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Volume 10, Number 2—February 2004
THEME ISSUE
2004 SARS Edition
Infection Control

Possible SARS Coronavirus Transmission during Cardiopulmonary Resuscitation

Michael D. Christian*†Comments to Author , Mona Loutfy‡, L. Clifford McDonald§, Kenneth F. Martinez§, Mariana Ofner*¶, Tom Wong*¶, Tamara Wallington*#, Wayne L. Gold*†, Barbara Mederski‡, Karen Green**, Donald E. Low, on behalf of the SARS Investigation Team
Author affiliations: *University of Toronto, Toronto, Canada; †University Health Network,Toronto, Canada; ‡North York General Hospital, Toronto, Canada; §Centers for Disease Control and Prevention, Atlanta, Georgia, USA; ¶Health Canada, Ottawa, Canada; #Toronto Public Health, Toronto, Canada; **Mount Sinai Hospital Toronto, Toronto, Canada

Main Article

Table

Healthcare worker exposures, personal protective equipment, and outcomea

Code team member Tasks
(duration of exposure) Exposure time Protective equipment Symptoms
(onset) SARS serologic findings
Ward RN1
Contact before code (120 min), compressions (<5 min), assisted IV insertion (5 min), observed code (10 min), wrap body (10–15 min)
150–155 min
Gown x 2, gloves x 2, safety glasses, shoe covers, hair cover, N95 respirator
None
Refused testing
Ward RN2
Set up suction equip (5 min), charting arrest record (15 min), wrapped body (10–15 min)
30–35 min
Gown x 2, gloves x 2, safety glasses, face shield, shoe covers, hair cover, N95 respirator
None
Negative
Ward RN3
Set up oxygen equip (5 min), prepared intubation equipment (10 min), observed (5 min),
wrapped body (10–15 min)
30–35 min
Gown x 2, gloves x 2, safety glasses, face shield, shoe cover, hair cover, N95 respirator
Headache, myalgia, Tmax 37.8°C (June 1)
Negative
ICU RN1
Chest compressions
(10–15 min)
10–15 min
Gown x 2, gloves x 2, safety glasses, face shield, shoe cover, hair cover, N95 respirator
Headache, malise, myalgia, nausea, Tmax 38.0°C (May 31)
Indeterminate
ICU RN2
IV insertion in foot (<5 min), medication administration (10 min), application of EKG leads (<1 min)
10–15 min
Gown x 2, gloves x 2, safety glasses, face shield, shoe cover, hair cover, N95 respirator
Myalgia, malaise, SOA, Tmax 38.5°C (May 31)
Positive
ICU RN3
Ventilated patient with bag-valve-mask (5–10 min)
5–10 min
Gown x 2, gloves x 2, safety glasses, face shield, shoe cover, hair cover, N95 respirator
None
Negative
RT1
Intubated patient (<30 s), ventilated patient with bag-valve-mask (10–15 min)
10–15 min
T4 Personal Protection System, N95 respirator
None
Refused testing
RT2
Put filter on ETT and assisted RT1 (5–7 min)
5–10 min
T4 Personal Protection System, N95 respirator
None
Refused testing
MD Chest compressions (5–7 min) 5–10 min T4 Personal Protection System, N95 respirator None Refused testing

aSARS, severe acute respiratory syndrome; RN1, ward nurse 1; RN2, ward nurse 2; RN3, ward nurse 3; ICU-RN1, intensive care unit nurse 1; ICU-RN2, intensive care unit nurse 2; ICU-RN3, intensive care unit nurse 3; RT1, respiratory therapist 1; RT2, respiratory therapist 2; MD, physician; IV, intravenous catheter; Tmax, maximum temperature; EKG, electrocardiogram; ETT, endotracheal tube

Main Article

1L.C. McDonald, K. Martinez (Centers for Disease Control and Prevention), Z. Abbas, D. Anderson, K. Dunn, R. Farmer, L. Gardiner, D. Gravel, L. Hansen, L. Maheux, M. Ngyuen, M. Ofner, C. Oxley, L. Srour, T. Tam, A. King, T. Wong (Health Canada), M. Loeb, L. Mandell (McMaster University), J. Farley, B. Mindell (Ontario Ministry of Health and Long Term Care), D. Low, M. Christian, A. McGeer (University of Toronto), B. Mederski (North York General Hospital), B. Henry, B. Yaffe, R. Shahin, L. Berger, T. Wallington, T. Svoboda, S. Basrur, M. Finkelstein, V. Pietropaolo (Toronto Public Health), J. Conly (University of Calgary), L. Nicolle (University of Manitoba)

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The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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