IFMBE CED & WHO

Call for Action, Update 7 May 2020

Situation
In response to the quest for reliable and timely information regarding healthcare technology challenges during these abnormal times, we are initiating twice
weekly topic based COVID19 Critical Issue virtual townhall broadcasts. Their purpose is to provide a virtual meeting hall for identifying solutions, proven
methodologies, and answers on subjects of importance for clinical engineers, biomedical engineers, technologists, technicians, HTM managers, and other
stakeholders facing challenging situations where wider knowledge and expertise from successfully implemented solutions (success stories) can help others. Both
those who are willing to share their expertise and those who are facing challenges are invited to join the townhalls.

WHO’s Adriana Velazquez has requested that CED host these broadcasts on Tuesdays and Fridays from 2:00-3:00 pm Geneva time (8 am New
York time).  Adriana suggests this timing to allow CE-HTM colleagues from all over the world and particularly Low to Middle Income Countries (LMIC) -
https://data.worldbank.org/income-level/low-and-middle-income - to join.

Content
Each broadcast, lasting 60 minutes, will be moderated by experts that will provide:
(1) Opportunity to hear your issue/opinion
(2) Engagement of topic-specific experts
(3) Targeted localities and their representation
(4) Encouraged discussion
(5) Discuss and search for recommendations

We are looking for topic-specific and for regional representatives to lead one of these sessions. We encourage you to participate in this WHO-response initiative
and solidify your region participation and voicing your needs. Please response by the end of first week of May with your contact information, affiliation, and
subject area expertise.
Broadcast structure
 Session chair, co-chair and one country presenter will be selected for each 1-hour session, see the table below.
 The session schedule as follows: (1) WHO Introduction (5-10 minutes); (2) Country perspective from LMIC (1 person re key challenges or solutions, 5-10
minutes); (3) Q&A with all attenders (30 minutes); (4) Conclusions and Next Steps (10 minutes)
 All are requested to fill out the following draft Session schedule, eg, volunteer where you think you can help the most, as appropriate.
Topics for Oxygen Systems discussion:
1. Supply of necessary equipment and accessories, as well as operation and support
2. Availability of support/maintenance materials, eg, Operator and Service Manuals in correct language
a. Related donation issues, language, accessories, etc.
3. Training for operation and support
4. Coordination of various activities at care delivery and national levels
5. Systems approach and safety management for all of the above
a. Oxygen concentrators performance, flow, purity
Topics for Masks, Respirators (N95 masks), and Face Shields = PPE
1. Supply of necessary PPE
a. Evidence based performance of PPE
b. Ensure quality of products
c. Some innovations
d. Definitions: An N95 ‘respirator’ is a masklike device, usually of gauze, worn over the mouth, or nose and mouth, to prevent the inhalation of noxious substances or the like. Health professionals wear respirators to filter out virus
particles as they breathe in so they don't get infected with COVID-19 while helping people and patients. Not the historical medical device called ‘respirator’ that is/was generally a lower-technology Ventilator.
2. Reprocessing of single use PPE
a. Safety from UV radiation for healthcare workers
3. Proper use and training
4. Coordination of various activities at care delivery and national levels
a. Inventory control, who is getting what, eg distribution
b. Waste management of used PPE, how to identify what was reprocessed how many times
5. Systems approach and safety management for all of the above
a. Efficacy (quality) and impact of fitting procedures on healthcare workers

Draft list of CPAP/BIPAP topics

1. Supply WHO list of Critical equipment, accessories for CPAP/BIPAP – sent out the day ahead
a. Devices
b. Oxygen supply
c. Accessories – filters, etc.
d. Oxygen Concentrators not always usable for these procedures
e. Use of pressurized air instead of Oxygen … Farid … particularly for low resource settings
f. other
2. Clinical picture
 From context of Paris Hospital large department
 Physiopathology chronology … patient history and continuum of care
o Timetable of patient episodically
o Treat by …

Pressure and oxygen to help lung function 2-3 days

Simple CPAP … published results … CPAP accessories

Measure O2 flow and saturation

Need pressurized air, electricity
 Want to avoid Ventilation if possible … patient intubated and (mechanical) ventilation, oxygenated
o Edema and other complications
3. Proper training
a. Nurses typically unused to CPAP procedures
i. or how widely the procedure is utilized outside of ICU on general patient floors
ii. Simple to install and train
b. Maintenance requirements of CPAP are minimal
4. Coordination of relevant activities at care delivery and national levels
5. Systems approach
a. Disinfection procedures to avoid passing virus
i. simple to assemble and operate
b. Not high-flow system
Proposed
1
Date Topic Chair / 2Co-Chair WHO Presenter(s) Country Presenter (from LMIC)
1
Tuesday, May 5 Oxygen Systems Mohammad Ameel (NHSRC, India), Adriana Velazquez & Alexandra Ashenafi Hussein (CE, Ethiopia) on behalf of WGAA
2
Anwar Hossain (MOH Bangladesh) Velez (Africa) 
Tom Judd, Dr. Yadin David, and Dr. Elliot Sloane on Panel

1
Friday, May 8 Masks, Respirators Leandro Pecchia (UK/Italy)  Adriana Velazquez & Ying Ling Lin Dr. Oluwatoyin Popoola & Dr. Stephen Akinloye (BME
2 Professors, University of Lagos, Nigeria)
Busola Oronti (UK/Nigeria)
(N95 masks), and
Face Shields Tom Judd and Dr. Yadin David on Panel

1
Tuesday, May CPAP/BIPAP Abderrahim (Farid) Benhagoug & Joel Delode, AFIB (France) = Adriana Velazquez & Alexandra Professor Gilles D’honneur (Intensivist, France, Paris,
12 Co-Chairs; Velez Cancer Curie Hospitals Group), Pascal Soreye (BME, Benin)
Cathy Blanc-Gonnet (HUMATEM, France) on Townhall Panel with
Tom Judd and Dr. Yadin David
1
Friday, May 15 Pulse Oximetry Tobey Clark (USA) Adriana Velazquez & Alexandra
Velez
1
Tuesday, May Ventilators Baset Khalaf (Canada/South Africa), 2Jennifer Jackson Adriana Velazquez & Alexandra Tom Larkin (CE, Ireland) 
19 (USA, Masimo) Velez

Friday, May 22 Decontamination &  

Reuse of PPE &
equipment accessories

Tuesday, May Gowns & Coveralls    

26
Friday, May 29 Sterilizers    

References: