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1.
Emergencias (Sant Vicenç dels Horts) ; 32(4): 269-277, ago. 2020. graf, tab
Artículo en Español | IBECS | ID: ibc-190943

RESUMEN

La investigación es una de las labores inalienables al ejercicio de la profesión médica. En el ámbito de la medicina de urgencias y emergencias (MUE), durante las últimas décadas se ha producido un aumento progresivo de esta actividad, liderada por los propios profesionales que trabajan en servicios de urgencias hospitalarios (SUH) y en los sistemas médicos de emergencias. No obstante, su producción científica se ha fundamentado más en la actividad de grupos unicéntricos que en redes de colaboración entre centros. Los últimos años, no obstante, han aparecido líneas de investigación exclusivamente dedicadas a la MUE en diversos institutos de investigación sanitaria españoles, reconocidos por el Instituto de Salud Carlos III, y también grupos de investigación de procesos específicos con una producción mantenida en el tiempo, muchos de ellos vinculados a la Sociedad Española de Medicina de Urgencias y Emergencias (SEMES). En el contexto de la pandemia de COVID-19 generada por el SARS-CoV-2, ha surgido la necesidad de que estos elementos investigadores unan sus fuerzas para hacer frente a los principales retos investigadores que supone esta pandemia desde la perspectiva de los SUH. Ello ha conducido a la fundación de la red de investigación SIESTA (Spanish Investigators on Emergency Situacions TeAm), cuyo primer reto es la realización del macroproyecto UMC-19 (Unusual Manifestations of Covid-19) en el plazo de un mes. A continuación se describen los pasos seguidos y los principales hitos de esta experiencia primigenia


Research is an inalienable part of medicine. The last few decades have seen a steady increase in research relevant to emergency medicine, led by professionals working in hospital emergency departments and related medical services. Most of the work has been done by groups in individual rather than networked centers. However, several Spanish institutions recognized by the Carlos III Health Institute (ISCIII) have developed lines of research that focus exclusively on emergency medicine. In addition, stable research groups - many of them associated with the Spanish Society of Emergency Medicine (SEMES) - have been engaged in ongoing studies of processes specific to our field. The coronavirus disease 2019 (COVID-19) pandemic caused by the acute respiratory syndrome coronavirus 2 (SARSCoV-2) created a need to focus all our efforts on the main challenges facing emergency departments. In response, the SIESTA (Spanish Investigators in Emergency Situations TeAm) network was created. The network's first challenge has been to complete the UMC-19 (Unusual Manifestations of COVID-19) macroproject within a single month. This paper describes the steps SIESTA followed and the main goals of this pioneering experience


Asunto(s)
Humanos , Colaboración Intersectorial , Servicios Médicos de Urgencia/organización & administración , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Servicios Médicos de Urgencia/ética , Servicios Médicos de Urgencia/métodos , Planes y Programas de Salud/organización & administración , Formulación de Proyectos , España/epidemiología
2.
J Bone Joint Surg Am ; 102(14): e80, 2020 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-32675668

RESUMEN

BACKGROUND: Coronavirus disease 2019 (COVID-19) has caused substantial disruptions to orthopaedic and trauma services. The purpose of the present study was to quantify its impact on surgical volume, hospitalizations, clinic appointments, and accident and emergency attendances to guide staffing and resource deployment for the sustenance of emergency services. METHODS: Data were retrieved from all 43 Hong Kong public hospitals and 122 outpatient clinics from a population of 7.5 million residents. The "COVID-19 cohort" of patients who received treatment from January 25 to March 27, 2020, was compared with the "control cohort" of patients who received treatment during the same time of year over the past 4 years. Primary outcomes consisted of changes in patient diagnoses, number of operations performed, and hospitalizations during the COVID-19 pandemic. Secondary outcomes included differences in patient age and comorbidity, the nature of operations performed, types of anesthesia for orthopaedic procedures, difference in anesthetic times, wait times, and personal protective equipment (PPE) reserves. RESULTS: A total of 928,278 patient-episodes (32,613 operations, 97,648 hospital admissions, 302,717 accident and emergency attendances, and 495,300 outpatient clinic attendances) were analyzed. Orthopaedic operations were reduced by 44.2%, from a mean (and standard deviation) of 795 ± 115.1 to 443.6 ± 25.8 per week (p < 0.001), with the ratio of emergency to elective operations increasing from 1.27:1 to 3.78:1. Operations for the treatment of upper and lower-limb fractures decreased by 23% (from 98.5 ± 14 to 75.9 ± 15.2 per week; p < 0.001) and 20% (from 210.6 ± 29.5 to 168.4 ± 16.9 per week; p < 0.001), respectively, whereas elective joint replacement and ligamentous reconstruction procedures decreased by 74% to 84% (p < 0.001). Operations for orthopaedic infections such as necrotizing fasciitis and septic arthritis remained similar (p > 0.05). The number of hospitalizations decreased by 41.2% (from 2,365 ± 243 to 1,391 ± 53 per week; p < 0.001), whereas clinical outpatient visits decreased by 29.4% (from 11,693 ± 2,240 to 8,261 ± 1,104 per week; p < 0.001). Patients did not endure longer wait times for emergency operations and accident and emergency consultations (p > 0.05). PPE consumption did not exceed procurement, with net increases in PPE reserves. CONCLUSIONS: Demand for orthopaedic care remains, despite weekly reductions of 351 orthopaedic operations, 974 hospital admissions, and 3,432 clinic attendances. Orthopaedic surgeons and health-care professionals should factor this into consideration during staffing and resource deployment. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Servicios Médicos de Urgencia/organización & administración , Procedimientos Ortopédicos/estadística & datos numéricos , Neumonía Viral/epidemiología , Instituciones de Atención Ambulatoria/estadística & datos numéricos , Anestesia , Betacoronavirus , Hong Kong , Hospitalización/estadística & datos numéricos , Humanos , Ortopedia , Pandemias , Equipo de Protección Personal/provisión & distribución , Estudios Retrospectivos
3.
East Mediterr Health J ; 26(6): 626-629, 2020 Jun 24.
Artículo en Inglés | MEDLINE | ID: mdl-32621492

RESUMEN

The COVID-19 pandemic began as a cluster of reported cases of acute respiratory illness in China on 31 December 2019 and went on to spread with exponential growth across the globe. By the time it was characterized as a global pandemic on 11 March 2020, 17 of 22 countries in the Eastern Mediterranean Region (EMR) had reports of infected persons. EMR countries are particularly susceptible to such outbreaks due to the presence of globally interconnected markets; complex emergencies in more than half of the countries; religious mass gatherings that draw tens of millions of pilgrims annually; and variation in emergency care systems capacity and health systems performance within and between countries.


Asunto(s)
Infecciones por Coronavirus/terapia , Servicios Médicos de Urgencia/organización & administración , Servicio de Urgencia en Hospital/organización & administración , Epidemiología/educación , Cooperación Internacional , Neumonía Viral/terapia , Salud Pública/educación , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Política de Salud , Accesibilidad a los Servicios de Salud , Humanos , Región Mediterránea/epidemiología , Pandemias , Neumonía Viral/epidemiología , Práctica de Salud Pública , Organización Mundial de la Salud
4.
Washington; Organización Panamericana de la Salud; jun. 15, 2020. 26 p.
No convencional en Español | LILACS | ID: biblio-1099999

RESUMEN

La finalidad de este documento es brindar orientación a los países de América Latina y el Caribe a fin de mejorar la vigilancia de la mortalidad por COVID-19. En este documento se amplían los métodos deanálisis de la mortalidad por todas las causas como uno de los enfoques propuestos para contribuir a la evaluación de la magnitud real de la carga de la epidemia de COVID-19 en los países de América Latina y el Caribe. Este documento está dirigido a las autoridades nacionales de salud, incluidos los equipos de vigilancia epidemiológica y de emergencia de salud pública que participan en la respuesta a la epidemia de COVID-19, así como a otros profesionales o instituciones a cargo de la vigilancia (como los departamentos de epidemiología) y de seguimiento de la mortalidad (como los institutos nacionales de estadística).


Asunto(s)
Humanos , Neumonía Viral/prevención & control , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/epidemiología , Pandemias/prevención & control , Vigilancia en Salud Pública/métodos , Betacoronavirus/patogenicidad , Estadísticas Vitales , Región del Caribe/epidemiología , Servicios Médicos de Urgencia/organización & administración , Monitoreo Epidemiológico , América Latina/epidemiología
6.
J Spec Oper Med ; 20(2): 104-109, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32573745

RESUMEN

In summer of 2017 in Charlottesville, Virginia, white nationalists clashed with counterprotestors, ultimately leading to the death of three people and leaving 34 more injured. Soon after, the same group was granted permission to speak on the campus of the University of Florida in Gainesville, Florida. Despite our college town having limited resources and personnel, the comprehensive and extensive preparation preceding the event ensured a peaceful resolution for such a large and potentially volatile situation. The preparatory steps required joint efforts from local and state partners in law enforcement, emergency medical services, and emergency departments. We describe here the situation we faced, the pre-event preparations, the response in the field and in our emergency department, and the outcomes from an emergency and tactical medicine perspective. We hope our successful experience will impart knowledge for similar events.


Asunto(s)
Habla , Universidades , Violencia/prevención & control , Servicios Médicos de Urgencia/organización & administración , Servicio de Urgencia en Hospital/organización & administración , Florida , Humanos , Aplicación de la Ley
7.
Neurologia ; 35(6): 372-380, 2020.
Artículo en Inglés, Español | MEDLINE | ID: mdl-32561333

RESUMEN

INTRODUCTION: The COVID-19 pandemic has had a great impact on healthcare systems. Spain, where headache is the main reason for outpatient neurology consultation, is one of the countries with the most reported cases of the disease. OBJECTIVE: This study aimed to analyse the impact of the COVID-19 pandemic on headache units in Spain and to evaluate how neurologists see the future of these units. METHODS: We conducted a cross-sectional online survey of headache units during the sixth week of the state of alarm declared in Spain in response to the pandemic. RESULTS: The response rate was 74%, with the participation of centres with different characteristics and from all Autonomous Communities of Spain. Limitations in face-to-face activity were reported by 95.8% of centres, with preferential face-to-face consultation being maintained in 60.4%, and urgent procedures in 45.8%. In 91.7% of centres, the cancelled face-to-face activity was replaced by telephone consultation. 95.8% of respondents stated that they would use personal protection equipment in the future, and 86% intended to increase the use of telemedicine. The majority foresaw an increase in waiting lists (93.8% for initial consultations, 89.6% for follow-up, and 89.4% for procedures) and a worse clinical situation for patients, but only 15% believed that their healthcare structures would be negatively affected in the future. CONCLUSIONS: As a consequence of the pandemic, headache care and research activity has reduced considerably. This demonstrates the need for an increase in the availability of telemedicine in our centres in the near future.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus , Cefalea/terapia , Pandemias , Neumonía Viral , Analgésicos/uso terapéutico , Anticuerpos Monoclonales/uso terapéutico , Antagonistas del Receptor Peptídico Relacionado con el Gen de la Calcitonina/uso terapéutico , Estudios Transversales , Manejo de la Enfermedad , Servicios Médicos de Urgencia/organización & administración , Predicción , Cefalea/tratamiento farmacológico , Cefalea/epidemiología , Encuestas de Atención de la Salud , Humanos , Visita a Consultorio Médico/estadística & datos numéricos , Aceptación de la Atención de Salud , Equipo de Protección Personal , Derivación y Consulta , España/epidemiología , Telemedicina/estadística & datos numéricos , Tiempo de Tratamiento
8.
JNMA J Nepal Med Assoc ; 58(225): 355-359, 2020 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-32538935

RESUMEN

The COVID-19 pandemic is unfolding at an unprecedented pace. The unprecedented threat provides an opportunity to emerge with robust health systems. Nepal has implemented several containment measures such as Rapid Response Team formulation; testing; isolation; quarantine; contact tracing;surveillance, establishment of COVID-19 Crisis Management Centre and designation of dedicated hospitals to gear up for the pandemic. The national public health emergency management mechanisms need further strengthening with the proactive engagement of relevant ministries; we need a strong, real-time national surveillance system and capacity building of a critical mass of health care workers; there is a need to further assess infection prevention and control capacity; expand the network of virus diagnostic laboratories in the private sector with adequate surge capacity;implement participatory community engagement interventions and plan for a phased lockdown exit strategy enabling sustainable suppression of transmission at low-level and enabling in resuming some parts of economic and social life.


Asunto(s)
Defensa Civil , Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Servicios Médicos de Urgencia/organización & administración , Pandemias/prevención & control , Neumonía Viral , Betacoronavirus/aislamiento & purificación , Defensa Civil/legislación & jurisprudencia , Defensa Civil/métodos , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Regulación Gubernamental , Humanos , Nepal/epidemiología , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Salud Pública/métodos
9.
Eur J Emerg Med ; 27(4): 274-278, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32516161

RESUMEN

INTRODUCTION: Worldwide, the COVID-19 epidemic has put health systems to the test. The excess mortality is partly due to the influx of patients requiring hospitalization and intensive care. We propose that the chronology of epidemic spread gives a window of time in which hospitals can act to prevent reaching capacity. METHODS: The out-of-hospital SAMU Emergency Medical System in an entry point into the French health care system. We recorded the number of patients managed, of patients transferred to emergency departments (ED), and of mobile intensive care units (MICUs) dispatched. Each criterion was compared to the mean of the same criterion over the previous 5 years. The alert threshold which indicated a public health crisis was defined as a 20% increase compared to the 5-year mean. RESULTS: The reference period, from January 2015 to December 2019, included 3 381 611 calls, and 1 137 856 patients. The study period, from 17 February to 28 March 2020, included 166 888 calls, and 56 708 patients. The daily numbers of patients managed crossed the threshold on February 25, and increased until the end of the study period. The daily number of patients transferred to ED crossed the threshold on March 16, and increased until the end of the period. The daily number of MICUs dispatched crossed the threshold on March 15, and increased until the end of the period. CONCLUSION: The COVID-19 epidemic reached our department in three consecutive waves which overwhelmed the health care system. The first wave preceded by 30 days the massive arrival of critical patients. Health care systems must take advantage of this delay to prepare for the third wave.


Asunto(s)
Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/epidemiología , Prestación de Atención de Salud/organización & administración , Servicios Médicos de Urgencia/organización & administración , Servicio de Urgencia en Hospital/estadística & datos numéricos , Unidades de Cuidados Intensivos/organización & administración , Neumonía Viral/epidemiología , Adulto , Anciano , Estudios de Casos y Controles , Cuidados Críticos/organización & administración , Brotes de Enfermedades/estadística & datos numéricos , Femenino , Francia , Humanos , Masculino , Persona de Mediana Edad , Innovación Organizacional , Evaluación de Resultado en la Atención de Salud , Pandemias/estadística & datos numéricos , Paris , Estudios Retrospectivos , Medición de Riesgo
12.
Emergencias (Sant Vicenç dels Horts) ; 32(3): 177-184, jun. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-187776

RESUMEN

OBJETIVOS: Diseñar y validar un modelo predictivo de mortalidad hospitalaria precoz (≤ 48 horas) en pacientes $ 65 años y basado en variables determinadas a nivel prehospitalario. MÉTODO: Estudio multicéntrico de cohorte prospectivo y observacional. Se incluyeron pacientes $ 65 años atendi¬dos por unidades de soporte vital avanzado y trasladados a un servicio de urgencias hospitalario. Se recogieron va-riables demográficas, clínicas y analíticas. Se construyó y validó una escala de puntuación mediante la categoriza¬ción de las variables seleccionadas mediante regresión logística en función de la mortalidad en ≤ 48 horas. RESULTADOS: Se reclutaron 1.759 pacientes, la edad mediana fue de 79 años (RIC 72-85), 766 eran mujeres (43,5%), y fallecieron 108 pacientes (6,1%) en ≤ 48 horas. El modelo predictivo -escala POAWS (Prehospital Older Adults Warning Score)- incluyó la edad, presión arterial sistólica, temperatura, saturación de oxígeno en relación con la frac¬ción inspirada de oxígeno, escala de coma de Glasgow y ácido láctico en sangre venosa. El área bajo la curva de la característica operativa del receptor para la mortalidad en ≤ 48 horas fue de 0,853 (IC 95%: 0,80-0,91; p < 0,001). La mortalidad en los pacientes de alto riesgo (> 7 puntos en la escala) fue del 69%. CONCLUSIONES: La escala POAWS desarrollada en el presente estudio puede ser de utilidad para estratificar el riesgo de muerte de los patientes de 65 o más años durante las 48 horas siguientes a la atención en el ámbito prehospitalario


OBJECTIVE: To develop and validate a prehospital risk model to predict early in-hospital mortality (󖽀 hours) in patients aged 65 years or older. METHODS: Prospective multicenter observational study in a cohort of patients aged 65 years or older attended by advanced life support emergency services and transferred to 5 Spanish hospitals between April 2018 and July 2019. We collected demographic, clinical and laboratory variables. A risk score was constructed and validated based on the analysis of prehospital variables associated with death within 48 hours. Predictors were selected by logistic regression. RESULTS: A total of 1759 patients were recruited. The median age was 79 years (interquartile range, 72-85 years), and 766 (43.5%) were women. One hundred eight patients (6.1%) died within 48 hours. Predictors in the Prehospital Older Adults Warning Scale (POAWS) were age, systolic blood pressure, temperature, the ratio of oxygen saturation to the fraction of inspired oxygen, score on the Glasgow coma scale, and lactic acid concentration in venous blood. The area under the receiver operating characteristic curve of the model to predict early mortality was 0.853 (95% CI, 0.80-0.91; P < .001). Mortality in patients at high risk (POAWS score, > 7) was 69%. CONCLUSIONS: The prehospital POAWS score can be used to stratify risk for death within 48 hours in patients aged 65 years or older


Asunto(s)
Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Enfermedad Aguda/mortalidad , Servicios Médicos de Urgencia/organización & administración , Atención Prehospitalaria/métodos , Pronóstico , Mortalidad Prematura , Enfermedad Aguda/terapia , Factores de Riesgo , Intervalos de Confianza , Supervivencia sin Enfermedad
14.
J Emerg Manag ; 18(3): 247-260, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32441041

RESUMEN

INTRODUCTION: Thirty-three separate local emergency medical services (EMS) authority agencies serve the 58 counties in California. Each local emergency medical services agency dictates widely different treatment and trans-port protocols for its paramedics. Although previous research has established the problem of geographic EMS dis-parities, nothing definitively explains their cause. METHODS: We analyze California's most recently available EMS performance-measure data to determine if there is still disparity in EMS patient care and patient outcomes in California. If there is a disparity, we determine whether the differences are accounted for by socioeconomic factors, geographical differences, or population size, by combin-ing California EMS data with other state and county level data. If none of these factors are significantly correlated, this supports the hypothesis that something different, such as system structure, could be a potential cause of Califor-nia's EMS disparities. As a secondary analysis, we attempt to replicate these types of analyses at national and inter-national levels, which could potentially permit a structural comparison as well. RESULTS: There is still disparity in EMS patient care and patient outcomes in California. Regression analyses did not identify a single factor to explain the disparity in performance measures. Most notably, the regression found that basic socioeconomic factors and geographical differences frequently speculated as common drivers for disparity of services, including median income, population density, and availability of specialty care facilities, did not account for the disparity in services. CONCLUSIONS: Unfortunately, the striking lack of performance-measure data-a data desert-for EMS throughout the United States meant that the secondary analyses were inconclusive. Based on these results, we propose three recommendations:(1) most importantly, the lack of data must be addressed. Data collection should be standardized and mandatory for all EMS providers. (2) Treatment protocols for the state should be standardized and based on the latest evidence-based research. Providers should be required to offer the same level of care, to all geographic re-gions. (3) It may be beneficial to consider restructuring the California EMS system. While the research is limited due to imperfect information, consolidated systems seem to perform better. An existing framework for this already exists.


Asunto(s)
Servicios Médicos de Urgencia/organización & administración , Disparidades en Atención de Salud , Características de la Residencia , California , Recolección de Datos , Sistemas de Información Geográfica , Humanos , Estados Unidos
17.
Anesth Analg ; 131(2): 365-377, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32398432

RESUMEN

In response to the rapidly evolving coronavirus disease 2019 (COVID-19) pandemic and the potential need for physicians to provide critical care services, the American Society of Anesthesiologists (ASA) has collaborated with the Society of Critical Care Anesthesiologists (SOCCA), the Society of Critical Care Medicine (SCCM), and the Anesthesia Patient Safety Foundation (APSF) to develop the COVID-Activated Emergency Scaling of Anesthesiology Responsibilities (CAESAR) Intensive Care Unit (ICU) workgroup. CAESAR-ICU is designed and written for the practicing general anesthesiologist and should serve as a primer to enable an anesthesiologist to provide limited bedside critical care services.


Asunto(s)
Servicio de Anestesia en Hospital/organización & administración , Betacoronavirus/patogenicidad , Infecciones por Coronavirus/terapia , Prestación Integrada de Atención de Salud/organización & administración , Servicios Médicos de Urgencia/organización & administración , Unidades de Cuidados Intensivos/organización & administración , Neumonía Viral/terapia , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/virología , Humanos , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/virología , Guías de Práctica Clínica como Asunto
18.
Int J Surg ; 79: 233-248, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32413502

RESUMEN

The Coronavirus (COVID-19) Pandemic represents a once in a century challenge to human healthcare with over 4.5 million cases and over 300,000 deaths thus far. Surgical practice has been significantly impacted with all specialties writing guidelines for how to manage during this crisis. All specialties have had to triage the urgency of their daily surgical procedures and consider non-surgical management options where possible. The Pandemic has had ramifications for ways of working, surgical techniques, open vs minimally invasive, theatre workflow, patient and staff safety, training and education. With guidelines specific to each specialty being implemented and followed, surgeons should be able to continue to provide safe and effective care to their patients during the COVID-19 pandemic. In this comprehensive and up to date review we assess changes to working practices through the lens of each surgical specialty.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Servicio de Cirugía en Hospital/organización & administración , Triaje , Betacoronavirus , Infecciones por Coronavirus/transmisión , Transmisión de Enfermedad Infecciosa/prevención & control , Servicios Médicos de Urgencia/organización & administración , Humanos , Cuerpo Médico de Hospitales/educación , Cuerpo Médico de Hospitales/provisión & distribución , Procedimientos Quirúrgicos Mínimamente Invasivos , Neumonía Viral/transmisión , Guías de Práctica Clínica como Asunto , Flujo de Trabajo
19.
Washington; Organización Panamericana de la Salud; abr. 14, 2020. 5 p.
No convencional en Español | LILACS | ID: biblio-1096678

RESUMEN

Las prácticas de prevención y control de infecciones necesitan implementarse para garantizar la seguridad de los trabajadores de salud y pacientes en establecimientos de salud, es fundamental prevenir la contaminación cruzada y contener la propagación del COVID 19. • Al día de esta publicación, están recomendadas las siguientes precauciones para el cuidado del paciente con sospecha o confirmación de COVID-19‡: o Para cualquier caso sospechoso o confirmado de COVID-19: precauciones estándares + contacto + precauciones en la transmisión por gotitas o Para cualquier caso sospechoso o confirmado de COVID-19 y procedimientos generadores de aerosoles: precauciones estándares + contacto + transmisión aérea (aerosoles o núcleo de gotitas) • Los resultados de la aplicación de esta herramienta de evaluación, en conjunto con otras herramientas§, proveerán una visión general sobre el cumplimiento de las actividades de prevención y control de infecciones asociadas a la atención médica en un establecimiento de salud, sin realizar juicios sobre el riesgo individual de los pacientes, o en casos particulares. Por su naturaleza, esta herramienta es sólo un diagnóstico externo de apoyo a profesionales de PCI y gerentes para evaluar las brechas y tomar medidas correctivas.


Infection prevention and control practices need to be implemented to guarantee the safety of healthcare workers and patients in healthcare settings, it is fundamental to prevent cross contamination and containment of spread of COVID 19. As of the day of this publication, the following precautions are recommended for the care of patients with suspected or confirmed cases of COVID-19: - For any suspected or confirmed cases of COVID-19: standard + contact + droplet precautions. -For any suspected or confirmed cases of COVID-19 and Aerosol Generated Procedure: standard + contact + airborne precautions. - The results of the application of this evaluation tool, in addition to other tools, will provide an overview regarding compliance with the activities of prevention and control of infections associated with provision of care in acute healthcare services in a health setting, without making judgments about the individual risk of patients, nor on particular cases. By its nature, this tool is only an external diagnostic to support IPC professionals and managers to assess the gaps and take corrective measures. To provide a tool for assessment of infection prevention and control practices in isolation areas in acute healthcare settings in the context of the novel coronavirus (COVID-19). These recommendations are preliminary and subject to review as new evidence becomes available.


Asunto(s)
Humanos , Neumonía Viral/prevención & control , Brotes de Enfermedades/prevención & control , Infecciones por Coronavirus/prevención & control , Servicios Médicos de Urgencia/organización & administración , Pandemias/prevención & control , Betacoronavirus
20.
J Am Acad Orthop Surg ; 28(11): 451-463, 2020 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-32282441

RESUMEN

By April 7, 2020, severe acute respiratory syndrome coronavirus 2 was responsible for 1,383,436 confirmed cases of Coronavirus disease 2019 (COVID-19), involving 209 countries around the world; 378,881 cases have been confirmed in the United States. During this pandemic, the urgent surgical requirements will not stop. As an example, the most recent Centers of Disease Control and Prevention reports estimate that there are 2.8 million trauma patients hospitalized in the United States. These data illustrate an increase in the likelihood of encountering urgent surgical patients with either clinically suspected or confirmed COVID-19 in the near future. Preparation for a pandemic involves considering the different levels in the hierarchy of controls and the different phases of the pandemic. Apart from the fact that this pandemic certainly involves many important health, economic, and community ramifications, it also requires several initiatives to mandate what measures are most appropriate to prepare for mitigating the occupational risks. This article provides evidence-based recommendations and measures for the appropriate personal protective equipment for different clinical and surgical activities in various settings. To reduce the occupational risk in treating suspected or confirmed COVID-19 urgent orthopaedic patients, recommended precautions and preventive actions (triage area, emergency department consultation room, induction room, operating room, and recovery room) are reviewed.


Asunto(s)
Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus , Quirófanos/organización & administración , Procedimientos Ortopédicos/tendencias , Pandemias/prevención & control , Equipo de Protección Personal/estadística & datos numéricos , Neumonía Viral , Betacoronavirus , Servicios Médicos de Urgencia/organización & administración , Femenino , Humanos , Masculino , Salud Laboral , Seguridad del Paciente , Atención Perioperativa , Guías de Práctica Clínica como Asunto , Evaluación de Programas y Proyectos de Salud , Dispositivos de Protección Respiratoria/estadística & datos numéricos , Estados Unidos
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