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. 2021 Jul;31(5):989-993.
doi: 10.1007/s00590-021-03006-z. Epub 2021 Jun 10.

COVID-19 infection is related to differences in the use of personal protective equipment by orthopaedic specialist trainees caring for hip fracture patients during the second surge of COVID-19 in the North West of England

S Mastan  1 , R A Malik  2   3 , C P Charalambous  4   5 ; COVIDHipFracture study group; Mustafa Abdulla, John Alonge, Ruth Chelva, Thomas Collins, Leanne Dupley, Azhar Din, John Ferns, Ghazal Hodhody, Isabel Hughes, Aral Jamalfar, Chris Jump, Kenneth Koo, Alham Qureshi, Mobeen Qureshi, Dhawal Patel, Neelam Patel, Adrian Pearce, Abubakar Rauf, Mohammed Ahmed Sajid, Samir Talha, Anna Walsh, Abdulsalam Yasen, Nasri Zreik
Affiliations

COVID-19 infection is related to differences in the use of personal protective equipment by orthopaedic specialist trainees caring for hip fracture patients during the second surge of COVID-19 in the North West of England

S Mastan et al. Eur J Orthop Surg Traumatol. 2021 Jul.

Abstract

Introduction: Personal protective equipment (PPE) may protect health-care workers from COVID-19 infection and limit nosocomial spread to vulnerable hip fracture patients.

Methods: We performed a cross-sectional survey amongst orthopaedic trainees to explore PPE practice in 19 hospitals caring for hip fracture patients in the North West of England.

Results: During the second wave of the pandemic, 14/19 (74%) hospitals experienced an outbreak of COVID-19 amongst staff or patients on the orthopaedic wards. An FFP3 respirator mask was used by doctors in only 6/19 (32%) hospitals when seeing patients with COVID-19 and a cough and in 5/19 (26%) hospitals when seeing asymptomatic patients with COVID-19. A COVID-19 outbreak was reported in 11/13 (85%) orthopaedic units where staff wore fluid resistant surgical masks compared to 3/6 (50%) units using an FFP3 respirator mask (RR 1.69, 95% CI 0.74-3.89) when caring for symptomatic patients with COVID-19. Similarly, a COVID-19 outbreak was reported in more orthopaedic units caring for asymptomatic patients with COVID-19 where staff wore fluid resistant surgical masks (12/14 (86%)) as compared to an FFP3 respirator mask (2/5 (40%)) (RR 2.14, 95% CI 0.72-6.4).

Conclusion: Urgent re-evaluation of PPE use is required to reduce nosocomial spread of COVID-19, amongst highly vulnerable patients with hip fracture.

Keywords: COVID-19; FFP3; Nosocomial covid; Surgical facemasks.

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Conflict of interest statement

The authors declare that they have no conflict of interests.

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