by Ken Capek, RRT
Maybe this is a wakeup call for the practice of respiratory care. Why has it been common practice to provide aerosol treatments to patients with a mouthpiece or mask which allows exhaled and nebulized particles to spread throughout the patient room? So it’s been okay for respiratory therapists to be exposed to those particles. We clearly don’t need repeated doses of albuterol. We also don’t need to breathe in our patients expired bacteria and viruses whether it be TB, the “safer, regular” flu or Covid-20.
I think we are in a “new” normal where exposing ourselves to all these diseases and medications is no longer acceptable and if complete containment is not yet achievable maybe we can at least mitigate the exposure. We found ourselves doing this during the COVID-19 pandemic. Amazing ideas came out of this crisis which centered on risk reduction by using filtering and containment methodologies. Necessity is the mother of invention and this was demonstrated when PPE ran out and healthcare workers were left vulnerable. I saw double masking, industrial mask use and even a full face snorkel mask with a small HEPA filter replacing the snorkel opening.
But aside from that, should we be thinking about changing the way we regularly practice in the future? Should we be wearing at least a surgical mask for every treatment? Should we be placing a loose covered mask over an aerosol mask to contain aerosolized particles from spreading freely? This was demonstrated during the pandemic with some patients using high flow cannulas. Should we be using more MDI type medications with spacers and should spacers have a filtered expiratory port? Maybe we can build and employ small battery powered portable HEPA filtered fan units placed by the patients head when therapy is given to “scrub the air”. Sure, it’s not the recommended externally vented negative pressure room but how may facilities had enough of those available during this pandemic?
RTs have always been great inventors, the time is now!
Just thinking out loud.