Protect The Protectors

HCWs should be constantly reminded that it takes a single slip in protocol to put themselves at risk of infection.’ 1. Establish triage areas and source control: • Triage stations with adequately trained staff should be allotted at the entrance of each health care facility. Physical barriers (glass/plastic barriers) • All patients must be assessed for possible COVID-19 infection and suspects (or those who test positive must be separated and treated in separate wards 2. Reinforce standard hygiene practices: • Adequate hand and respiratory hygiene practices in their busy clinics and on ward rounds. • Visual alerts at the entrance and strategic areas (waiting areas, elevators and cafeterias) • Combining hand-washing, masks, gloves and a protective gown — increased the intervention effectiveness to 91 % in SARS 3. Safety measures whilst dealing with OPD/Clinic patients • Social distancing within clinics and hospitals, with waiting-room chairs • All patients with respiratory symptoms made to wear a paper mask in the waiting area and instructed on cough and sneeze hygiene • Wear a surgical mask and scrub hands after each patient interaction 4. Safety measures whilst caring for hospitalised COVID-19 patients • Bed spacing must be at least 2 metres apart in such wards. • Dedicated team of medical staff for such patients to limit transmission and conserve personal protective equipment (PPE). • The HCWs involved in patient care should use a N-95 mask, eye protection (goggles) or face shield • Dedicated equipment (thermometers, sphygmomanometers and stethoscopes) should be used after proper cleaning and disinfection with 70% ethyl alcohol before and after attending each patient • Use designated portable X-ray equipment as far as possible. • Avoid relative visits, use ideo conferencing to allow patients and their loved ones to stay in touch. 5. Casually exposed HCWs should not be self-quarantined: • Quarantine recommendation should be based on the duration of exposure. • In Hong Kong, “close contact” means fifteen minutes at a distance of less than six feet and without the use of a surgical mask; in Singapore, thirty minutes. • The HCWs involved in patient care should use a N-95 mask, eye protection (goggles) or face shield • If the exposure is shorter than the prescribed limit but within six feet for more than two minutes, workers can stay on the job if they wear a surgical mask and have twice-daily temperature checks • People who have had brief, incidental contact are just asked to monitor themselves for symptoms. • If health care workers are quarantined after even casual exposure and hospitals shut down, there will be no one left to treat patients. . 6. Prophylactic drug for HCWs • The use of prophylactic chloroquine is controversial with an RCT ongoing present on 40000 HCWs 7. Special precautions for aerosol generating procedures (AGP) • Tracheal intubation, non-invasive ventilation, tracheostomy, cardiopulmonary resuscitation, and bronchoscopy • Should be carried out in an adequately ventilated room • HCWs conducting such procedures should be wearing full-body PPEs including N95 particle-filtering masks • High flow nasal canula and non-invasive ventilation are even more aerosol generating than closed circuit mechanical ventilators • Hence it may be more prudent to move from non-rebreathing (NRB) face mask directly to intubation, if resources exist 8. LAB Specimens • All laboratory specimens are potentially infectious. • Spills of small volume of blood/body fluids (<10 ml) are to be cleaned with chlorine containing (5000mg/L) disinfecting wipes, while for large volume spills, higher concentrations of chlorine containing disinfectant (10,000 mg/L) or peroxyacetic acid is used. 9. Equipment cleaning Bronchoscopes should be disinfected with 0.23% of peroxyacetic acid followed by high level of disinfection in an automatic washing and disinfection machine if available, and sterilized finally with ethylene oxide References: 1. Udwadia ZF, Raju RS, How to protect the protectors: 10 lessons to learn for doctors fighting the COVID-19 Coronavirus, Medical Journal Armed Forces India, https:// doi.org/10.1016/j.mjafi.2020.03.009.

1 Like

LikeAnswersShare
Dear Dr. Gaurav Chhaya Sir, In nowadays its proper guide line .
Thank you doctor
0

Cases that would interest you