HHS backs respirator use in caring for pandemic flu patients

first_imgOct 18, 2006 (CIDRAP News) – The US Department of Health and Human Services (HHS) has issued new guidance calling for stronger respiratory protection for healthcare workers in the event of an influenza pandemic.A new interim guidance document says the use of N-95 respirators—designed to stop 95% of small airborne particles—is “prudent” for medical workers providing any direct care for patients ill with confirmed or suspected pandemic flu and is recommended in caring for those with pneumonia. It also says respirator use is prudent for support workers in direct contact with patients.In contrast, HHS’s pandemic influenza plan issued last November recommends that healthcare workers wear simple surgical masks, designed to block large respiratory droplets, for routine care of pandemic flu patients. Both the pandemic plan and the new guidance recommend using an N-95 respirator or similar protection during procedures likely to generate airborne infectious particles, such as endotracheal intubation.The new document also advises healthcare facilities to expect and plan for shortages of  N-95 respirators and similar protective equipment in the event of a pandemic.The new recommendation reflects increased concern about the possibility of airborne transmission of flu viruses, though the document says the Centers for Disease Control and Prevention (CDC) has found no new scientific evidence on the question. HHS says the new guidance “augments and supersedes” the advice in the pandemic flu plan.HHS has received many questions and comments about mask and respirator use since it issued its pandemic plan, the document says. Scientific debate on the issue has led to conflicting recommendations by public health agencies, while wrong, incomplete, and confusing information has flourished online and in the news media, the agency says.The new advice comes less than a month after a Canadian expert asserted in a CDC journal that the US, Canadian, and British plans for pandemic flu didn’t give strong enough advice on respiratory protection for healthcare workers.The CDC “is aware of no new scientific information related to the transmission of influenza viruses since the drafting of the HHS Pandemic Influenza Plan,” the new guidance states. “As stated in the plan, the proportional contribution and clinical importance of the possible modes of transmission of influenza (i.e., droplet, airborne, and contact) remains unclear and may depend on the strain of virus ultimately responsible for a pandemic.”But because of the need for “practical clarification,” the CDC decided to review the evidence again and issue recommendations “to provide a science-based framework to facilitate planning for surgical mask and respirator use” during a pandemic.The new document is titled “Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Health Care Settings during an Influenza Pandemic.” It says that “convincing evidence of airborne transmission of influenza viruses from person to person over long distances (e.g., through air-handling systems, or beyond a single room) has not been demonstrated.”But it adds, “Although data are limited, the possibility remains that short-range aerosol transmission is a route of influenza transmission in humans and requires further study.”The report recommends that healthcare workers caring for pandemic flu patients use respirators rated at N-95 or higher during activities likely to generate infectious aerosols, such as intubation, nebulizer treatment, bronchoscopy, and resuscitation. In addition, a respirator should be used when providing any kind of direct care for a confirmed or suspected pandemic flu patient who has pneumonia, because such patients may produce unusual amounts of infectious particles when they cough.Further, the guidance says, “Use of N-95 respirators for other direct care activities involving patients with confirmed or suspected pandemic influenza is also prudent. Hospital planners should take this into consideration during planning and preparation in their facilities when ordering supplies.”By comparison, the 2005 HHS pandemic plan advises medical workers, “Wear a [surgical] mask when entering a patient’s room.” Aerosol-generating procedures are the only activities in which N-95 respiratory protection is clearly recommended, according to the HHS plan. However, it says the precaution “may be considered” when dealing with highly transmissible flu strains, during the early stages of an outbreak of a new strain, and in other special circumstances.The new guidance also warns hospital officials to anticipate shortages of respirators. Because such shortages are likely in a sustained pandemic, planners should take care to save enough respirators for use during high-risk procedures, without depriving workers who need them for other activities, it says. It also says managers should take steps to minimize the number of personnel exposed to pandemic flu patients, such as establishing specific wards for such patients.”If supplies of N-95 (or higher) respirators are not available, surgical masks can provide benefits against large droplet exposure, and should be worn for all health care activities for patients with confirmed or suspected pandemic influenza,” the guidance states.The new recommendations represent “an important step forward,” according to infectious disease expert Michael T. Osterholm, PhD, MPH, director of the University of Minnesota Center for Infectious Disease Research and Policy, which publishes the CIDRAP Web site. “The CDC is acknowledging that we have a lot of questions that aren’t answered and that aerosol transmission may play a role” in the spread of flu.”This is another example of where the dogma that has existed for years about transmission is being challenged,” he added.Osterholm said the new advice implies that respiratory protection may be important for more than just healthcare workers. “If it is prudent for healthcare workers to be wearing N-95s, then you have to also consider that [step] as the baseline for protection for anyone who might come into contact with influenza,” he said.”But having said that, we all know that there’ll be an inadequate number of respirators for use even by healthcare workers,” he said. Still, the prospect of shortages shouldn’t be a reason for avoiding frank discussion of the evidence about how flu viruses spread, he added.See also:HHS’s “Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Health Care Settings during an Influenza Pandemic”Sep 29 CIDRAP News article “Airborne flu viruses threaten health workers, expert says”last_img read more

Area Basketball Scores (11-25)

first_imgArea Basketball Scores.Saturday  (11-25)Boys ScoresBatesville  70     Jac-Cen-Del  35Oldenburg  63     South Decatur  46Greensburg  78     South Dearborn  53Milan  59     North Decatur  57South Ripley  67     Rising Sun  57Connersville  41     Delta  27Clarksville  63     Switz. County  49New Washington  46     Shawe Memorial  45SW Hanover  55     Austin  47Columbus North  62     Hauser  61Morristown  66     Northeastern  57Indian Creek  58     Edinburgh  55Girls ScoresNew Washington  46     Milan  42Seymour  65     Greensburg  57  (OT)Rising Sun  63     Seton Catholic  25North Decatur  66     Knightstown  47Greenwood Christian  49     Waldron  43Edinburgh  61     Medora  20Trinity Lutheran  65     SW Shelby  46last_img read more

Beat-up UW looks to end losing streak

first_imgWisconsin head coach Lisa Stone coached Drake for three years before coming to Madison, grabbing a Sweet 16 birth in 2001-02.[/media-credit]After dropping another game to Oklahoma State (8-0) yesterday and now trying to recover from a seven-game losing streak, Wisconsin women’s basketball head coachLisa Stone made it clear that the Badgers are staying optimistic.Feeling the effects of a very difficult non-conference schedule, the Badgers now stand at 2-7 after a 50-42 loss to the Cowgirls, their second loss in the Big Ten/Big 12 Challenge. However, Stone remains confident in her team and is not disregarding the Badgers’ high expectations coming into the season.“We’ve had a very very rough schedule,” Stone said. “We are at full strength now, and … we’re looking forward to foraging forward. We’ve got to keep our noses up, and our chins up because this is a good basketball team. I believe in them, I know that we can get better, I know that we can shore some things up.”Wisconsin continued to struggle with turnovers in their road game against Oklahoma State, committing 25 of them in the game and making it very difficult to come away with a win.With no UW player putting up double figures in the game, Stone acknowledged that some changes need to be made to try to put an end to this losing streak. Stone noted that she will be giving some new players the chance to give the team the spark it needs.“We’re looking for some leadership on the court right now, and we’re going to give Tiera a look,” Stone said. “Both Cassie Rochel and Tiera Stephen, you’ll see them start to emerge. We need to take a little bit more pressure off of Alyssa [Karel]. We’re going to look at some other kids too, and continue to get better, continue to be confident with the ball.”Rochel, a 6-foot-4 freshman forward/center out of Minnesota, has seen limited action this year but will provide a post presence that could definitely help Wisconsin turn things around. Rochel should lessen the burden on senior forward Tara Steinbauer and help UW defend some of the strong inside players that the team has had trouble controlling throughout the year.Stephen is a redshirt sophomore guard who transferred from Louisville and has also not seen much playing time this season. Stephen should help take the load off Karel, the star senior point guard who is undoubtedly one of the offensive leaders of the team.Apart from these personnel changes, the team is also trying to instill a sense of confidence in its players to combat their struggles.“The attitude of the team is very good in terms of the team, and the belief in that we can get this thing turned around,” Stone said. “What’s wavering right now may be their confidence, and that is something that we need to continue drill, and find success, have some fun, lighten it up a little bit.”Stone also discussed Wisconsin’s game against Drake this Thursday. The matchup has special meaning for the Wisconsin coach as she was the head coach at Drake from 2000-2003. Reaching the Sweet 16 with Drake in the 2001-2002 season, the trip to a familiar arena will certainly bring back some good memories for Stone.However, while Stone admitted she is looking forward to this homecoming, she was sure to point out that she is focusing on her own team rather than the past.“It will be nice to be back and see some people. I’ve never been in… the visiting locker room, so that will be new,” Stone said. “It will be nice to go back, but right now it’s more about us. [We’re] playing a good team, they’re a very good team.”Despite their recent struggles, Stone is optimistic that this is just a rough stretch for Wisconsin, one that will help them in the future. As the conference season starts up at the end of this month, the Badgers will need to start playing their best basketball if they hope to fulfill their lofty preseason goals.“This storm that we’re in, we’re going to come out of it, and we’re going to be better for it,” Stone said. “And I believe that, and so does the team.”last_img read more