Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 27 , ISSUE 1 ( January, 2023 ) > List of Articles

Original Article

Fogging of Protective Eyewear in Intensive Care Unit and a Comparative Study of Techniques to Reduce It

Natesh Prabu Ravisankar, Carol Shayne D'Silva, Manu Manjula Krishnappa Gowda Varma, Thomas Isiah Sudarsan, Sriram Sampath, Tinku Thomas, Bhuvana Krishna

Keywords : Fogging, Fogging impairing vision, Protective eyewear, Soap coating

Citation Information : Ravisankar NP, D'Silva CS, Varma MM, Sudarsan TI, Sampath S, Thomas T, Krishna B. Fogging of Protective Eyewear in Intensive Care Unit and a Comparative Study of Techniques to Reduce It. Indian J Crit Care Med 2023; 27 (1):32-37.

DOI: 10.5005/jp-journals-10071-24383

License: CC BY-NC 4.0

Published Online: 31-12-2022

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Background: Fogging of protective eyewear (PEW) can hinder routine work in the intensive care unit (ICU). The prevalence of fogging impairing vision (FIV) and the technique that reduces fogging have not been evaluated previously. Methods: After donning personal protective equipment (PPE) with an N95 mask, the healthcare workers (HCWs) sequentially tried plain PEW, soap-coated PEW, PEW worn at a distance over the PPE hood, and the use of tape over a mask. The vision (distant and near) was checked before wearing PEW and with each technique. The prevalence of fogging and FIV, that is, change in vision in either eye was estimated and compared among various techniques. Mixed-effects logistic regression was used to analyze factors affecting fogging and to compare techniques. Room temperature, room humidity, and lens temperature were measured during the study. Results: A total of 125 HCWs participated (151 observations) and the prevalence of FIV was 66.7%. The fogging of PEW, as well as the extent of PEW fogging, was least with soap coating followed by a mask with tape and goggles worn at a distance. The FIV was significantly lesser only with the mask with tape with an odds ratio (OR) [confidence interval CI)] of 0.45 (0.25–0.82). The prevalence of fogging while at work in the COVID ICU was 38%. Conclusion: The prevalence of FIV is 66%. Application of tape over the mask can avoid disturbances in vision best. Soap coating of the PEW and PEW worn at distance from the eyes are potential alternatives.


PDF Share
  1. Yuli Hu, Lan Wang, Fang Fang. Prevention of fogging of protective eyewear for medical staff during the COVID-19 pandemic. J Emerg Nurs 2020;46(5):564–546. DOI: 10.1016/j.jen.2020.05.003.
  2. Schurr MO, Kunert W, Arezzo A, Buess G. The role and future of endoscopic imaging systems. Endoscopy 1999;31(7):557–562. DOI: 10.1055/s-1999-52.
  3. Malik SS, Malik SS. A simple method to prevent spectacle lenses misting up on wearing a face mask. Ann R Coll Surg Engl 2011;93(2):168. DOI: 10.1308/rcsann.2011.93.2.168b.
  4. Reed MJ. Preventing fogging of spectacles whilst wearing a protective face-mask. J R Coll Surg Edinb 2001;46:377. PMID: 11768580.
  5. Crebolder JM, Sloan RB. Determining the effects of eyewear fogging on visual task performance. Appl Ergon 2004;35(4):371–381. DOI: 10.1016/j.apergo.2004.02.005.
  6. Chainansamit S, Piromchai P, Anantpinijwatna I, Kasemsiri P, Thanaviratananich S. Baby shampoo versus commercial anti-fogging solution to prevent fogging during nasal endoscopy: A randomized double-blinded, matched-pair, equivalent trial. J Med Assoc Thai 2015;98(Suppl. 7):S128–S131.
  7. Piromchai P, Kasemsiri P, Thanaviratananich S. Alternative agents to prevent fogging in head and neck endoscopy. Clin Med Insights Ear Nose Throat 2011;4:1–4. DOI: 10.4137/CMENT.S6597.
  8. Manning TG, Perera M, Christidis D, Kinnear N, McGrath S, O'Beirne R, et al. Visual occlusion during minimally invasive surgery: A contemporary review of methods to reduce laparoscopic and robotic lens fogging and other sources of optical loss. J Endourol 2017;31(4):327–333. DOI: 10.1089/end.2016.0839.
  9. Song T, Lee DH. A randomized Comparison of laparoscopic LEns defogging using Anti-fog solution, waRm saline, and chlorhexidine solution (CLEAR). Surg Endosc 2020;34(2):940–945. DOI: 10.1007/s00464-019-06852-5.
  10. Yao W, Wang T, Jiang B, Gao F, Wang L, Zheng H, et al. Emergency tracheal intubation in 202 patients with COVID-19 in Wuhan, China: Lessons learnt and international expert recommendations. Br J Anaesth 2020;125(1):e28–e37. DOI: 10.1016/j.bja.2020.03.026.
  11. Cook TM, El-Boghdadly K, McGuire B, McNarry AF, Patel A, Higgs A. Consensus guidelines for managing the airway in patients with COVID-19: Guidelines from the Difficult Airway Society, the Association of Anaesthetists the Intensive Care Society, the Faculty of Intensive Care Medicine and the Royal College of Anaesthetist. Anaesthesia 2020;75(6):785–799. DOI: 10.1111/anae.15054.
  12. Mansour E, Vishinkin R, Rihet S, Saliba W, Fish F, Sarfati P, et al. Measurement of temperature and relative humidity in exhaled breath. Sens Actuators B Chem 2020;304:127371. DOI: 10.1016/j.snb.2019.127371.
  13. Madan M, Malhotra N, Gupta N, Ish S, Ish P. Fogging of goggles in PPE during COVID-19 pandemic. A practical problem with multiple possible solutions. 2020;88(6):636–637. DOI: 10.5603/ARM.a2020.0164.
  14. Palvia V, Gonzalez AJH, Vigh RS, Anasti JN. A randomized controlled trial comparing laparoscopic lens defogging techniques through simulation model. Gynecol Minim Invasive Ther 2018;7(4):156–160. DOI: 10.4103/GMIT.GMIT_39_18.
  15. Bhardwaj A, Sharma C, A Rajan MB. Simple solutions for the fogging of spectacles when wearing surgical masks. J Am Acad Dermatol 2021;85(4):e237–e238. DOI: 10.1016/j.jaad.2020.08.041.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.