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𝚃𝚘𝚖 𝙻𝚊𝚠𝚝𝚘𝚗 💙

28 Jun, 6 tweets, 3 min read

@CUH_NHS

At #FreshAirNHS we've pushed for airborne precautions for an airborne disease for a while, but the UK guidance has lagged behind - and now suggests NHS trusts must make their own decision.

@CUH_NHS decided to use FFP3 respirators for COVID-19 care, and now provide data. 1/

A simple swap of surgical masks (droplet) for FFP3 (airborne) appears to have eliminated the excess risk of infection from working on a red ward - from what was a 47-fold increase. 2/

Also notably, cases in red ward staff were not associated with community transmission; whereas on green wards the link was seen - a strong suggestion that "red" staff infections prior to FFP3 use were from their patients. 3/

This is brilliant, pragmatic, data. It's a shame that we aren't already using full airborne mitigations for COVID-19 in the NHS, but these results are the final nail in the coffin for any reasonable objections by those who would restrict airborne PPE to "AGPs". 4/

The recent PHE guidance puts a response to this very much in the court of individual trusts - can we continue to risk staff health, lives, and sickness rates which will harm the NHS post-COVID recovery?

Paper at: authorea.com/users/421653/a…

n/

https://twitter.com/FreshAirNHS/status/1409630362733514752?s=20

#FreshAirNHS response:

https://twitter.com/FreshAirNHS/status/1409630362733514752?s=20

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More from @LawtonTri

𝚃𝚘𝚖 𝙻𝚊𝚠𝚝𝚘𝚗 💙

@LawtonTri

3 Jun

As a researcher working with data like this, I'm aware there is a balance between the needs to plan and research, and to reassure people about what happens to their data - particularly health data which was given in the expectation of confidentiality. 1/

theguardian.com/commentisfree/…

There has been a growth - particularly during the pandemic - of massive databases seeking to include as much of the UK population as they can. And COPI rules have (temporarily) removed many of the protections people believed they had. 2/

I believe that data belongs to the people it concerns. So databases like this are best set up and run locally, with local involvement - people and organisations - to ensure data is used in a way that benefits the people it covers. 3/

Read 12 tweets

𝚃𝚘𝚖 𝙻𝚊𝚠𝚝𝚘𝚗 💙

@LawtonTri

30 Jan

Updated chart of probable hospital-acquired COVID-19
(diagnosed over 7 days after hospital admission)

English Acute Trusts with over 300 total cases since August 2020

Can we share learning points from the Trusts near the bottom?

Updated chart (data to 31st Jan 21)

Probable hospital acquired COVID-19 (diagnosed >7 days after admission).
English Acute Trusts with over 300 cases since August 2020

Chart shows percentage of cases that are probable HAI, and total case numbers.

@elinlowri

As requested by @elinlowri - were busier trusts worse?

(divided total cases by acute overnight beds open September 2020)

Answer appears to be the opposite (though frankly it's a pretty poor correlation and looks strongly affected by a few outliers)

1/

Read 7 tweets

𝚃𝚘𝚖 𝙻𝚊𝚠𝚝𝚘𝚗 💙

@LawtonTri

11 Jan

A quick thread on running in masks

I should start by saying I'm not advocating for masks outside; but like all good scientists I reserve the right to change my opinion.

However there are rumours UK rules may change, and I've done this before...

1/

yorkshireeveningpost.co.uk/health/coronav…

So after being tagged in some discussions I ran home today testing three different masks to remind myself of my original run (which was in a "nan's curtains" 3-layer cloth mask)

But first a few tips on masked running:

2/

It feels weird at first. It restricts flow to a degree and can reduce top speed.
However, it does not drop your oxygen levels!

It helps to breathe in more slowly (ie change breathing pattern to in slow, out quick) so you can still take deep breaths.

Start slow and build up.

3/

Read 10 tweets

𝚃𝚘𝚖 𝙻𝚊𝚠𝚝𝚘𝚗 💙

@LawtonTri

4 May 20

There is an urban myth in anaesthesia about August Bier, his assistant Hildebrandt, and the invention of spinal anaesthesia. We were having a giggle about it on Covid ICU this weekend – but it turns out the truth is so much better:

(a thread, edited from the paper) (1/n)

At 7:38 p.m. I injected 0.5 cc. of a 1 per cent solution of cocaine. This resulted in Hildebrandt experiencing a feeling of warmth in both legs.

After 7 minutes: Needle pricks in the thigh were perceived as pressure; tickling of the the sole of the foot was barely felt. (2/n)

After 8 minutes: A small incision in the skin of the thigh was felt as pressure; introduction of a large, blunt, curved needle into the soft tissues of the thigh produced no pain at all.

(7 minutes is how we often check. 8 is a reasonable test of anaesthesia) (3/n)

Read 19 tweets

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