Proposed Topic (Most preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Proposed Topic (Second preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
To YL (1), Tsang HC (1), Mo KC (1), To CW (1), Choi CM (1), Or YL (2), Sun TF (3) Ngai PC (4)
Affiliation :
(1) Physiotherapy Department, North District Hospital
(2) Department of Anaesthesiology & Operating Services, North District Hospital
(3) Hospital Chief Executive Office, North District Hospital
(4) Department of Rehabilitation Sciences, Hong Kong Polytechnic University
Introduction :
Open nasopharyngeal suction is a common practice in chest physiotherapy management, not only in hospitals but also in community settings. However, suction can trigger coughing, which in turn generates aerosols. The pattern of aerosol dispersal and the potential benefits of using an enclosure barrier device during open nasopharyngeal suction remain unclear.
Objectives :
This study aims to investigate the aerosol-generating patterns during coughing and open nasopharyngeal suction in a simulated setting and to evaluate the protective effects, if any, of a simple and practical barrier device.
Methodology :
This prospective, non-blinded, randomized controlled trial was conducted on a simulated model. The number and size of air particles ranging from 0.3 to 10 microns were measured under four conditions: simulated coughing, suction without an enclosure device, suction with a surgical mask, and suction with a plastic tent. The total particle counts across all sizes were used for statistical analysis.
Paired t-tests were used to compare the changes in air particle count during coughing and suction. Independent t-tests were used to compare the differences between these two conditions.
One-way ANOVA was used to examine the differences in the number of air particle counts among the three suction conditions. Tukey’s test was used for post-hoc analysis to examine the differences in the number of air particle counts between each group.
Result & Outcome :
Thirteen physiotherapists with more than three years of work experience were voluntarily recruited. Peak air particle counts were statistically significantly higher than the baseline during both coughing (p=0.017) and suction (p=0.013). However, there was no statistically significant difference between the groups in terms of changes in air particle count (cough: 73,000±109,302, suction: 64,868±92,429, p=0.420).
There was a statistically significant difference among the three suction groups (p=0.014). Post-hoc analysis revealed that changes in suction without any enclosure devices (p=0.023) and suction with a surgical mask covered to simulated model (p=0.036) were significantly higher than changes in suction with a plastic tent.
Conclusion:
Physiotherapists are significantly exposed to aerosol particles during coughing and nasopharyngeal suction, even with a surgical mask covered to simulated model. In this study, a plastic tent was found to be an effective barrier in reducing total aerosol particle exposure.
