key: cord-0755440-h3a3uvnr
authors: Higashimori, Akira; Maruyama, Hirotsugu; Nadatani, Yuji; Fujiwara, Yasuhiro
title: The “New Normal” Following the COVID-19 Pandemic: A Simple Infection-Prevention Measure Using a Surgical Mask during Transnasal Endoscopy
date: 2021-03-03
journal: Clin Endosc
DOI: 10.5946/ce.2020.291
sha: a1ce570c673fea57e594e1fc20d182582487251e
doc_id: 755440
cord_uid: h3a3uvnr

nan

The Coronavirus-19 (COVID-19) pandemic continues to accelerate worldwide. 1 Since endoscopy may pose a risk for transmission, there is a medical need to establish a "new normal" for endoscopic procedures that reduce the risk. Although we previously reported a technique to prevent infection during endoscopy, it did not completely block leakage of aerosol droplets through the hole in a modified mask. 2 Hence, we propose a safer method using a transnasal endoscope ( Following the procedure performed without a surgical mask, the dye was found on the endoscopist's gloves, upper chest, abdomen, and shoe covers ( Fig. 2A) , and floor contamination of up to approximately 1.5 m away from the bed was observed. When transnasal endoscopy was performed with a surgical mask, the simulated cough contaminated only the inner surface of the mask (Fig. 3) , with no detectable dye deposits on the endoscopist (Fig. 2B) or the floor. For clinical validation, 732 patients underwent screening transnasal endoscopy while wearing a mask. During those procedures, vital signs were unaffected and no problems were encountered.

This new and safer method completely covered the examinee's mouth with a surgical mask and prevented the spread of aerosol droplets. Transnasal endoscopy is well tolerated, and is also a valuable diagnostic tool. Furthermore, transnasal endoscopy can reduce pharyngeal stimulation, resulting in less coughing and reduction of the vomiting reflex than occurs during per-oral endoscopy. Therefore, we propose the 

adoption of this method as the "new normal" for endoscopy following the COVID-19 pandemic.

The authors have no potential conflicts of interest.

None.

Geneva: WHO; c2020

Coronavirus disease outbreak: a simple infection prevention measure using a surgical mask during endoscopy

Barrier enclosure during endotracheal intubation

Flow dynamics and characterization of a cough

Endoscopic shield: barrier enclosure during the endoscopy to prevent aerosol droplets during the COVID-19 pandemic