Volume 10, Number 2—February 2004
THEME ISSUE
2004 SARS Edition
Infection Control
Possible SARS Coronavirus Transmission during Cardiopulmonary Resuscitation
, 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
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
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)