Privileged to have this equipment

"We must recognize that in our hospital we are privileged to have this equipment"

We at the Puerta del Mar Hospital in Cadiz have been using Flyte in our surgeries on a regular basis for several years now. Especially in prosthetic surgery. We started using it routinely after a stay at HSS in New York during the year 2015. There it was unthinkable for any member of the team to perform a surgical intervention without the proper protection. After some time struggling to acquire it and once its use was justified, our Hospital acquired this equipment.

At first, they were only used by a group of colleagues in the service, but over time, their use became standardized and today almost all the equipment is used routinely. During the last weeks, when we have spent some time without them, we have felt unprotected, because once you get used to their use, it is difficult to work without them. 
At our center in particular, initially, all Flyte equipment we had available has been used by those colleagues active during the period of lockdown.

According to the testimony given to us by Dr. Mikel Celaya López, a specialist in the Intensive Care Unit of the Puerta del Mar Hospital in Cádiz, they had good use for the helmets. In combination with the helmets, in order to meet the official indications, the team ensured the use protective glasses and FFP2/3 masks since protective eyewear and respirators protection^1,.2 are prescribed when performing those procedures in which aerosols were generated or could be generated. 

That is, orotracheal intubations, pronation of patients at risk of disconnection, filter or tubing changes, patients with spontaneous ventilation with high-flow nasal cannulas or those with non-invasive mechanical ventilation. In his own words : "The feeling of protection as well as the comfort with the use of these equipment has been unanimous among all those colleagues who have used them, even if, when using them in a reduced environment, we have banged our heads amongst us since we were not aware of the sudden increase of our heads when wearing this equipment."

Because the way Flyte equipment is used in this environment differs from the usual way of using it, Dr. Celaya has proposed some improvement adjusting to the protocol of placement and removal of PPE that they carry out. As far as our environment is concerned, in the Orthopoedic and traumatology operating theatre, now that we are slowly returning to normal, at the same time as we have restarted our programmed interventions, we have once again had our own equipment, with which we can continue to make use of it as we had been doing before.

We have added the use of surgical masks according to hospital protocol at all times and on an individual basis, and following the recommendations of the scientific societies^1,2,3, I use FFP2 masks in all my surgeries. Although these masks have not been provided to the operating theatre staff, except in confirmed cases of COVID 19.
The high generation of aerosols in the surgical environment, together with the use to a large extent of motorized instruments in our operating theatre, as well as the proximity between team members, makes the use of these FFP2/FFP3 masks associated^3,4 with the Flyte team necessary, and their use criteria are never based on the availability or otherwise of the masks.

Unfortunately, the situation we are currently experiencing with COVID 19, has brought to light the shortage of means of protection and equipment that we have in our environment. On the other hand, we must recognize that in our hospital we are privileged to have this equipment and that it has increased the deposit of the same. Let us hope that at least it will serve to make our managers and some of our own colleagues aware of the importance of being equipped with adequate protective equipment.

#EsteVirusLoParamosUnidos⁵ 

Read more about dr. Cachero

Dr. Cachero is a specialist in reconstructive surgery, preservative techniques of the cartilage and minimally invasive surgery. He works in the Puerta del Mar Hospital in Cadiz.

All opinions expressed in this blog are solely and exclusively from Dr. Cachero and do not represent Stryker's.

"

Once you get used to their use, it is difficult to work without them. 

"

- Dr. Cachero - 

References:

1)     Gobierno de España – Prevención y control de la infección en el manejo de pacientes con COVID-19 14.04.2020 https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/Documento_Control_Infeccion.pdf
2)     ECDC – Infection prevention and control and preparedness for COVID-19 in healthcare settings https://www.ecdc.europa.eu/en/publications-data/infection-prevention-and-control-and-preparedness-covid-19-healthcare-settings
3)     Springer Link, COVID-19 coronavirus: recommended personal protective equipment for the orthopaedic and trauma surgeon https://link.springer.com/article/10.1007/s00167-020-06022-4
4)     Springer Link, Returning to orthopaedic business as usual after COVID-19: strategies and options https://link.springer.com/article/10.1007/s00167-020-06031-3
5)     Gobierno de Espana - #EsteVirusLoParamosUnidos - campaign. https://www.mscbs.gob.es/campannas/campanas20/coronavirus.htm 

Disclaimers:

1)    The Flyte PPE products are not cleared as respiratory protective products. European Centre for Disease Prevention and Control guidance for respiratory protection directs the use of an FFP 2/3 respirator mask for medical staff performing Aerosol Generating Procedures.
2)    Dr. Cachero is a paid consultant of Stryker. The opinions expressed herein are the opinions of Dr. Cachero and not necessarily those of Stryker. Individual experiences may vary.
3)    This information is intended solely for the use of healthcare professionals.

SMACC Project No 2020-25186