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1.
Texto & contexto enferm ; 29: e20200106, Jan.-Dec. 2020. tab, graf
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1101977

RESUMO

ABSTRACT Objective: to analyze the COVID-19 pandemic and what we have (re)learned from the world experience of adopting prevention measures recommended by the World Health Organization as well as the epidemiological overview in the world, in Latin America and in Brazil. Results: the World Health Organization has pointed out that the path to reduce the speed of circulation of the virus, control and decrease in the number of cases and deaths resulting from this pandemic can only be accomplished with mass adoption of fundamental measures that include hand hygiene, alcohol gel use, cough etiquette, cleaning surfaces, avoiding agglomerations and social distancing. The epidemiological curve of the disease clearly shows the devastating proportions in Italy, Spain and the United States, surpassing China in death records, due to the delay in adopting the aforementioned measures. In Brazil, the rapid progression in relation to the world and Latin America points to an important increase in the number of cases. Conclusion: this is possibly the most serious pandemic in recent human history, and its course can be influenced by the rigor in adopting individual and collective behavioral measures.


RESUMEN Objetivo: analizar la pandemia de COVID-19 y lo que hemos (re)aprendido de la experiencia mundial para la adopción de las medidas de prevención recomendadas por la Organización Mundial de la Salud, así como el panorama epidemiológico en el mundo, en América Latina y en Brasil. Resultados: la Organización Mundial de la Salud ha señalado que el camino hacia la reducción de la velocidad de circulación del virus, el control y la reducción del número de casos y muertes resultantes de esta pandemia solo se puede lograr con la adopción masiva de medidas fundamentales que incluyan la higiene de las manos, uso de alcohol en gel, etiqueta respiratoria, limpieza de superficies, evitando hacinamiento y distancia social. La curva epidemiológica de la enfermedad muestra claramente las proporciones devastadoras en Italia, España y Estados Unidos, superando a China en los registros de defunciones, debido a la demora en la adopción de estas medidas. En Brasil, la rápida progresión en relación con el mundo y América Latina apunta a un aumento importante en el número de casos. Conclusión: esta pandemia es posiblemente la más grave en la historia humana reciente y su curso puede verse influenciado por el rigor en la adopción de medidas de comportamiento individuales y colectivas.


RESUMO Objetivo: analisar a pandemia da Covid-19 e o que temos (re)aprendido com a experiência mundial para adoção das medidas de prevenção preconizadas pela Organização Mundial de Saúde bem como o panorama epidemiológico no mundo, na América Latina e no Brasil. Resultados: a Organização Mundial de Saúde tem apontado que o caminho para a redução da velocidade de circulação do vírus, o controle e queda do número de casos e óbitos decorrentes dessa pandemia só poderá ser alcançado com adoção em massa de medidas fundamentais que incluem higienização das mãos, uso do álcool em gel, etiqueta respiratória, limpeza de superfícies, evitar aglomerações e distanciamento social. A curva epidemiológica da doença mostra claramente as proporções devastadoras na Itália, Espanha e nos Estados Unidos, superando a China em registros de óbitos, devido ao atraso na adoção dessas medidas. No Brasil, a progressão rápida em relação ao mundo e à América Latina aponta um importante aumento do número de casos. Conclusão: essa pandemia possivelmente é a mais grave da história recente da humanidade e seu curso pode ser influenciado pelo rigor na adoção de medidas comportamentais individuais e coletivas.


Assuntos
Humanos , Infecções por Coronavirus , Prevenção de Doenças , Pandemias , Equipamento de Proteção Individual , Betacoronavirus , Isolamento de Pacientes , Distância Social , Comportamento , Educação em Saúde
2.
Rev. enferm. UERJ ; 28: 49923, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1097213

RESUMO

Objetivo: refletir sobre as intervenções/ações de cuidado em saúde mental voltados aos profissionais da saúde que prestam assistência ao paciente suspeito ou diagnosticado com COVID-19. Conteúdo: A pandemia de COVID-19 traz o desafio para profissionais da saúde em lidar com sua própria saúde mental e a dos pacientes. É fundamental conhecer e refletir sobre iniciativas que países apresentam para lidar com a manutenção da saúde mental de profissionais da saúde em tempos de pandemia e que contribuem para repensar o planejamento, execução e avaliação de estratégias a serem utilizadas no Brasil. Considerações finais: foi possível elencar ações em saúde mental que têm se mostrado assertivas no cuidado aos trabalhadores de saúde, atuantes na ponta do cuidado, sobretudo as baseadas no esclarecimento da doença, uso adequado de equipamentos de proteção individual, além do mapeamento daqueles profissionais fragilizados emocionalmente e/ou com sofrimento mental anterior à pandemia, além do suporte emocional oferecido por meio de plataformas digitais.


Objective: to reflect on mental health care interventions/actions aimed at health professionals who provide assistance to patients suspected or diagnosed with COVID-19. Content: The COVID-19 pandemic challenges health professionals to lead with their own and patients' mental health. It is essential to know and to reflect about countries' initiatives to deal with health professional's mental health maintenance in times of pandemic, and to help to re-think strategies planning, execution and evaluation to be used in Brazil. Final considerations: it was possible to list actions in mental health that have shown to be assertive in the care of health workers who are in the front line of caring, especially those based on clarifying the disease, appropriate use of individual protective equipment, in addition to mapping those emotionally weakened professionals and or with mental suffering prior to the pandemic, in addition to the emotional support offered through digital platforms.


Objetivo: reflexionar sobre las intervenciones/acciones de atención de salud mental dirigidas a profesionales de la salud que prestan asistencia a pacientes sospechosos o diagnosticados con COVID-19. Contenido: La pandemia COVID-19 desafía a los profesionales de la salud a hacer frente con la salud mental propia y de los pacientes. Es esencial conocer y reflexionar sobre las iniciativas de los países para enfrentar al mantenimiento de la salud mental de los profesionales de la salud en tiempos de pandemia, y para ayudar a repensar la planificación, ejecución y evaluación de estrategias que se utilizarán en Brasil. Consideraciones finales: fue posible enumerar acciones en salud mental que han demostrado ser asertivas en la atención de los trabajadores de salud que trabajan en la primera línea de atención de la salud, especialmente aquellos basados en la aclaración de la enfermedad, el uso apropiado de equipos de protección individual, además de mapear aquellos profesionales debilitados emocionalmente y / o con sufrimiento mental antes de la pandemia, además del apoyo emocional ofrecido a través de plataformas digitales.


Assuntos
Humanos , Masculino , Feminino , Saúde Mental/normas , Pessoal de Saúde/psicologia , Infecções por Coronavirus , Pandemias , Betacoronavirus , Brasil , Saúde do Trabalhador , Disseminação de Informação , Equipamento de Proteção Individual
3.
Rev. enferm. UERJ ; 28: e50360, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1097275

RESUMO

Objetivo: descrever as recomendações sobre o uso racional e seguro dos equipamentos de proteção individual (EPI) no transcorrer da cadeia assistencial de pessoas com suspeita ou confirmação de contaminação pelo novo coronavírus. Conteúdo: o novo coronavírus é responsável pela doença Covid-19, e dentre as pessoas com maior risco de desenvolver a infecção estão os trabalhadores de saúde, devido ao contato muito próximo a pacientes. Desse modo, a utilização de EPI é recomendação prioritária a estes trabalhadores. Todavia, em função do desabastecimento internacional e nacional relacionado a estes equipamentos, o uso racional é fundamental a fim de evitar que o impacto do desabastecimento seja ainda maior. Conclusão: o uso de EPI é indispensável aos trabalhadores de saúde durante a pandemia de Covid-19, contudo, é imprescindível coordenar a cadeia de fornecimento destes insumos, implementar estratégias que minimizem a necessidade de EPI e garantir o uso de maneira adequada.


Objective: to describe the recommendations on the rational, safe use of personal protective equipment (PPE) throughout the chain of care for people with suspected or confirmed contamination by the new coronavirus. Content: the new coronavirus is responsible for the disease Covid-19, and among those at high risk of infection are health workers in very close contact with patients. It is thus a priority recommendation for these workers to use PPE. However, international and national shortages of this equipment make rational use essential in order to prevent even greater impact from these shortages. Conclusion: it is essential that health workers use PPE during the Covid-19 pandemic, but it is also essential to coordinate the supply chain for these inputs, implement strategies that minimize the need for PPE and ensure proper use.


Objetivo: describir las recomendaciones sobre el uso racional y seguro del equipo de protección personal (EPP) en toda la cadena de atención para las personas con sospecha o confirmación de contaminación por el nuevo coronavirus. Contenido: el nuevo coronavirus es responsable de la enfermedad de Covid-19, y entre aquellos con alto riesgo de infección se encuentran los trabajadores de la salud en contacto muy cercano con los pacientes. Por lo tanto, es una recomendación prioritaria para estos trabajadores usar EPP. Sin embargo, la escasez internacional y nacional de este equipo hace que el uso racional sea esencial para evitar un impacto aún mayor de esta escasez. Conclusión: es esencial que los trabajadores de la salud usen EPP durante la pandemia de Covid-19, pero también es esencial coordinar la cadena de suministro para estos insumos, implementar estrategias que minimicen la necesidad de EPP y garantizar un uso adecuado.


Assuntos
Infecções por Coronavirus/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Betacoronavirus , Máscaras/provisão & distribução , Riscos Ocupacionais , Contenção de Riscos Biológicos/normas , Equipamento de Proteção Individual/normas , Máscaras/normas
4.
Neurodiagn J ; 60(3): 195-207, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33006508

RESUMO

Since 1995, ASET has periodically published updates to recommendations for best practices in infection prevention for Neurodiagnostic technologists. The latest installment was accepted in December 2019 for publication in Volume 60, Issue 1, before we had much knowledge or understanding about the SARS-CoV-2, the virus that causes COVID-19. This Technical Tips article is presented as an addendum to the 2020 update and includes important information about infection prevention measures specific to procedure protocols when working with patients positive or under investigation for a highly infectious disease, and when working with patients in general during the current pandemic. All Neurodiagnostic technologists who have direct patient care are responsible for ensuring the use of best practices to prevent the spread of infection.


Assuntos
Infecções por Coronavirus/prevenção & controle , Eletroencefalografia/métodos , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Pessoal Técnico de Saúde , Betacoronavirus , Técnicas de Diagnóstico Neurológico/instrumentação , Desinfecção/métodos , Eletroencefalografia/instrumentação , Contaminação de Equipamentos , Humanos , Polissonografia/instrumentação , Polissonografia/métodos
5.
BMC Pregnancy Childbirth ; 20(1): 580, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008308

RESUMO

BACKGROUND: During the ongoing global outbreak of COVID-19, pregnant women who are susceptible to COVID-19 should be highly concerned. The issue of vertical transmission and the possibility of neonatal infection is a major concern. CASE PRESENTATION: Case 1: A 35-year-old pregnant woman with a gestational age of 37 weeks and 6 days was admitted to our hospital at the point of giving birth. Except for the abnormalities in her chest CT image, she was asymptomatic. She had an uncomplicated spontaneous vaginal delivery, and her infant was discharged home for isolation. Because of the positive result of the maternal swabs for SARS-CoV-2 obtained on the 2nd day after sampling, we transferred the mother to the designated hospital and followed up with her by telephone interviews. Luckily, it was confirmed on February 23 that the newborn did not develop any COVID-19 symptoms after observation for 14 days after birth. Case 2: Another pregnant woman, with a gestational age of 38 weeks and 2 days, was also admitted to our hospital because of spontaneous labor with cervical dilation of 5 cm. Since she had the typical manifestations of COVID-19, including cough, lymphopenia, and abnormal chest CT images, she was highly suspected of having COVID-19. Based on the experience from case 1, we helped the mother deliver a healthy baby by vaginal delivery. On the 2nd day after delivery, the maternal nasopharyngeal swab result was positive, while the infant's result was negative. CONCLUSION: There is still insufficient evidence supporting maternal-fetal vertical transmission for COVID-19-infected mothers in late pregnancy, and vaginal delivery may not increase the possibility of neonatal infection.


Assuntos
Infecções Assintomáticas , Infecções por Coronavirus/diagnóstico , Parto Obstétrico/métodos , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico , Complicações Infecciosas na Gravidez/diagnóstico , Adulto , Antibacterianos/uso terapêutico , Antivirais/uso terapêutico , Betacoronavirus , Aleitamento Materno , Técnicas de Laboratório Clínico , Infecções por Coronavirus/terapia , Tosse , Medicamentos de Ervas Chinesas/uso terapêutico , Feminino , Idade Gestacional , Humanos , Linfopenia , Máscaras , Oxigenoterapia , Pandemias , Isolamento de Pacientes , Equipamento de Proteção Individual , Pneumonia Viral/terapia , Reação em Cadeia da Polimerase , Gravidez , Complicações Infecciosas na Gravidez/terapia , Testes Sorológicos , Tomografia Computadorizada por Raios X
6.
Biomed Eng Online ; 19(1): 75, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008462

RESUMO

BACKGROUND: The world is facing an unprecedented outbreak affecting all aspects of human lives which is caused by the COVID-19 pandemic. Due to the virus novelty, healthcare systems are challenged by a high rate of patients and the shortage of medical products. To address an increased need for essential medical products, national authorities, worldwide, made various legislative concessions. This has led to essential medical products being produced by automotive, textile and other companies from various industries and approved under the emergency use authorizations or legal concessions of national regulatory bodies. This paper presents a narrative commentary of the available documentation on emergency use authorizations and legal concessions for medical products during COVID-19 pandemic. METHODOLOGY: The basis for narrative commentary includes scientific articles published in Web of Science, Scopus, PubMed and Embase databases, official publications of international organizations: Food and Drug Agency (FDA), World Health Organisation (WHO), World Bank and United Nations (UN), and national regulatory agency reports in native languages (English, German, Bosnian, and Croatian) published from November 1, 2019 to May 1, 2020. This paper focuses on three types of essential medical products: mechanical ventilators, personal protective equipment (PPE) and diagnostic tests. Evidence-informed commentary of available data and potential identified risks of emergency use authorizations and legal concessions is presented. DISCUSSION: It is recognized that now more than ever, raising global awareness and knowledge about the importance of respecting the essential requirements is needed to guarantee the appropriate quality, performance and safety of medical products, especially during outbreak situation, such as the COVID-19 pandemic. Emergency use authorizations for production, import and approval of medical products should be strictly specified and clearly targeted from case to case and should not be general or universal for all medical products, because all of them are associated with different risk level. CONCLUSION: Presented considerations and experiences should be taken as a guide for all possible future outbreak situations to prevent improvised reactions of national regulatory bodies.


Assuntos
Betacoronavirus , Comércio/legislação & jurisprudência , Infecções por Coronavirus , Licenciamento/legislação & jurisprudência , Indústria Manufatureira/legislação & jurisprudência , Pandemias , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral , Kit de Reagentes para Diagnóstico/provisão & distribução , Ventiladores Mecânicos/provisão & distribução , Técnicas de Laboratório Clínico/normas , Infecções por Coronavirus/diagnóstico , Falha de Equipamento , União Europeia , Saúde Global , Humanos , Equipamento de Proteção Individual/normas , Kit de Reagentes para Diagnóstico/normas , Medição de Risco , Estados Unidos , United States Food and Drug Administration , Ventiladores Mecânicos/normas
7.
Air Med J ; 39(5): 340-342, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33012469

RESUMO

In late 2019, a novel coronavirus was identified as the cause of a cluster of atypical pneumonia cases in Wuhan, China. It subsequently spread throughout China and around the world, quickly becoming a public health emergency. In March 2020, the World Health Organization declared coronavirus disease 2019 a pandemic. This article explores the preparation and early experiences of a large Canadian critical care transport program during the coronavirus disease 2019 pandemic focused on 6 broad strategic objectives centered around staff welfare, regular and transparent communication, networking, evidenced-based approach to personal protective equipment, agile mission planning, and an expedited approach to clinical practice and policy updates and future state modeling.


Assuntos
Comunicação , Infecções por Coronavirus , Cuidados Críticos/organização & administração , Disseminação de Informação , Liderança , Pandemias , Transferência de Pacientes/organização & administração , Pneumonia Viral , Transporte de Pacientes/organização & administração , Medicina Aeroespacial , Resgate Aéreo , Ambulâncias , Betacoronavirus , Colúmbia Britânica , Prática Clínica Baseada em Evidências , Humanos , Equipamento de Proteção Individual/provisão & distribução , Resiliência Psicológica
8.
J Otolaryngol Head Neck Surg ; 49(1): 71, 2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-33023663

RESUMO

Within Neurotology, special draping systems have been devised for mastoid surgery recognizing that drilling of middle ear mucosa is an aerosol generating medical procedure (AGMP) which can place surgical teams at risk of COVID-19 infection. We provide a thorough description of a barrier system utilized in our practice, along with work completed by our group to better quantify its effectiveness. Utilization of a barrier system can provide near complete bone dust and droplet containment within the surgical field and prevent contamination of other healthcare workers. As this is an early system, further adaptations and national collaborations are required to ultimately arrive at a system that seamlessly integrates into the surgical suite. While these barrier systems are new, they are timely as we face a pandemic, and can play a crucial role in safely resuming surgery.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Otopatias/epidemiologia , Processo Mastoide/cirurgia , Procedimentos Cirúrgicos Otológicos/métodos , Pneumonia Viral/epidemiologia , Base do Crânio/cirurgia , Comorbidade , Otopatias/cirurgia , Humanos , Pandemias , Equipamento de Proteção Individual
10.
J Cancer Res Ther ; 16(5): 974-978, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33004737

RESUMO

The pandemic of coronavirus disease 2019 (COVID-19) has become a major public health threat to the whole world. Although the control of COVID-19 has been in the forefront of interventional practice, most interventional radiologists (IRs) are not equipped adequately to cope with such a crisis. In this review, we share our experience from Chinese IRs' perspective, report on the acute measures instituted within interventional radiology (IR) units, and give recommendations to the prevention and control of COVID-19.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/normas , Pandemias/prevenção & controle , Equipamento de Proteção Individual/normas , Pneumonia Viral/prevenção & controle , Padrões de Prática Médica/normas , Radiologia Intervencionista/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Radiologia Intervencionista/instrumentação
14.
Psychiatr Serv ; 71(10): 1088-1090, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32998660

RESUMO

Specific guidance on how to manage COVID-19 in forensic psychiatric institutions is necessary because these settings differ substantially from both acute-care psychiatric hospitals and correctional institutions. The challenges raised by COVID-19 in these settings are unique, given the nature of the patients treated, length of stay, and need to collaborate with various partners in the criminal justice system during both the admission and discharge planning processes. This column outlines these specific challenges, which are likely to recur in subsequent epidemics, and suggests potential strategies to address them.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Psiquiatria Legal/métodos , Hospitais Psiquiátricos , Transtornos Mentais/complicações , Transtornos Mentais/terapia , Pneumonia Viral/complicações , Infecções por Coronavirus/prevenção & controle , Humanos , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle
15.
Best Pract Res Clin Anaesthesiol ; 34(3): 539-551, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33004165

RESUMO

Coronavirus disease 2019 (COVID-19) is spreading rapidly around the world with devastating consequences on patients, healthcare workers, health systems, as well as economies. While, healthcare systems are globally operating at maximum capacity, healthcare workers and especially anesthesia providers are facing extreme pressures, something that is also leading to declining availability and increasing stress. In this regard, it is extremely concerning the fact that some regions worldwide have reported up to 20% of their cases to be healthcare workers. When considering that the global case fatality rate may be as much as 5.4%, these numbers are concerning and unacceptable. As this pandemic accelerates, access to personal protective equipment for health workers is a key concern since at present, healthcare workers are every country's most valuable resource in the fight against COVID-19. Governments and heath organizations should take care of their staff and support them in any way possible. This review aims to describe the current situation anesthesia providers are facing in the setting of COVID-19 and provide solutions and evidence on important concerns, including which guidance to follow, the level of equipment that is adequate, and the level of protection they need for every patient being administered an anesthetic.


Assuntos
Anestesiologia/métodos , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Humanos , Equipamento de Proteção Individual
16.
Rev Sci Tech ; 39(2): 561-577, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33046919

RESUMO

Personal protective equipment (PPE) is used every day in veterinary practice. In the context of infectious disease control, PPE functions as a barrier against disease transmission and spread. It is selected based on a disease risk assessment and the circumstances in which it is to be used. Higher levels of protection require more complex PPE. However, PPE is only effective as a barrier if it corresponds to the level of protection needed for the infectious agent involved and its chain of transmission; fits the employee correctly and remains uncompromised; is put on (donned) and taken off (doffed) according to a protocol that minimises contamination; is disposed of safely; and no errors occur during patient examination or any of the other steps in the process. Training veterinary personnel in the use of PPE is often neglected and ample evidence in the literature suggests that fewer than 50% of healthcare workers receive such training and use the equipment according to protocol. Developing evidence-based training programmes that allow employees to demonstrate their proficiency is an opportunity to improve PPE use. Methods that highlight potential contamination and let employees assess their performance are highly desirable. This paper will discuss which factors determine PPE selection, what PPE options are available, and the different training levels that should be considered.


Assuntos
Pessoal de Saúde , Equipamento de Proteção Individual , Animais , Humanos
17.
J Breath Res ; 14(4): 040202, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33021207

RESUMO

In contrast to blood and urine samples, breath is invisible and ubiquitous in the environment. Different precautions are now necessary beyond the usual 'Universal Precautions'. In the era of COVID-19, breath (especially the aerosol fraction) can no longer be considered as harmless in the clinic or laboratory. As Journal of Breath Research is a primary resource for breath-related research, we (the editors) are presently developing safety guidance applicable to all breath research , not just for those projects that involve known COVID-19 infected subjects. We are starting this process by implementing requirements on reporting safety precautions in research papers and notes. This editorial announces that authors of all new submissions to JBR henceforth must state clearly the procedures undertaken for assuring laboratory and clinical safety, much like the existing requirements for disclosing Ethics Committee or Institutional Review Board protocols for studies on human subjects. In the following, we additionally make some recommendations based on best practices drawn from our experience and input from the JBR Editorial Board.


Assuntos
Pesquisa Biomédica/tendências , Testes Respiratórios , Controle de Doenças Transmissíveis , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Aerossóis , Betacoronavirus , Pesquisa Biomédica/normas , Humanos , Pandemias , Equipamento de Proteção Individual , Saúde Pública , Risco , Segurança
18.
G Ital Nefrol ; 37(5)2020 Oct 05.
Artigo em Italiano | MEDLINE | ID: mdl-33026200

RESUMO

The epidemic wave that hit Italy from February 21st, 2020, when the Italian National Institute of Health confirmed the first case of SARS­CoV­2 infection, led to a rapid and efficient reorganization of Dialysis Centers' activities, in order to contain large-scale spread of disease in this clinical setting. We herein report the experience of the Hemodialysis Unit of Parma University Hospital (Azienda Ospedaliero-Universitaria, Parma, Italy) and the Dialysis Centers of Parma territory, in the period from March 1st, 2020 to June 15, 2020. Among patients undergoing chronic haemodialysis, 37/283 (13%) had positive swabs for SARS­CoV­2, 9/37 (24%) died because of COVID-19. Twenty-three patients required hospitalization, while the remaining were managed at home. The primary measures applied to contain the infection were: the strengthening of personal protective equipment use by doctors and nurses, early identification of infected subjects by performing oro-pharyngeal swabs in every patient and in the healthcare personnel, the institution of a triage protocol when entering Dialysis Room, and finally the institution of two separate sections, managed by different doctors and dialysis nurses, to physically separate affected from unaffected patients and to manage "grey" patients. Our experience highlights the importance and effectiveness of afore-mentioned measures in order to contain the spread of the virus; moreover, we observed a higher lethality rate of COVID-19 in dialysis patients as compared to the general population.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Unidades Hospitalares de Hemodiálise/organização & administração , Reestruturação Hospitalar , Falência Renal Crônica/terapia , Pandemias , Pneumonia Viral/epidemiologia , Diálise Renal , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Diagnóstico Precoce , Emergências , Unidades Hospitalares de Hemodiálise/estatística & dados numéricos , Hemodiálise no Domicílio/estatística & dados numéricos , Mortalidade Hospitalar , Hospitais Universitários/estatística & dados numéricos , Humanos , Controle de Infecções/métodos , Itália/epidemiologia , Falência Renal Crônica/epidemiologia , Nasofaringe/virologia , Pandemias/prevenção & controle , Isolamento de Pacientes , Diálise Peritoneal , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Utilização de Procedimentos e Técnicas , Triagem
19.
G Ital Nefrol ; 37(5)2020 Oct 05.
Artigo em Italiano | MEDLINE | ID: mdl-33026201

RESUMO

Coronavirus disease 2019 is an infectious respiratory syndrome caused by the virus called SARS-CoV-2, belonging to the family of coronaviruses. The first ever cases were detected during the 2019-2020 pandemic. Coronaviruses can cause a common cold or more serious diseases such as Middle Eastern Respiratory Syndromes (MERS) and Severe Acute Respiratory Syndrome (SARS). They can cause respiratory, lung and gastrointestinal infections with a mild to severe course, sometimes causing the death of the infected person. This new strain has no previous identifiers and its epidemic potential is strongly associated with the absence of immune response/reactivity and immunological memory in the world population, which has never been in contact with this strain before. Most at risk are the elderly, people with pre-existing diseases and/or immunodepressed, dialyzed and transplanted patients, pregnant women, people with debilitating chronic diseases. They are advised to avoid contacts with other people, unless strictly necessary, and to stay away from crowded places, also observing scrupulously the recommendations of the Istituto Superiore di Sanità. In this article we detail the recommendations that must be followed by the nursing care staff when dealing with chronic kidney disease patients in dialysis or with kidney transplant patients. We delve into the procedures that are absolutely essential in this context: social distancing of at least one meter, use of PPI, proper dressing and undressing procedures, frequent hand washing and use of gloves, and finally the increase of dedicated and appropriately trained health personnel on ward.


Assuntos
Betacoronavirus , Infecções por Coronavirus/enfermagem , Infecção Hospitalar/prevenção & controle , Controle de Infecções/métodos , Transplante de Rim/enfermagem , Pandemias , Pneumonia Viral/enfermagem , Guias de Prática Clínica como Assunto , Diálise Renal/enfermagem , Insuficiência Renal Crônica/enfermagem , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Desinfecção , Desinfecção das Mãos , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Resíduos de Serviços de Saúde , Processo de Enfermagem/normas , Registros de Enfermagem , Pandemias/prevenção & controle , Isolamento de Pacientes , Equipamento de Proteção Individual , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Insuficiência Renal Crônica/cirurgia , Insuficiência Renal Crônica/terapia , Precauções Universais
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