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Disposable filtering face piece respirators (FFRs) are usually not approved for routine practice of decontamination and reuse. However, such practice of decontamination and reuse may be needed only as a crisis capacity strategy to ensure continued availability. The current severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic would help us enlighten about more effective and efficient ways of decontamination and reuse. Based on the limited research available, ultraviolet irradiation, vapors of hydrogen peroxide, and moist heat showed the most promising potential methods to decontaminate FFRs. This article summarizes available research about decontamination of FFRs before reuse. [ABSTRACT FROM AUTHOR]

Medical device reuse has been accepted worldwide. Reuse benefits are not only cost-saving but also have a positive effect on the environment. On the other hand, it is necessary to meet certain requirements for considering reprocess to be harmless and efficient. The technique of reprocessing single-use medical devices was simplified and well regulated in the United States and Japan. However, this pattern continues unhindered in India because of irregularity of regulations. This study covers the history of reuse policy, known activities in the Indian and foreign contexts and also discusses the social and monetary consequences of reprocessing. The triggers for recycling are limited resources, poor training of healthcare workers and patients' confidence in the efficacy of injections. Among developed countries, the reuse of single-use products is less common, but may require sophisticated technological equipment. Reuse is restricted in many nations (e.g., the U.S., Canada, and some European countries) requiring ethical and legal requirements, high standards of personnel reprocessing and preparation, risk evaluation, monitoring, and confirmation of reprocessing. Decisions on the reprocessing of single-use products should only be taken in developing and developed nations after serious consideration of their benefits and drawbacks. The present study highlights the importance of reprocessing, provides information about the regulatory requirements in emerging and developed countries, and emphasizes the necessity of reprocessing in India. [ABSTRACT FROM AUTHOR]

Background  Neurological patients who are ventilator-dependent occupy scarce beds in the hospitals for prolonged periods of time. Most, if not all, can be discharged on home mechanical ventilation (HMV). However, due to lack of insurance and state support, it remains prohibitively expensive for the vast majority of those who require it most. Materials and Methods  The authors discuss three patients admitted in the Department of Neurosurgery between January and August 2019, who were discharged on HMV after remaining on ventilator support for prolonged period in the hospital. Each patient was discharged with two units (one as standby) of AgVa home ventilator (AgVa Healthcare; New Delhi, India), one Ambu-bag, one pulse oximeter, and one backup power supply unit capable of supplying power to ventilator for a minimum of 24 hours. All the equipment were given free-of-cost through donations by hospital staffs and other donors. All patients were followed up telephonically from their homes and the incidence of complications, ventilator malfunction, and additional cost of HMV on the families were ascertained. Observation and Results  Of the three patients, two were male and one female. Age ranged from 12 to 17 years. The duration of in-hospital ventilator support prior to discharge on HMV varied from 1 to 5 years. There was no insurance cover available for any of the patients with all expenses being "out of pocket." The equipment cost Indian Rupees (INR) 115,700 (USD 1,615: two units of AgVa home ventilator costing INR 100,000 [USD 1,396], one Ambu-bag costing INR 1,100 [USD 15], one pulse oximeter costing INR 1,600 [USD 22], and one backup power supply unit costing INR 13,000 [USD 182]). Discharge on HMV was planned on specific request from patients' families and informed consent was taken from all. All patients had tracheostomies. Mode of HMV was pressure support ventilation in all. Telephonic follow-up ranged from 1 to 7 months. The cost of disposables was INR 100 per month (USD 0.7) for all the patients. No complications occurred in any patient. There was no incidence of ventilator-associated pneumonia (VAP) or ventilator malfunction. Conclusions  Availability of cost-effective indigenous ventilator like AgVa home has made HMV possible, even for poor patients with neurological diseases, and has the potential to improve quality of life, decrease VAP rates, and free up scarce ventilator beds in hospitals. Longer-term follow-up in larger number of patients will improve the data on safety and feasibility in developing countries like India. [ABSTRACT FROM AUTHOR]