LitCovid-sentences  

PMC:7143707 / 74-12841 JSONTXT 11 Projects

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Id Subject Object Predicate Lexical cue
T2 0-15 Sentence denotes 1 Introduction
T3 16-110 Sentence denotes In December 2019, a novel corona virus infection was detected in Wuhan, China, Hubei province.
T4 111-195 Sentence denotes Initial cases all had a common link to an large seafood and live animal marketplace.
T5 196-361 Sentence denotes Corona viruses are a broad class of viruses that are responsible for most of the common colds, as well as several viral illnesses transmitted from animals to humans.
T6 362-515 Sentence denotes They are so-named due to their similar appearance under electron microscopy to the sun's corona during a total solar eclipse (see Fig. 1, Fig. 2 1 , 2 ).
T7 516-916 Sentence denotes The virus responsible for the current outbreak was originally called novel corona virus, now renamed SARS-CoV-2, since it is related to the SARS virus that caused an epidemic in China in 2002-2003 (postulated at that time to have originated in civet cats and then jumped to humans , and the MERS corona virus-related to transmission from camels https://www.cdc.gov/coronavirus/2019-nCoV/summary.html.
T8 917-1131 Sentence denotes The infection is now called COVID-19, and within a few weeks, it became clear that COVID-19 infection was easily spread from person to person, as there was an exponential rise in newly-reported cases seen in China.
T9 1132-1286 Sentence denotes Travelers from China then spread the COVID-19 to other countries, causing the WHO to declare the epidemic a Global Health Emergency on January 30, 20203 .
T10 1287-1658 Sentence denotes Simple recommendations of respiratory protection and glove use early on in the official guidance from health agencies contrasted sharply with wide coverage in the 24-hour news media, showing graphic pictures of civilian authorities and health care personnel in Asian countries wearing extensive protective gear reminiscent of that used for Ebola or even hazmat incidents.
T11 1659-2178 Sentence denotes While initially it was felt that droplet transmission was most the likely mode, recommendations have been upgraded to airborne and contact transmission, since the natural course of this infection is still not completely understood, infectivity or contagiousness seems higher than SARS, and people seem to be able to transmit infection before they ever become symptomatic, and for some days after seemingly full recovery (https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html) (Figs. 3 4 , 3a 5 , 6 , 4a 7 ).
T12 2179-2203 Sentence denotes Fig. 1 Coronavirus- CDC.
T13 2204-2216 Sentence denotes Fig. 2 NASA:
T14 2217-2267 Sentence denotes Sun's Corona during Solar Eclipse August 21, 2017.
T15 2268-2313 Sentence denotes Fig. 3 CDC- airborne particles from a sneeze.
T16 2314-2398 Sentence denotes Fig. 3a NIOSH- Approved N95 mask (above) and N95 duck bill and other styles (below).
T17 2399-2491 Sentence denotes Fig. 4a fit testing N95 mask with qualitative solutions (isoamyl acetate, saccharine, etc.).
T18 2493-2536 Sentence denotes 2 Types of transmission and precautions8,9
T19 2537-2815 Sentence denotes Emergency providers of patient care to persons with suspected COVID-19 infections or who will be in the same room or compartment with such patients should follow Standard, Contact, and Airborne Precautions, including the use of eye protection, as recommended by the CDC and WHO.
T20 2816-2874 Sentence denotes Care should be in single isolated negative-pressure rooms.
T21 2875-2932 Sentence denotes The following sections further explain these precautions.
T22 2934-2959 Sentence denotes 3 Standard precautions10
T23 2960-3151 Sentence denotes The CDC defines standard precautions as common sense utilization of practices and PPE to protect healthcare workers from infections and to prevent spread of infection from patient to patient.
T24 3152-3369 Sentence denotes This includes respiratory hygiene and cough etiquette, proper patient placement/isolation, handling and cleaning of patient care equipment, devices, laundry, clothing, and environment; and sharps and procedure safety.
T25 3371-3396 Sentence denotes 4 Contact transmission11
T26 3397-3632 Sentence denotes Transmission of infection by skin-to-skin contact with an infected person, or by touching contaminated items from a person's room (fomites: patient care equipment, telephones, TV remote controls, countertops, as well as bedding, etc.).
T27 3633-3754 Sentence denotes Wound drainage, as well as secretions or bodily fluids (vomitus, diarrhea, etc.) increase risks for contact transmission.
T28 3755-3951 Sentence denotes Some notable pathogens transmitted by contact include norovirus, MRSA, C. difficile, VRE (vancomycin resistant enterococcus), CRE (carbepenum-resistant enterococcus), SARS, and MERS, among others.
T29 3953-3980 Sentence denotes 5 Respiratory transmission
T30 3981-4100 Sentence denotes Respiratory transmission of diseases can occur when people with certain infections talk, laugh, cough, sneeze, or sing.
T31 4101-4144 Sentence denotes There are two types: droplet, and airborne.
T32 4146-4158 Sentence denotes 6 Droplet12
T33 4159-4340 Sentence denotes Droplet transmission occurs when a patient coughs, sneezes, or talks, which generates infected droplets that can contact the eyes nose, or mouth of another person causing infection.
T34 4341-4439 Sentence denotes These droplets are fairly large and do not remain airborne for long and settle out fairly quickly.
T35 4440-4539 Sentence denotes Simply placing a disposable mask on the patient will reduce transmissibility to healthcare workers.
T36 4540-4686 Sentence denotes Diseases transmitted by droplets are influenza, meningococcal disease, H. flu (HIB), mycoplasma, whooping cough, rubella, and mumps, among others.
T37 4687-4874 Sentence denotes Droplet particles are larger than those exhibiting airborne transmission (see below), and therefore simply maintaining a distance of at least 6 feet away from the patient may be adequate.
T38 4875-4977 Sentence denotes Negative pressure rooms are not required, but patients are generally isolated in single-patient rooms.
T39 4978-5207 Sentence denotes Disposable surgical masks and procedure masks are protective to healthcare workers for droplet transmission, but many institutions err on the side of caution and recommend N95 masks for prevention of any respiratory transmission.
T40 5208-5586 Sentence denotes A recent study showed simple medical procedure mask use was just as effective as N95 respirator use for influenza prevention in the outpatient healthcare setting.13 While predominant thought is that the coronaviruses are transmitted via droplets (like influenza), the quick spread of this epidemic and contagiousness suggests airborne particles may be more possible (see below).
T41 5588-5601 Sentence denotes 7 Airborne14
T42 5602-5878 Sentence denotes Airborne transmission refers to situations where smaller droplet nuclei or dust particles containing the pathogen can remain suspended in air for long periods of time (2 hours or more), and can travel a much greater distance from the patient, since they stay suspended longer.
T43 5879-5976 Sentence denotes Patients with COVID-19 and other airborne transmissible diseases require negative pressure rooms.
T44 5977-6074 Sentence denotes Other diseases exhibiting airborne transmission include TB, chicken pox (varicella), and measles.
T45 6075-6187 Sentence denotes These diseases are much more transmissible than droplet, and a higher level of respiratory protection is needed.
T46 6188-6315 Sentence denotes NIOSH recommends N95 respirators that have been properly fit-tested for all personnel caring for COVID-19 patients (see below).
T47 6317-6355 Sentence denotes 8 Personal Protective Equipment (PPE)
T48 6357-6373 Sentence denotes 8.1 Respiratory
T49 6374-6476 Sentence denotes N-95 respirators (see Fig 3 & Fig 3a & Fig. 4 15 ) are required for airborne protection from COVID-19.
T50 6477-6673 Sentence denotes Per OSHA regulations, HCW must be properly fit-tested with either a qualitative or quantitative device to ensure the mask makes a proper seal with the wearer's skin and offers adequate protection.
T51 6674-6742 Sentence denotes Users must be clean shaven for mask use as well as for the fit test.
T52 6743-6841 Sentence denotes Numerous brands are available from multiple manufacturers16 (see photos from NIOSH webiste below).
T53 6842-6936 Sentence denotes Users with beards cannot be fit tested with an N95, since an adequate seal is not possible17 .
T54 6937-7135 Sentence denotes HCW with beards can use a powered air-purifying respirator (PAPR) with a hood, since these function without the need for a tight skin seal and therefore also do not require fit testing (see photos).
T55 7136-7187 Sentence denotes Fig. 4 face shield and N95 for airborne protection.
T56 7188-7375 Sentence denotes N95 designation is from NIOSH, meaning it is actually a dust-mist respirator which filters out 95% of small particles, but is not resistant to oil (N= Not; 95= 95% filtration efficiency).
T57 7376-7469 Sentence denotes An R95 has the same filtering capacity but is recommended for oily solvents (R= recommended).
T58 7470-7592 Sentence denotes Higher designations such as P100 mean they filter out 99.99% of particles (P= particles; 100=essentially 100% efficiency).
T59 7593-7802 Sentence denotes Higher levels of protection (i.e., R95, P100) are acceptable if a situation calls for N95 and an N95 is not available, but lower levels of protection (i.e., simple procedure or surgical mask) are not (Fig. 9).
T60 7803-7845 Sentence denotes Some of the styles of N95 masks available:
T61 7846-7900 Sentence denotes Photos courtesy of 3M, Kimberly-Clark, and Moldex 18 .
T62 7901-8033 Sentence denotes Since OSHA declares N95 masks for HCW as respirators, their use is governed by the OSHA Respiratory Protection Standard 1910.13419 .
T63 8034-8142 Sentence denotes Employers must have a program in place with the following components:• Written worksite specific procedures;
T64 8143-8164 Sentence denotes • Program evaluation;
T65 8165-8223 Sentence denotes • Selection of an appropriate respirator approved by NIOSH
T66 8224-8234 Sentence denotes • Training
T67 8235-8248 Sentence denotes • Fit testing
T68 8249-8363 Sentence denotes • Inspection, cleaning, maintenance, and storage (for loose-fitting hoods- N/A to disposable single-use N95 masks)
T69 8364-8385 Sentence denotes • Medical evaluations
T70 8386-8739 Sentence denotes Paragraph 1910.134(e)(2)(i) of the standard explains that the medical evaluations are to be performed by a physician or other licensed health care professional (PLHCP) identified by the employer to perform medical evaluations using a medical questionnaire or an initial medical examination that obtains the same information as the medical questionnaire.
T71 8740-9038 Sentence denotes The employer shall ensure that a follow-up medical examination is provided for an employee who gives a positive response to any question among questions 1 through 8 in Section 2, Part A of Appendix C 20 or whose initial medical examination demonstrates the need for a follow-up medical examination.
T72 9039-9163 Sentence denotes Questions 10-15 and all of part B regarding full-face respirators do not apply to HCW using N95 or loose fitting PAPR hoods.
T73 9164-9442 Sentence denotes Since the N95 respirator is a negative pressure respirator, if the PLHCP finds a medical condition that may place the employee's health at increased risk if the respirator is used, the employer shall provide a PAPR (such as the hood described above and pictured in Fig. 5, Figs.
T74 9443-9456 Sentence denotes 5 and 6 21 ).
T75 9457-9465 Sentence denotes Fig. 5 .
T76 9466-9471 Sentence denotes Figs.
T77 9472-9572 Sentence denotes 5 and 6 PAPR loose fitting hood with HEPA filters (no fit test required; suitable for bearded HCWs).
T78 9573-9836 Sentence denotes Fit testing for the N95 respirators is required, but can be performed qualitatively using isoamyl acetate (banana oi), saccharin solution, or Bitrex© Fig. 4a (see Fig. 4a), or quantitative using an approved device, such as Port-a-Count® (see Fig. 7, Fig. 8 ) 22 .
T79 9837-9954 Sentence denotes The fit test must be performed with exact make, model, and size of respirator the HCW with be using in the workplace.
T80 9955-10153 Sentence denotes Qualitative testing does not compromise the mask integrity and therefore after the test the employee can take the N95 with them for future single use (important consideration in time sof shortages).
T81 10154-10323 Sentence denotes Quantitative fit tests require insertion of a probe through the mask, compromising mask integrity, and therefore the N95 must be discarded after a quantitative fit test.
T82 10324-10611 Sentence denotes Fit testing is not required for loose-fitting PAPR hoods (which are used primarily by HCW with facial hair that does not allow a proper seal), because the breathing zone environment is under positive pressure and therefore a tight seal is not required for proper function and protection.
T83 10612-10657 Sentence denotes Fig. 7 Fit testing N95 mask with PortaCount®.
T84 10658-10706 Sentence denotes Fig. 8 Portacount® quantitative fit test device.
T85 10707-10777 Sentence denotes Fig. 9 Simple procedure mask with integrated face shield (not an N95).
T86 10778-10801 Sentence denotes Used by general public.
T87 10802-10854 Sentence denotes This could be worn on top of N95 for eye protection.
T88 10856-10868 Sentence denotes 9 Contact23
T89 10869-10945 Sentence denotes Contact PPE includes a single pair of disposable patient examination gloves.
T90 10946-11004 Sentence denotes Change gloves if they become torn or heavily contaminated.
T91 11005-11173 Sentence denotes A more conservative approach would include double gloving and frequent changing of outer gloves when soiled or torn, with full removal when at risk tasks are completed.
T92 11174-11227 Sentence denotes In addition, a disposable isolation gown is required.
T93 11228-11551 Sentence denotes Many facilities are using clothing that has a hood integrated into a zip-up gown or full jumpsuit-type clothing, with a face shield worn along with an N95; a procedure or surgical mask that has a built-in face shield could be worn over an N95 for the eye protection if goggles or face shields aren't available (see photos).
T94 11552-11623 Sentence denotes All personnel must be mindful of not touching their face while working.
T95 11624-11845 Sentence denotes Upon completion of patient care activities in the negative pressure respiratory isolation room, clinicians should remove gown first, then mask and face shield, and discard PPE; then remove gloves and perform hand hygiene.
T96 11846-11913 Sentence denotes Used PPE should be discarded in accordance with routine procedures.
T97 11914-12056 Sentence denotes Ancillary personnel (ambulance drivers, medics, and techs/aids who help move patients onto stretchers), should wear all above-recommended PPE.
T98 12057-12247 Sentence denotes After completing patient care/transport duties, and before entering clean areas, personnel should remove and dispose of their PPE and perform hand hygiene to avoid contaminating clean areas.
T99 12248-12665 Sentence denotes In addition to the PPE described above, EMS clinicians should exercise caution if an aerosol-generating procedure, such as bag valve mask (BVM) ventilation, oropharyngeal suctioning, endotracheal intubation, nebulizer treatment, continuous positive airway pressure (CPAP), bi-phasic positive airway pressure (biPAP), or resuscitation involving emergency intubation or cardiopulmonary resuscitation (CPR) is necessary.
T100 12666-12767 Sentence denotes BVMs, and other ventilatory equipment, should be equipped with HEPA filtration to filter expired air.