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Use of nebulizers may increase the risk of spread of Coronavirus infection

Use of nebulizers may increase the risk of spread of Coronavirus infection

Last Reviewed : 12/16/2020
Use of nebulizers may increase the risk of spread of Coronavirus infection

When we cough or sneeze several droplets are expelled out of our respiratory tract. Sneezing creates more droplets than coughing given the force generated by sneezing. Depending on the size of these particles, Infectious Disease Society of America (IDSA) classifies them as ‘respirable particles’ if they are smaller than 10 microns, ‘inspirable particles’ if they are above 10 microns. The smaller respirable particles can go through our nose, throat and straight into the lungs. The larger inspirable particles usually reach our nose and sinuses but do not reach our lungs. When we cough or sneeze, almost all the expelled particles are larger inspirable particles, very few smaller respirable particles are expelled out.

Based on the study published in the New England Journal of Medicine, small aerosols may last in the air for around three hours. In a hospital setting, during certain procedures like intubation, bronchoscopy, airway suctioning or when patients are on BIPAP, CPAP, high-flow nasal cannula or when nebulizations are administered, more smaller respirable particles are generated. During these procedures and treatments, Coronavirus can spread through air. It is imperative to wear N95 respirator masks to prevent airborne spread. In the hospitals, use of nebulizations is minimized to a large extent to reduce the spread of the disease.

In a community setting, if the infected person uses a CPAP machine or a nebulizer at home, they should be under strict quarantine with closed doors. If any healthy individual walks into the quarantine room when the infected person is on CPAP machine or using a nebulizer, it is advisable to wear an N95 respirator mask. As smaller aerosols may last up to three hours in the air after nebulizations are used, N95 respirator mask may need to be used if entering the room during this period.

 

References:

Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. Van Doremalen et al. N Engl J Med. https://doi.org/10.1056/NEJMc2004973

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