infection Isolation room. Caregivers must use airborne and contact precautions and eye protection in the room.
Personal protective equipment (PPE) requirements include:
- An N95 mask that’s been fit-tested or a powered air-purifying respirator (PAPR)
- Goggles or a face shield
- A gown
- Gloves
Perform hand hygiene before donning and after doffing PPE. Care providers may use an alcohol-based sanitizer or soap and water. Dispose of used PPE in the appropriate manner and container.
Also, limit moving the patient around the facility. If the patient needs transporting, the staff must wear full PPE as described earlier.
If possible, use a closed suction system when suctioning the patient’s airway. Also, use disposable bed/table sheets and gowns. All ultrasound, temperature, and other types of probes must have disposable covers.
All surfaces need cleaning with an EPA-approved hospital disinfectant. This helps reduce exposure to droplets attached to furniture and equipment.
Prepare for Patient Complications
Many SARS-CoV-2 complication treatments can increase the risk for healthcare providers. For example, rapid intubation for a patient in respiratory arrest can increase viral spread due to barrier mishaps.
Thus, consider early, controlled intubation at the first signs of acute respiratory failure. The use of a video laryngoscope can provide a clear view of the glottis. This allows the practitioner to achieve intubation more easily on the first attempt.
Use HEPA filters between bag-valve-mask devices to decrease exposure. If the patient has an endotracheal tube, place a HEPA filter on the expiratory end of the breathing circuit. Before intubation, double glove and then remove the outer glove after intubation.
If the patient doesn’t need a ventilator, they should wear a surgical mask.
CDC Recommendations for Isolation Rooms
Current CDC guidelines state that SARS-CoV-2 patients should stay in a negative pressure isolation room. This room will optimally contain only one patient. Additional requirements include the following:
- Negative pressure ventilation that directs airflow away from the corners to the center of the room
- Direct transmission of exhaust air from the room to outside the building
- Recirculate the air through a HEPA filter
- The doors and windows must always remain closed
- Designated toilet and sink for the patient
- Separate designated sink for healthcare worker hand washing
- Alarms on all monitoring equipment
It’s optimal to have an anteroom between the hall and the isolation room. This provides an area for donning and doffing PPE and handwashing.
Medical Supply Shortages
Shortages of medical supplies during this pandemic is far more than an inconvenience. The National Nurses United is the largest nurses union in the United States. They are tracking the number of fatalities among healthcare workers due to SARS-CoV-2.
Their reports from chapters across the country put the death total at 939. Nurses make up 15% of these deaths. A lack of sufficient medical supplies can contribute to this number.
The previous explanation of isolation precautions demonstrates the volume of equipment used. Medical facilities have voiced fears about medical supply shortages since the pandemic began. The FDA also expressed concerns about interrupted supply chains on top of the increased demand.
One question posed to the FDA, addressed the potential COVID-19 supply shortages. The FDA is working under an Emergency Use Authorization (EUA) to limit supply shortages.
Based on current scientific evidence, the FDA approved the importation of certain respirators. This deviates from the required National Institute for Occupational Safety and Health (NIOSH) approval.
Under the EUA, the FDA states that non-NIOSH-approved N95 respirators are allowed from certain countries. These countries include Australia, Brazil, Europe, Japan, Korea, and Mexico. The FDA is also collaborating with US manufacturers regarding increasing PPE availability.
Examples of Hospital Supply Shortages
In April 2020, a survey was posted asking what supplies healthcare facilities needed. They had 978 institutions respond from 47 states and Washington DC. Also, they heard from home health agencies, hospices, ambulance crews, and correctional facilities.
On April 8, 36% of respondents said they had no more face shields. Another 34% said they had no thermometers, and 19% had no gowns. Almost all the facilities were out of at least one type of PPE.
In June, the SARS-CoV-2 cases began escalating in many states after relaxing restrictions. Many medical facilities are now reaching their maximum capacity. They’re having to convert any space they have into “COVID Units.”
Thus, the demand for PPE and ventilators continues to increase. Yet, other equipment is also in high demand. For example, many of these hospitalized patients need continuous cardiovascular and respiratory monitoring.
This need is outpacing most hospital’s supply. They are forced to look for new and different options. One example is the Omni® Express.
This machine can measure any combination of capnography (EtCO2) and Sp02. It also monitors EKG rhythms and offers non-invasive blood pressure. This lightweight machine allows staff members to set it up wherever they need it quickly.
For Facilities Facing Medical Supply Shortages:
Is your staff facing medical supply shortages while caring for SARS-CoV-2 patients? Do they lack the needed PPE or ventilators? Are you looking for options to fill in the gaps?
If you’re located in a “hot spot,” each day brings more fear and anxiety among the healthcare providers.
Outpatient Supply began developing and marketing medical equipment in 2015. Our base is in the United States, but we serve over 50 countries. We pride ourselves on the state-of-the-art medical device technology we offer.
We specialize in outpatient medical equipment for operating rooms. Many of our customers are physicians who perform minor procedures in their office.
While we sell our equipment worldwide, our focus is on our United States Market. Contact us today to learn how we can help with your supply shortage.