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Answers to queries remained unanswered

1. AHU should be used or not for 'query covid patients' and for covid positive patients?

2. What about split AC in the OT?

3. What about laminar flow with HEPA filters?

Answers by Abhay Gahukamble - Faculty from CMC -Vellore

1. AHUs should not be used for Covid positive patients and better to have the same protocol for suspects also. The AHUs produce a positive pressure so they will pump the aerosols and viruses outside the OT also. That is the basis of the recommendation.

2. Split AC is the lesser evil. Ideal not to use but in PPE it is very hot. We had a ObG doctor and a nurse faint before we restarted using split ACs.

3. Laminar flow if not ideal will produce turbulence in the theatre. This circulates the aerosols further in the theatre. They call it Viral wind tunnel. In most of our setups, the laminar flow is not ideal- the door may be opened on and off, the vents may be partially obstructed by trolleys or mayo stand etc so better to avoid. The Hepa filters are at the exhaust level so it does not help with what happens in the theatre per se.

Our surgical teams are doing a study on aerosol generation and infectivity in COVID. Hopefully the findings, when they come, will give us more evidence for recommendations.