COVID-19対策における気管挿管時の陰圧・高性能フィルタ付き挿管ボックスの開発

Ancillary protective gears in the COVID- 19 Era.

<p>Although great strides have been made to tackle hospital-acquired pressure ulcers (HAPUs), there is a need for greater recognition of device-related pressure ulcers (DRPUs), including their causes, management and prevention. This consensus statement, an updated second edition, aims to continue raising awareness of these largely preventable injuries and, crucially, to stimulate action. DRPUs are relatively common and account for a growing proportion of HAPUs. Updated information on the incidence of DRPUs is described in chapter 1. Although it is recognised that DRPUs increase the financial burden of healthcare, there is little formal analysis of their economic impact. This needs to be addressed; robust evidence on the burden of DRPUs and the value that can be released by adopting prevention strategies is needed to help drive action. Our understanding of the pathophysiology of DRPUs has improved significantly over the past few years; this is described in chapter 2. One crucial difference between PUs and DRPUs is that body-weight forces are less significant in DRPUs, with the force being exerted from a device that is typically strapped or taped onto the body. Devices and their securement may generate high stress concentrations in tissues, leading to cell and tissue-damage pathways associated with sustained deformation. As more evidence is published on DRPUs, recurring themes are emerging, as outlined in chapter 3: The most vulnerable patients are bearing the brunt of DRPUs; paediatric and neonatal patients, and all those needing critical care are particularly susceptible. During the COVID-19 pandemic, a new high-risk population (people with severe COVID-19 infection) emerged. They are at increased risk of DRPUs because of their need for prolonged ventilatory support, especially when 'proning' Devices associated with DRPUs are often used to perform essential, life-saving functions. They include continuous positive airway pressure (CPAP) masks or endotracheal tubes. Minimising their use is clearly not an option, so practice innovation is needed Although the most common locations for DRPUs are the face, ears, lower legs and heels, any location where a device comes into close contact with the skin can be at risk. In the same vein, any device, whether needed for a medical purpose or not, has the capacity to cause injury if its use is not properly managed. Vigilance is needed for all patients. What can be done? The importance of routine risk assessment is covered in chapter 4. Although use of a validated risk assessment tool is the vital first step, this will not be enough on its own. Several steps can be taken to ensure the safe use of devices. These are described in chapter 5 and include device repositioning, cushioning with prophylactic dressings and moisture control (only where possible and clinically appropriate). Of key importance is the development of an institutional protocol and champions to ensure all necessary steps are adopted. For any of these changes to be put into practice, awareness of DRPUs needs to increase. A number of proposals are outlined in chapter 6. A change of focus among health professionals and policy makers, along with more investment in education and training, are needed. All patients being managed with a medical device must be considered as at high risk. The pandemic introduced the world to the problem of DRPUs in health professionals caused by the extended wear of personal protective equipment. Health professionals also have a right to expect institutional protocols and provision of devices that protect them from DRPUs. Cutting-edge ideas and technologies that may be available in the future are described in chapter 7. When designing new products, manufacturers of medical devices have a duty of care to investigate the risks of DRPUs associated with their products and mitigate them, wherever possible. Our developing understanding of how the design, structure and materials used in medical devices contribute to DRPUs will help us develop new solutions for tomorrow. The first step is for everyone involved to ask themselves, 'what can I do to help?' There is work to be done-your journey to reduce DRPUs starts here!.</p>

Objective:Intubation is a highly aerosol-generating procedure. Recent airway management guidelines advocate the use of appropriate personal protective equipment, videolaryngoscope, and “intubation box” while intubating a suspected or infected coronavirus patient. We undertook a study to compare C-MAC videolaryngoscope with McGrath videolaryngoscope for tracheal intubation using an intubation box by donned anaesthesiologists.Methods:The patients were randomly allocated to 2 groups by computer-generated random numbers, depending upon the videolaryngoscope used. In group C, C-MAC videolaryngoscope (n = 30) was used, whereas McGrath videolaryngoscope was used in group M (n = 30). The primary outcome was the total time required for successful intubation. The secondary outcomes included the number of attempts required, Cormack and Lehane grade, the percentage of glottis opening score, the difficulty faced while using the device, and the user’s preference.Results:The time to intubation was 57.17 ± 19.98 seconds with C-MAC videolaryngoscope as compared to 57.93 ± 14.92 seconds with McGrath. Both the devices had a good percentage of glottis opening score. Twelve patients in each group were found to have a Cormack and Lehane grade of 1. The time to glottis visualization was more with McGrath than with C-MAC although not significant (23.8 ± 14.03 vs 20.10 ± 10.78 seconds). Both the devices were easy to use.Conclusions:Both C-MAC and McGrath videolaryngoscopes are equally effective devices for intubation by a donned anaesthesiologist using an intubation box. McGrath with a disposable blade should be preferred for intubation in these conditions.

Out-of-hospital traumatic cardiac arrest (TCA) often has a poor prognosis despite rescue efforts. Although the incidence and mortality of out-of-hospital cardiac arrest have increased, bystander cardiopulmonary resuscitation (CPR) has decreased in some countries during the COVID-19 pandemic. In the prehospital setting, immediate treatment of cardiac arrest is required without knowing the patient's COVID-19 status. Because COVID-19 is usually transmitted through the respiratory tract, airway management can put medical personnel at risk for infection. This study explored whether on-scene treatments involving CPR for TCA patients changed during the COVID-19 pandemic in Korea. This retrospective study used data from emergency medical services (EMS) run sheets in Gangwon Province from January 2019 to December 2021. Patients whose initial problem was cardiac arrest and who received CPR were included. Data in 2019 were classified as pre-COVID-19 and all subsequent data (from 2020 and 2021) as post-COVID-19. Age, sex, possible cause of cardiac arrest, and treatments including airway maneuvers, oropharyngeal airway (OPA) or i-gel insertion, endotracheal intubation (ETI), bag-valve mask (BVM) ventilation, intravenous (IV) line establishment, neck collar application, and wound dressing with hemostasis were investigated. During the study period, 2,007 patients received CPR, of whom 596 patients had TCA and 367 had disease-origin cardiac arrest (DCA). Among the patients with TCA, 192 (32.2%) were pre-COVID-19 and 404 (67.8%) were post-COVID-19. In the TCA group, prehospital treatments did not decrease. The average frequencies were 59.7% for airway maneuvers, 47.5% for OPA, 57.4% for BVM, and 51.3% for neck collar application. The rates of ETI, i-gel insertion, and IV-line establishment increased. The treatment rate for TCA was significantly higher than that for DCA. Prehospital treatments by EMS workers for patients with TCA did not decrease during the COVID-19 pandemic. Instead, the rates of ETI, i-gel insertion, and IV-line establishment increased.

IntroductionCovid 19 epidemic has affected the people making them undergo emergency procedures requiring intubation. A protective box was innovated at our tertiary care centre to safeguard the HCW during intubation and/or extubation and the study was planned to assess its use and safety among the anaesthesiologists.MethodsA cross sectional, questionnaire base survey was done among anaesthesiologists in various strata of residency. The intubation box was used on the patient for intubation and extubation. The experience of participants was recorded via a Google Form and one response per participant was restricted. Participants were divided into two groups, Group 1(1stand 2nd year junior residents) and Group 2 (Senior resident and 3rd year junior resident). A valid response, was received from 25 anaesthesiologists who were either performing or assisting the intubation. The residents were evaluated based on the ease of use and safety features of the box.ResultsThere was a significant difference in the time taken to intubate between the two groups (p = 0.048) and it was found that Group 2 with more experience took less time to intubate than Group 1. Also, more respondents in Group 2 found it easier to manoeuvre the hands to handle instruments than Group 1(p = 0.024).ConclusionWe recommend that usage of intubation box during intubation or extubation is a non-harmful and necessary compromise that we must make to protect the /safeguard the well-being of Health Care Worker without affecting patient care in our fight with COVID-19.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12070-023-03692-7.

Acute lung injury resulting from SARS-CoV-2 infection has led to high number of prolonged invasive mechanical ventilation. Role and timing of tracheostomy for patients requiring critical care for coronavirus disease 2019 (COVID 19) remains unclear. So far, published data on early versus late tracheostomy are conflicting. Actual recommendations suggest that this procedure should be considered in patients with COVID 19 when mechanical ventilation is anticipated to be over 10-15 days.1 Tracheostomy is a highly aerosol generating procedure and exposes healthcare providers to viral contamination via air droplets.2 Recommendations have been suggested for safe surgical tracheostomy during COVID-19 pandemic by several societies.3-6 In order to ensure maximal protection to staff performing the procedure, full personal protective equipment (PPE) is strongly recommended.7 This includes N95 mask, goggles or face shiels, surgical gown and gloves. The use of such equipment may affect communication, visibility and other non-technical skills.8 However, it remains essential to prevent healthcare workers contamination. In addition to PPE, tracheostomy should be performed in a negative-pressure room. Utilisation of techniques which minimise aerosolisation is recommended when performing tracheostomy. We describe a tracheostomy technique for patients requiring prolonged mechanical ventilation. We aim to minimise aerosol contamination, using flow-controlled ventilation (FCV) provided by a new ventilator, the Evone® (Ventinova medical BV), through a specifically designed cuffed endotracheal tube, the Tritube® (Ventinova Medical BV).9 FCV system is designed to maintain constant flow during inspiration and expiration. The main specificity of this ventilator is that it provides active expiration. Tritube® is a 40-cm-long, narrow-bore tube (outer diameter = 4.4 mm) with three independent lumens for, respectively, pressure measurement, ventilation and cuff inflation. Patient, already intubated and sedated, is anesthetised and a deep neuromuscular block is ensured. Once ventilation and fresh gas flow are stopped at end expiration, the endotracheal tube (ETT) is cut at its proximal end. This allows easier insertion of the Tritube® through the standard ETT at the desired depth. After checking both tubes’ length markings, the Tritube® is introduced into the ETT and is pushed down as caudally as possible into the trachea, in order to protrude the distal end of the ETT. Tritube® cuff is inflated. Ventilation with Evone® FCV system through Tritube® can then be started. (Figure 1). ETT cuff can be deflated safely and lifted above the vocal cords to allow a good working space for the surgeon. (Figure 2). Trachea is opened by the surgeon without risk of aerosolisation, as Tritube® cuff is inflated and isolates the ventilated lower airways. The small diameter of the Tritube® allows the tracheal cannula to be inserted while the Tritube® is still in place. Cannula's cuff can be inflated and patient is ventilated through the cannula with conventional ventilator. (Figure 3). After deflating its cuff, Tritube® can be removed with the ETT around it. Tritube® passes easily beside the inflated tracheostomy cannula cuff. (Figure 4). Safety profile and effectiveness of FCV with Evone® system and Tritube® has been demonstrated by Meulemans and coll. No adverse effects had been described.9, 10 The technique we suggest has many advantages. First, it decreases dramatically the aerosolisation of viral particles during the tracheostomy as closed system of ventilation is provided during the entire surgical procedure. Second, apnoea time is decreased as patient is ventilated even during cannula insertion. This allows safe conduction of tracheostomy in very hypoxic patient. Third, this technique could also be performed for percutaneous tracheostomy as it allows safe fiberoscopic visualisation during critical moments. Tritube® diameter allows easy fiberoscopy while Evone® insures ventilation with minimal aerosolisation. The main goal of this letter was to present a safe tracheostomy technique protecting healthcare providers from aerosolisation during COVID-19 pandemic. Further studies should be conducted regarding the use of FCV with Tritube® as a protective tool in ENT surgery for operating room teams. Illustrations realised by Wag Design and Communications. The authors declare no competing interests. Support was provided solely from institutional and departmental sources. Not applicable.

ObjectiveTo compare and analyze the differences in the sociodemographic and clinical characteristics of suicide attempters who visited an emergency department (ED) before and during the coronavirus disease (COVID-19) pandemic.MethodsThis single center, retrospective study was conducted by reviewing the medical records of patients in the “self-injury/suicide” category of the National Emergency Department Information System who visited an ED between January 2019 and December 2020. We obtained information on baseline characteristics, suicide attempt, and disposition. Data were analyzed using the chi-squared test.ResultsA total of 456 patients were included. The number of patients visiting the ED for suicide attempts increased by 18.2% (from 209 to 247 cases) during the COVID-19 pandemic, and the ratio of suicide attempters to the total number of ED visits increased by 48.8% (from 0.43% to 0.64%, P<0.001). There were significant differences in methods of suicide attempt, endotracheal intubation, ED disposition, and the presence of mental illness. Drug overdose (42.1% vs. 53.4%) and gas inhalation (5.7% vs. 8.5%) increased, and hanging decreased (6.0% vs. 2.0%) during the pandemic. Endotracheal intubation (13.9% vs. 5.7%) and intensive care unit admission (29.7% vs. 14.6%) decreased. More patients with the history of mental illness visited during the pandemic (54.0% vs. 70.1%).ConclusionSince the COVID-19 pandemic began, suicide attempts have increased in this single ED although the lethality of those attempts is low.

In this paper, we reviewed the Fourth Industrial Revolution (4IR) technologies applied to waves of the coronavirus disease (COVID-19). COVID-19 is an existential threat that has resulted in an unprecedented loss of lives, disruption of flight schedules, shutdown of businesses and much more. Though several researchers have highlighted the enormous benefits of 4IR technologies in containing the COVID-19 pandemic, the recent waves of the pandemic call for a thorough review of these technological interventions. The cyber-physical space has had its share of the COVID-19 pandemic effect, and through this review, we highlight the salient issues to help policy formulation towards managing the impact of subsequent COVID-19 waves within such environments. Hence, the purpose of this paper is to review the application of 4IR technologies during the COVID-19 pandemic waves and to highlight their shortcomings. Recent research articles were sourced from an online repository and thoroughly reviewed to highlight 4IR technology applications, innovations, shortcomings and multi-sector challenges. The outcome of this review indicates that the second wave of the pandemic resulted in a lower proportion of patients requiring invasive mechanical ventilation and a lower rate of thrombotic events. In addition, it was revealed that the delay between ICU admissions and tracheal intubation was longer in the second wave in the health care sector. Again, the review suggests that 4IR technologies have been utilized across all the sectors including education, businesses, society, manufacturing, healthcare, agriculture and mining. Businesses have revised their service delivery models to include 4IR technologies and avoid physical contacts. In society, digital certificates, among other digital platforms, have been utilized to assist with the movements of persons who have been vaccinated. Manufacturing concerns have also utilized robots in manufacturing to reduce human-to-human physical contact. The mining sector has automated their work processes, utilising smart boots to prevent infection, smart health bands and smart disinfection tunnels or walkthrough sanitization gates in the mining work environment. However, the identified challenges of implementing 4IR technologies include low-skilled workers, data privacy issues, data analysis poverty, data management issues and many more. The boom in 4IR technologies calls for intense legislation on sweeping data privacy for regulated tech companies. These findings hold salient implications for policy formulation towards tackling future pandemic outbreaks.

The COVID-19 pandemic has resulted in the exposure of many surgeons and healthcare providers (HCPs) to disease given high patient loads and limited availability of negative pressure rooms. For these reasons we pursued the development of a portable patient isolation system (COVIAGE™ by iSolace, Inc.) that can be used to contain patients with respiratory illness and minimize the exposure of HCPs. COVIAGE™ is comprised of a reusable aluminum frame, a disposable thermoplastic polyurethane tent and a HEPA filtration/ventilation system (HVAC) utilizing two inline filters. The efficacy of filtration was tested by comparing particulate concentration inside and outside of the device by an independent third party. Additionally, physician, nursing, and respiratory tasks were performed initially on simulated patients and then on intubated patients in the ICU. The system attained a verified filtration efficiency greater than 99.999% for an average 0.3-μm size particulates. Simulation testing revealed that most common physician, nursing, and respiratory tasks could be completed in the device, including endotracheal intubation. Emergency removal of the device can be accomplished in 8.8 ± 2.8seconds. The reusable aluminum frame allows for simple attachment to the bed, and adaptability to different types and sizes of beds/stretchers. An emergency use authorization was granted by the FDA. The device created results in a portable negative pressure isolation system that can be placed over the patient's bed to contain aerosols during high aerosol generating procedures, transportation of patients or for total patient care in environments where negative pressure rooms are not available.

BACKGROUNDThe COVID-19 pandemic has revealed deficiencies in the adequacy of personal protective equipment (PPE) for healthcare workers. Endoscopic endonasal skull base surgery is thought to be among the highest-risk aerosol-generating procedures for surgeons and operating room personnel.OBJECTIVETo validate the efficacy and clinical feasibility of a novel surgical device.METHODSA low-cost, modifiable, and easily producible negative pressure, face-mounted antechamber was developed utilizing 3D printing and silicone molding. Efficacy was evaluated using an optical particle sizer to quantify aerosols generated during both cadaver and intraoperative human use with high-speed drilling.RESULTSParticle counts in the cadaver showed that drilling led to a 2.49-fold increase in particles 0.3 to 5 μm (P = .001) and that the chamber was effective at reducing particles to levels not significantly different than baseline. In humans, drilling led to a 37-fold increase in particles 0.3 to 5 μm (P < .001), and the chamber was effective at reducing particles to a level not significantly different than baseline. Use of the antechamber in 6 complex cases did not interfere with the ability to perform surgery. Patients did not report any facial discomfort after surgery related to antechamber use.CONCLUSIONThe use of a negative pressure facial antechamber can effectively reduce aerosolization from endoscopic drilling without disturbing the flow of the operation. The antechamber, in conjunction with appropriate PPE, will be useful during the COVID-19 pandemic, as well as during flu season and any future viral outbreaks.

RATIONALE During the COVID-19 pandemic, creating tools to assess disease severity is one of the most important aspects of reducing the burden on emergency departments. Lung ultrasound has a high accuracy for the diagnosis of pulmonary diseases;however, there are few prospective studies demonstrating that lung ultrasound can predict outcomes in COVID-19 patients. We hypothesized that lung ultrasound score (LUS) at hospital admission could predict outcomes of COVID-19 patients. METHODS This is a prospective cohort study conducted from 14 March through 6 May 2020 in the emergency department (ED) of an urban, academic, level I trauma center. Patients aged 18 years and older and admitted to the ED with confirmed COVID-19 were considered eligible. Emergency physicians performed lung ultrasounds and calculated LUS, which was tested for correlation with outcomes. This protocol was approved by the local Ethics Committee number 3.990.817 (CAAE: 30417520.0.0000.0068). RESULTS The primary endpoint was death from any cause. The secondary endpoints were ICU admission and endotracheal intubation for respiratory failure. Among 180 patients with confirmed COVID-19 who were enrolled (mean age, 60 years;105 male), the average LUS was 18.7 ± 6.8. LUS correlated with findings from chest CT and could predict the estimated extent of parenchymal involvement (mean LUS with 50% involvement, p<0.001), death (AUC 0.72, OR 1.13, 95% CI 1.07 to 1.21;p < 0.001), endotracheal intubation (AUC 0.76, OR 1.17, 95% CI 1.09 to 1.26;p < 0.001), and ICU admission (AUC: 0.71, OR 1.14, 95% CI 1.07 to 1.21;p < 0.001). CONCLUSION In this study, LUS was a good predictor of death, ICU admission, and endotracheal intubation in patients with COVID-19 admitted in ED. The study provides support for further research, ideally combining clinical, laboratory, and imaging parameters, to estimate the risk of poor outcomes from COVID-19 infection.

I sincerely thank the authors for describing an experienced-based technique to support the safe tracheal intubation of patients with suspected or confirmed coronavirus disease (COVID-19).1 Their suggestion to use a delayed sequence technique in selected patients is a valuable addition to the “Recommendations for endotracheal intubation of COVID-19 patients.”2 Specifically, they suggest that agitated and uncooperative patients be sedated with ketamine during the preoxygenation phase, to gain their cooperation while minimizing the risk of respiratory depression and cardiovascular instability. The authors describe a difficult and high-stakes scenario. An agitated and uncooperative patient with COVID-19 represents a considerable safety risk to the airway management team. Dislodgement of or damage to personal protective equipment can expose health care providers to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus. In addition, movement of glasses, goggles, or a face shield can lead to fogging or an obstructed view, which makes tracheal intubation more difficult. Thus, it may be desirable to optimize conditions by sedating certain patients before tracheal intubation. Additional suggestions from others include using a 2-handed technique with the hands in the VE position when using a self-inflating bag-valve-mask device during preoxygenation,3 cross-checking team members’ personal protective equipment (particularly when managing agitated patients), having all needed materials prepared in advance, and knowing the patients’ code status.4 I applaud the authors and others for sharing their lived experiences as we learn together to support patients and each other during the COVID-19 pandemic. Beverley A. Orser, MD, PhDDepartments of Anesthesiology and Pain Medicine and PhysiologyUniversity of TorontoToronto, Ontario, CanadaDepartment of AnesthesiaSunnybrook Health Sciences CentreToronto, Ontario, Canada[email protected]

Amb les transformacions de la societat postfordista i la progressiva retirada dels estats de Benestar, emergeixen per una part, noves modalitats de transicions juvenils de bloqueig i precarietat, aixi com noves formes de marginalitat urbana per efecte de tres components; l’extensio de l’atur de llarga durada i la relacio precaritzada amb el treball, la relegacio en barris de concentracio de la pobresa i l’estigmatitzacio territorial; dinamiques que generen la nova marginalitat avancada. Aquest treball, planteja una aproximacio teorica als condicionants i els efectes de les noves formes de marginalitat sobre els joves en determinats contextos territorials, plantejant hipotesis respecte el micro-context de Salt

&lt;p class="abstract"&gt;COVID-19 disease was first identified in December 2019 in Wuhan, the capital of China's Hubei province. Amid the ongoing COVID-19 pandemic, India has witnessed a massive surge of coronavirus cases. This study reviews the measures to take by the clinicians involved in rhinology surgery in light of the recent COVID-19 pandemic. The current finding about COVID-19 infection and its relation with severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2) virus is evaluated and possible safety measure guidelines to be taken while doing rhinology procedures is reviewed. The risk of coronavirus 2019 can be largely reduced by wearing personal protective equipment (PPE) kit with powered air purifying respirator, double gloves, eye protection, face shield, gown, shoe covers, limiting attendance to operation theatre, negative pressure room, using negative-pressure otolaryngology viral isolation drape (NOVID) system to cover the patient and proper removal of patient drape after operation. Additionally, low oscillation speeds of microdebrider with continuous suction is associated with low risk of aerosol transmission into the environment. Rhinology and endonasal surgeries are high risk procedures and should adhere to general guidelines set for high-risk procedures. If the proposed protocols are strictly maintained then the risk of getting infected by coronavirus is markedly reduced. In this current scenario is it mandatory to attain the emergent surgical cases with all possible precautions as mentioned and defer the rest of the cases till the pandemic gets over.&lt;/p&gt;

Deaths from COVID-19 continue to increase globally, the diversity of management strategies during the pandemic has resulted in high rates of local transmission. Indonesia is currently in the early stages of the COVID-19 pandemic, where thw situation of the spread of COVID-19 has almost reached all regions in Indonesia’s provinces with the number of cases and/or the number of deaths increasing. Health care providers, particularly nurses, experience not only increased workloads but also psychological changes associated with the anxiety and fear that nurses are forced to face. This qualitative study explored of nurses caring for COVID-19 patient. This study used a phenomenological approach with 6 male an 4 female participants. The interviews were conducted by telephone and were analysed by thematic analysis methodes. There are four themes identified in this study, including changes that have been felt since treating COVID-19 patients, behavior in dealing with perceived changes, obstacles faced while in service and expectations during COVID-19 patients. Comprehensive support and intensive training are needed by nurses and provide an adequate basis in providing optimal nursing care for patients. Comprehensive support both morally and materially as well as intensive traineng such as pre-employment training, adaptation training for other patient nurses in the infection department and negative pressure ward training are needed by nurses for the welfare of nurses and as an adequate basis in providing optimal nursing care for patients. Keywords: coronavirus disease 2019; nurses; change experienced by nurses caring for COVID-19 patient ABSTRAK Kematian akibat COVID-19 terus meningkat secara global, keberagaman strategi penatalaksanan selama pandemik menyebabkan tingginya angka penularan secara lokal. Indonesia saat ini berada pada tahap awal pandemi COVID-19, dimana situasi penyebaran COVID-19 yang sudah hampir menjangkau seluruh wilayah di Provinsi di Indonesia dengan jumlah kasus dan/atau jumlah kematian semakin meningkat. Penyedia layanan kesehatan, khususnya perawat tidak hanya mengalami peningkatan beban kerja tetapi juga perubahan psikologis yang berhubungan dengan kecemasan dan ketakutan yang dimana perawat dipaksa untuk menghadapi situasi tersebut. Tujuan penelitian ini adalah untuk menggali pengalaman perawat dalam menangani pasien dengan COVID-19. Studi ini menggunakan pendekatan fenomenologi dengan jumlah partisipan 6 laki-laki dan 4 perempuan. Wawancara dilakukan melalui telepon dan dianalisis dengan metode analisis tematik. Terdapat 4 tema yang diperoleh dalam penelitian ini yaitu perubahan yang dirasakan sejak menangani pasien dengan COVID-19, perilaku mengatasi perubahan yang dirasakan, kendala yang ditemui saat berdinas serta harapan selama menangani pasien dengan COVID-19. Dukungan menyeluruh baik secara moril maupun materil serta pelatihan intensif seperti pelatihan pra kerja, pelatihan adaptasi perawat pasien lain di departemen infeksi serta pelatihan bangsal tekanan negatif diperlukan perawat demi kesejahteraan perawat dan sebagai dasar yang cukup dalam memberikan asuhan keperawatan yang optimal bagi pasien. Kata kunci: COVID-19; perawat; perubahan perawat dalam menangani pasien dengan COVID-19