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  Table of Contents 
Year : 2020  |  Volume : 21  |  Issue : 2  |  Page : 156-157

Hearing the unsaid – “Pravara sign language” for COVID-19 intensive care unit

Department of Anesthesiology, Rural Medical College, PIMS, Rahata, Maharashtra, India

Date of Submission06-May-2020
Date of Decision11-May-2020
Date of Acceptance13-May-2020
Date of Web Publication19-Sep-2020

Correspondence Address:
Dr. Akshaya N Shetti
Department of Anesthesiology, Rural Medical College, PIMS, Loni, Taluka, Rahata - 413 736, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/TheIAForum.TheIAForum_55_20

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How to cite this article:
Shetti AN, Singla B, Bhandari B, Gurav KP. Hearing the unsaid – “Pravara sign language” for COVID-19 intensive care unit. Indian Anaesth Forum 2020;21:156-7

How to cite this URL:
Shetti AN, Singla B, Bhandari B, Gurav KP. Hearing the unsaid – “Pravara sign language” for COVID-19 intensive care unit. Indian Anaesth Forum [serial online] 2020 [cited 2023 Jun 7];21:156-7. Available from: http://www.theiaforum.org/text.asp?2020/21/2/156/295386


Personal protective equipment (PPE) has been the buzzword across the globe during this pandemic of COVID-19. Various guidelines and protocols have emphasized on the importance of PPEs while managing COVID patients to reduce the exposure risk.[1],[2] A PPE kit usually comprises of a coverall or gown, a face shield, a mask, strike a goggles, gloves, shoe covers, and/or a surgical hood. Donning the PPE not only makes the identification of the person difficult, but also makes it hard for the health-care providers to speak and hear. The lack of effective communication might lead to misdiagnosis and misinterpretation of instructions, further leading to a compromised patient care.

Various alternative communication options, involving latest technology, are available in developed countries. The scenario in a developing country is, unfortunately, not the same. Considering the limited funds and resources, there is a need to develop cost-effective and relatively simple method of communication among nurses and doctors working in a COVID-19 intensive care unit (ICU) in a developing country. For the easy identification of the health-care provider, one can make use of the white strap on the face shield on which the name and role of the individual can be displayed. We also propose the use of sign language as one such communication tool to be utilized by health-care providers for better flow of information as well as patient care. Few of the crucial lifesaving procedures and treatments undertaken in an ICU while treating COVID patients have been illustrated with the signs developed by us at our rural tertiary care hospital [Figure 1].
Figure 1: Pravara sign language for communication in COVID-19 intensive care unit

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As per the institutional protocols, four teams are prepared to serve the COVID isolation hospital. We are training the individuals of each team separately and by maintaining social distancing for donning and doffing PPE. During the PPE training, we have incorporated the sign language training for all the health-care providers who are expected to work in the critical care area. Once the training is completed, each participant is randomly asked questions, and clearance for working is not given in case if any one fails. The sign language is prepared in such a way that it is easily understood. The person who fails the test is re-trained till the goal is achieved. Handouts and soft copies are provided to the participants to practice the same in the house as and when time permits. There is a separate poster of size 21” × 21” made available in the ICU area for the reference in case anyone forgets.

Further validation and implementation of this standardized communication tool using sign language may help in overcoming the communication barrier in a COVID-19 critical care unit.

Financial support and sponsorship


Conflicts of interest

There are no conflict of interest.

  References Top

Centers for Disease Control and Prevention (CDC). Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Finfection-control%2Fcontrol-recommendations.html. [Last updated on 2020 Apr 01; Last accessed 2020 May 04].  Back to cited text no. 1
World Health Organization. Rational use of Personal Protective Equipment (PPE) for Coronavirus Disease (COVID-19): Interim Guidance; 19 March, 2020. Available from: https://apps.who.int/iris/handle/10665/331498. License: CC BY-NC-SA 3.0 IGO. [Last accessed on 2020 May 04].  Back to cited text no. 2


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