CJEM Articles: outbreak

Displaying 1-3 of 3 results

  • January 2009 11 1
    Brian Schwartz, Laura M. Visentin, Laurie J. Morrison, Susan J. Bondy

    Objective: We sought to assess the knowledge of, use of and barriers to the use of personal protective equipment for airway management among emergency medical technicians (EMTs) during and since the 2003 Canadian outbreak of Severe Acute Respiratory Syndrome (SARS).

    Methods: Using a cross-sectional survey, EMTs in Toronto, Ont., were surveyed 1 year after the SARS outbreak during mandatory training on the use of personal protective equipment in airway management during the outbreak and just before taking the survey. Practices that were addressed reflected government directives on the use of this equipment. Main outcome measures included the frequency of personal protective equipment use and, as applicable, why particular items were not always used.

    Results: The response rate was 67.3% (n = 230). During the SARS outbreak, an N95-type particulate respirator was reported to be always used by 91.5% of respondents. Conversely, 72.9% of the respondents reported that they never used the open face hood. Equipment availability and vision impairment were often cited as impediments to personal protective equipment use. In nonoutbreak conditions, only the antimicrobial airway filter was most often reported to be always used (52.0%), while other items were used at an intermediate frequency. The most common reason for not always donning equipment was that paramedics deemed it unnecessary for the situation.

    Conclusion: Personal protective equipment is not consistently employed as per medical directives. Reasons given for nonuse included nonavailability, judgment of nonnecessity or technical difficulties. There are important public health implications of noncompliance.

  • May 2005 7 3
    Karyn Popovich, Rick Penciner, Tim Rutledge

    The Toronto SARS outbreak began in February 2003 and lasted more than 16 weeks. The city and its health care system faced enormous challenges in responding to this new infectious disease, learning about its transmission, diagnosis and treatment, in containing its spread and in coping with its socioeconomic impact. As the site of a significant cluster of cases in the second wave of the outbreak, North York General Hospital (NYGH) quickly adapted many components of its operations, focusing on the fight against SARS. In order to assess potential SARS cases in a safe, efficient and effective manner, NYGH established a SARS assessment clinic. We describe the design features, construction, layout and operation of this clinic. This type of clinic can be rapidly deployed and may be of great value during future infectious outbreaks, including pandemic influenza.

  • January 2004 6 1
    Marcus Ong

    On Mar. 12, 2003, the World Health Organization issued a global alert regarding cases of a severe atypical pneumonia termed "severe acute respiratory syndrome" (or SARS). In Singapore alone, there have been 238 SARS cases and 33 deaths, including 5 health care workers. With modern global inter-connectivity, SARS rapidly spread to become a worldwide phenomenon. This article describes the Singapore "war on SARS" from an emergency physician's perspective, focusing on the "prevent, detect and isolate" strategy. Notable innovations include the use of home quarantine orders, mass temperature screening using thermal imaging, modular systems of hospital staffing, "virtual" hospital visits, and innovations in emergency department design. Most emergency departments, hospitals and health care systems appear to be psychologically and logistically unprepared for a massive infectious disease outbreak. In light of recent natural and terrorism-related threats, emergency care providers around the world must adopt a new paradigm. The current SARS outbreak may be merely a taste of things to come.