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2.
Anesth Analg ; 132(1): 38-45, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33315602

RESUMO

BACKGROUND: Numerous barrier devices have recently been developed and rapidly deployed worldwide in an effort to protect health care workers (HCWs) from exposure to coronavirus disease 2019 (COVID-19) during high-risk procedures. However, only a few studies have examined their impact on the dispersion of droplets and aerosols, which are both thought to be significant contributors to the spread of COVID-19. METHODS: Two commonly used barrier devices, an intubation box and a clear plastic intubation sheet, were evaluated using a physiologically accurate cough simulator. Aerosols were modeled using a commercially available fog machine, and droplets were modeled with fluorescein dye. Both particles were propelled by the cough simulator in a simulated intubation environment. Data were captured by high-speed flash photography, and aerosol and droplet dispersion were assessed qualitatively with and without a barrier in place. RESULTS: Droplet contamination after a simulated cough was seemingly contained by both barrier devices. Simulated aerosol escaped the barriers and flowed toward the head of the bed. During barrier removal, simulated aerosol trapped underneath was released and propelled toward the HCW at the head of the bed. Usage of the intubation sheet concentrated droplets onto a smaller area. If no barrier was used, positioning the patient in slight reverse Trendelenburg directed aerosols away from the HCW located at the head of the bed. CONCLUSIONS: Our observations imply that intubation boxes and sheets may reduce HCW exposure to droplets, but they both may merely redirect aerosolized particles, potentially resulting in increased exposure to aerosols in certain circumstances. Aerosols may remain within the barrier device after a cough, and manipulation of the box may release them. Patients should be positioned to facilitate intubation, but slight reverse Trendelenburg may direct infectious aerosols away from the HCW. Novel barrier devices should be used with caution, and further validation studies are necessary.


Assuntos
/terapia , Controle de Infecções/instrumentação , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Exposição por Inalação/prevenção & controle , Intubação Intratraqueal , Exposição Ocupacional/prevenção & controle , Equipamento de Proteção Individual , Aerossóis , Humanos , Exposição por Inalação/efeitos adversos , Intubação Intratraqueal/efeitos adversos , Manequins , Teste de Materiais , Exposição Ocupacional/efeitos adversos , Saúde do Trabalhador
4.
Clin Microbiol Infect ; 27(1): 130.e1-130.e4, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33010442

RESUMO

OBJECTIVES: We aimed to compare the prevalence of asymptomatic coronavirus disease 19 (COVID-19) among clinical staff in designated COVID-19 units versus that among staff in similar units with no known or suspected COVID-19 patients. METHODS: We conducted a cross-sectional survey of healthcare workers (HCWs) in eight Israeli general hospitals. The survey involved a questionnaire and a PCR test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We surveyed HCWs in COVID-19 units and comparison units (internal medicine and cardiology) between 30th April and 7th May 2020. RESULTS: There were 522 participants: 291 from COVID-19 units and 231 from comparison units. Only one participant (0.2%, 95%CI: 0.005-1.1%)-an asymptomatic nurse on a COVID-19 unit-tested positive for SARS-CoV-2. In participating COVID-19 units there were two symptomatic HCWs with confirmed COVID-19 in the 2 weeks before the survey; both were infected by contact with a co-worker outside of the COVID-19 unit. CONCLUSIONS: The low prevalence of asymptomatic COVID-19 among HCWs, coupled with an absence of symptomatic COVID-19 acquired during patient care, suggest that Israel's national guidelines for personal protective equipment, which are consistent with those of the World Health Organization, adequately protect HCWs.


Assuntos
/epidemiologia , Pessoal de Saúde , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Equipamento de Proteção Individual/estatística & dados numéricos , /patogenicidade , Adulto , Doenças Assintomáticas , /virologia , Cuidados Críticos/organização & administração , Estudos Transversais , Feminino , Humanos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Prevalência , Reação em Cadeia da Polimerase Via Transcriptase Reversa , /genética
5.
Curr Opin Pediatr ; 33(1): 136-143, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33315687

RESUMO

PURPOSE OF REVIEW: Given the limited evidence and experience with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), this novel pathogen has challenged the field of infection prevention. Despite uncertainty, infection prevention principles and experience with similar diseases have helped guide how to best protect providers and patients against disease acquisition. RECENT FINDINGS: Guidance to date has relied on data from SARS-CoV-1 and MERS-CoV to guide practices on patient isolation and personal protective equipment (PPE) use. Although a face mask and eye protection are likely adequate for most clinical scenarios, published guidelines for PPE can be confusing and conflicting. Consensus for what constitutes a high-risk aerosol-generating procedure (AGP) is lacking, but most agree providers performing procedures such as bronchoscopy, intubation, and cardiopulmonary resuscitation would likely benefit from the use of an N95 respirator and eye protection. SUMMARY: Needed research to elucidate the predominant SARS-CoV-2 mode of transmission is not likely to be completed in the immediate future. Recommendations for PPE to mitigate procedure-associated risk remain controversial. Nonetheless, implementation of existing measures based on basic infection prevention principles is likely to prevent transmission significantly.


Assuntos
Infecção Hospitalar , Infecção Hospitalar/prevenção & controle , Pessoal de Saúde , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle
6.
Anesth Analg ; 132(1): 2-14, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33002929

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic created an extraordinary demand for N95 and similarly rated filtering facepiece respirators (FFR) that remains unmet due to limited stock, production constraints, and logistics. Interest in decontamination and reuse of FFR, a product class designed for single use in health care settings, has undergone a parallel surge due to shortages. A worthwhile decontamination method must provide effective inactivation of the targeted pathogen(s), and preserve particle filtration, mask fit, and safety for a subsequent user. This discussion reviews the background of the current shortage, classification, structure, and functional aspects of FFR, and potentially effective decontamination methods along with reference websites for those seeking updated information and guidance. The most promising techniques utilize heat, hydrogen peroxide, microwave-generated steam, or ultraviolet light. Many require special or repurposed equipment and a detailed operational roadmap specific to each setting. While limited, research is growing. There is significant variation between models with regard to the ability to withstand decontamination yet remain protective. The number of times an individual respirator can be reused is often limited by its ability to maintain a tight fit after multiple uses rather than by the decontamination method itself. There is no single solution for all settings; each individual or institution must choose according to their need, capability, and available resources. As the current pandemic is expected to continue for months to years, and the possibility of future airborne biologic threats persists, the need for plentiful, effective respiratory protection is stimulating research and innovation.


Assuntos
/prevenção & controle , Descontaminação , Contaminação de Equipamentos , Reutilização de Equipamento , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Exposição por Inalação/prevenção & controle , Exposição Ocupacional/prevenção & controle , /transmissão , Humanos , Exposição por Inalação/efeitos adversos , Exposição Ocupacional/efeitos adversos , Saúde do Trabalhador , Medição de Risco , Fatores de Risco
7.
Ear Nose Throat J ; 100(1): 19-25, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32894699

RESUMO

INTRODUCTION: During the COVID-19 pandemic, worldwide over 600,000 human beings died due to the cause of the disease. In order to deescalate the transmission rate and to avoid crush loading the countries medical health systems social distancing, face masks, and lockdowns have been considered essential by the majority of governments. Whereas some countries have highly reduced or completely stopped otorhinolaryngological procedures, other countries have continued selected surgeries. The objective of this study was to analyze procedures and outcomes of continuing semielective and emergency surgeries during the COVID-19 pandemic. METHODS: Retrospective analysis of n = 750 patients who received semi-elective or emergency surgery between March 26 and June 16, 2020, in the Otolaryngology Department of the Friedrich-Alexander-University of Erlangen-Nürnberg. All patients were screened for COVID symptoms and swabbed for SARS-CoV-2 prior to surgery. RESULTS: Of the n = 750 patients, n = 699 patients received semielective surgery and n = 51 emergency surgery. For 27 patients, the swab result could not be awaited due to a life-threatening condition. In these cases, surgery was performed in full protective equipment. No patient was tested positive during or after the surgery (follow-up 45 to 127 days). No member of the medical personnel showed symptoms or was tested positive after contact with patients. Due to the continuation of surgeries, patients' lives were saved and improvement of long-term quality-of-life and outcomes is anticipated. CONCLUSIONS: Continuing selected otorhinolaryngological surgeries is crucial for patients' health, survival, and long-time quality of life, yet, the protection of the medical personnel has to be granted.


Assuntos
/prevenção & controle , Controle de Infecções/organização & administração , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Procedimentos Cirúrgicos Otorrinolaringológicos , Seleção de Pacientes , Adulto , Idoso , /transmissão , Procedimentos Cirúrgicos Eletivos , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
8.
Ultrasound Med Biol ; 47(2): 222-229, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33187758

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has caused a worldwide pandemic and poses a serious public health risk. It has been proven that lung ultrasound can be extremely valuable in the diagnosis and treatment of the disease, which could also minimize the number of exposed healthcare workers and equipment. Because healthcare workers in ultrasound departments are in close contact with patients who might be infected or virus carriers, it is extremely important that they be provided sufficient protection. Extremely aggressive protection should be avoided because it might lead to a lack of protection equipment for the hospital. Guidance on proper protection management should be provided in detail, for example, how to choose personal protective equipment, how to disinfect the environment. To address these problems, on behalf of the Chinese Ultrasound Doctors Association, Chinese PLA Professional Committee of Ultrasound in Medicine, Beijing Institute of Ultrasound in Medicine and Chinese Research Hospital Association Ultrasound Professional Committee, the authors have summarized the recommendations for effective protection according to existing hygienic standards, their experience and available literature. After the recommendations were completed, two online conferences were held on January 31, 2020 and February 7, 2020, at which the recommendations were discussed in detail. A modified version of the work was circulated and finally approved by all authors, and is the present Chinese Expert Consensus on Protection for Ultrasound Healthcare Workers against COVID-19.


Assuntos
/prevenção & controle , Pessoal de Saúde , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Ultrassonografia/métodos , China , Consenso , Desinfecção , Humanos , Exposição Ocupacional/prevenção & controle , Equipamento de Proteção Individual , Quarentena , Triagem
11.
Surg Endosc ; 35(1): 493-501, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32974779

RESUMO

BACKGROUND: Viral particles have been shown to aerosolize into insufflated gas during laparoscopic surgery. In the operating room, this potentially exposes personnel to aerosolized viruses as well as carcinogens. In light of circumstances surrounding COVID-19 and a concern for the safety of healthcare professionals, our study seeks to quantify the volumes of gas leaked from dynamic interactions between laparoscopic instruments and the trocar port to better understand potential exposure to surgically aerosolized particles. METHODS: A custom setup was constructed to simulate an insufflated laparoscopic surgical cavity. Two surgical instrument use scenarios were examined to observe and quantify opportunities for insufflation gas leakage. Both scenarios considered multiple configurations of instrument and trocar port sizes/dimensions: (1) the full insertion and full removal of a laparoscopic instrument from the port and (2) the movement of the scope within the port, recognized as "dynamic interaction", which occurs nearly 100% of the time over the course of any procedure. RESULTS: For a 5 mm instrument in a 5 mm trocar, the average volume of gas leaked during dynamic interaction and full insertion/removal scenarios were 43.67 and 25.97 mL of gas, respectively. Volume of gas leaked for a 5 mm instrument in a 12 mm port averaged 41.32 mL and 29.47 for dynamic interaction vs. instrument insertion and removal. Similar patterns were shown with a 10 mm instrument in 12 mm port, with 55.68 mL for the dynamic interaction and 58.59 for the instrument insertion/removal. CONCLUSIONS: Dynamic interactions and insertion/removal events between laparoscopic instruments and ports appear to contribute to consistent leakage of insufflated gas into the OR. Any measures possible taken to reduce OR gas leakage should be considered in light of the current COVID-19 pandemic. Minimizing laparoscope and instrument removal and replacement would be one strategy to mitigate gas leakage during laparoscopic surgery.


Assuntos
/prevenção & controle , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Laparoscopia/métodos , Doenças Profissionais/prevenção & controle , Exposição Ocupacional/prevenção & controle , Recursos Humanos em Hospital , Aerossóis , Humanos , Insuflação/instrumentação , Insuflação/métodos , Laparoscopia/instrumentação
13.
Br J Radiol ; 94(1117): 20200686, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33216637

RESUMO

COVID-19 pandemic has had a catastrophic impact on the society, economy and heath-care system all over the globe with virus showing no signs of losing potency. As the situation appears to worsen, extra burden on other specialities like oncology seems to increase. Specific recommendations are necessary for management of cervical cancer in the current context. All concerned specialities must work together in the best interest of the patient. Attempts should be made at managing cervical cancer while limiting the viral spread among the patients and health-care workers without the loss of opportunity. Surgical intervention for early cervical cancer should be postponed or alternative modalities be considered. In a locally advanced disease, concurrent chemoradiation is the treatment of choice. In addition, the following under mentioned suggestions aim to discuss ways of minimizing infection spread, workload rationalization and providing guidance for management of cervical cancer in the presence of COVID-19 infection.


Assuntos
Neoplasias do Colo do Útero/radioterapia , /prevenção & controle , Feminino , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle
14.
Ann Emerg Med ; 77(1): 1-10, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32893040

RESUMO

STUDY OBJECTIVE: Throughout the coronavirus disease 2019 pandemic, many emergency departments have been using passive protective enclosures ("intubation boxes") during intubation. The effectiveness of these enclosures remains uncertain. We sought to quantify their ability to contain aerosols using industry standard test protocols. METHODS: We tested a commercially available passive protective enclosure representing the most common design and compared this with a modified enclosure that incorporated a vacuum system for active air filtration during simulated intubations and negative-pressure isolation. We evaluated the enclosures by using the same 3 tests air filtration experts use to certify class I biosafety cabinets: visual smoke pattern analysis using neutrally buoyant smoke, aerosol leak testing using a test aerosol that mimics the size of virus-containing particulates, and air velocity measurements. RESULTS: Qualitative evaluation revealed smoke escaping from all passive enclosure openings. Aerosol leak testing demonstrated elevated particle concentrations outside the enclosure during simulated intubations. In contrast, vacuum-filter-equipped enclosures fully contained the visible smoke and test aerosol to standards consistent with class I biosafety cabinet certification. CONCLUSION: Passive enclosures for intubation failed to contain aerosols, but the addition of a vacuum and active air filtration reduced aerosol spread during simulated intubation and patient isolation.


Assuntos
/prevenção & controle , Controle de Infecções/instrumentação , Intubação Intratraqueal/instrumentação , Pneumonia Viral/prevenção & controle , Aerossóis , Infecção Hospitalar/prevenção & controle , Desenho de Equipamento , Filtração/instrumentação , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Manequins , Pandemias , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Vácuo
16.
J Infect Chemother ; 27(1): 120-122, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32988731

RESUMO

INTRODUCTION: Information on the effectiveness of personal protective equipment (PPE) for preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among healthcare workers (HCWs), especially among HCWs with frequent contact with patients with SARS-CoV-2, is limited. METHODS: We conducted a prospective cohort study on 49 HCWs who worked in close contact with patients with SARS-CoV-2 infection. HCWs had blood samples taken every 2 weeks to test for SARS-CoV-2 antibodies using two different types of assay. RESULTS: Forty-nine participants (31 nurses, 15 doctors, 3 other workers) were enrolled. In total, 112 blood samples are obtained from participants. The median work days in 2 weeks was 9 (interquartile range (IQR): 5-10) days. In a single work day, 30 of the 49 participants (61.5%) had contact with patients with suspected or conformed SARS-CoV-2 at least 8 times, and approximately 60% of participants had more than 10 min of contact with a single patient. The median self-reported compliance to PPE was 90% (IQR: 80-100%). Seven participants tested positive for SARS-CoV-2 antibody using enzyme-linked immunosorbent assay (ELISA); however, none were seropositive for SARS-CoV-2 neutralizing antibody, so the positive ELISA results were assumed to be false-positive. CONCLUSIONS: The study provides evidence that appropriate PPE is sufficient to prevent infection amongHCWs. It is necessary to establish a system that provides a stable supply of PPE for HCWs to perform their duties.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Pessoal de Saúde , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Adulto , Idoso , Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/diagnóstico , Estudos Prospectivos , Adulto Jovem
17.
J Neurosurg Anesthesiol ; 33(1): 73-76, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32976309

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus, is highly contagious. Global medical systems have been heavily impacted by the COVID-19 pandemic. Although the majority of patients with intracranial disease require time-sensitive surgery, how to conduct neurosurgery and prevent and control nosocomial infection during a pandemic is challenging. MATERIALS AND METHODS: We retrospectively reviewed the clinical data of patients undergoing neurosurgical and neurointerventional procedures at Beijing Tiantan Hospital, China during the early stages of the COVID-19 pandemic between January 21 and July 31, 2020. A 3-level system of COVID-19 risk was established based on medical conditions, epidemiologic, and symptom inquiry and the results of triage. A transitional unit was established for patients in whom COVID-19 had not been ruled out on admission to hospital. RESULTS: A total of 4025 patients underwent neurosurgery during the study period, including 768 emergent and 3257 nonemergent procedures. Of these patients, 3722 were low-risk for COVID-19, 303 were moderate-risk, and none were high-risk. In addition, 1419 patients underwent neurointerventional procedures, including 114 emergent and 1305 nonemergent interventions, of which 1339 were low-risk patients, 80 were moderate-risk and none were high-risk. A total of 895 patients (neurosurgical and neurointerventional) were admitted to the transitional unit. Forty-five patients were diagnosed with COVID-19 and transferred to the COVID-19 designated hospital. There were no cases of COVID-19 nosocomial infections among surgical patients or health care workers. CONCLUSION: On the basis of our single-center experience, developing a full screening protocol for COVID-19, establishing a risk level, and using a transitional unit for those with unknown COVID-19 status are effective measures to provide a safe environment for patients and health care workers.


Assuntos
Anestesia/tendências , Neurocirurgia/tendências , Pandemias , /epidemiologia , China/epidemiologia , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Salas Cirúrgicas/organização & administração , Admissão do Paciente , Equipamento de Proteção Individual , Estudos Retrospectivos , Medição de Risco , Triagem
18.
J Neurosurg Anesthesiol ; 33(1): 44-50, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33048865

RESUMO

BACKGROUND: According to early reports, patients affected by coronavirus disease 2019 (COVID-19) are at an increased risk of developing cerebrovascular events, including acute ischemic stroke (AIS). The COVID-19 pandemic may also impose difficulties in managing AIS patients undergoing endovascular thrombectomy (EVT), as well as concerns for the safety of health care providers. This international global survey aims to gather and summarize information from tertiary care stroke centers on periprocedural pathways and endovascular management of AIS patients during the COVID-19 pandemic. METHODS: A cross-sectional survey-based research questionnaire was sent to 259 tertiary care stroke centers with neurointerventional facilities worldwide. RESULTS: We received 114 responses (response rate: 44%) from 25 different countries across all 5 continents. The number of AIS patients and EVT cases were reported to have decreased during the pandemic. Most participants reported conducting COVID-19 testing before (49%) or after the procedure (31%); 20% of centers did not test at all. Only 16% of participating centers reported using a negative pressure room for the thrombectomy procedure. Strikingly, 50% of participating centers reported no changes in the anesthetic management of AIS patients undergoing EVT during the pandemic. CONCLUSIONS: This global survey provides information on the challenges in managing AIS patients undergoing EVT during the COVID-19 pandemic. Its findings can be used to improve patient outcomes and the safety of the health care team worldwide.


Assuntos
/diagnóstico por imagem , Pandemias , Anestesia , Estudos Transversais , Procedimentos Endovasculares , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Segurança do Paciente , Inquéritos e Questionários , Centros de Atenção Terciária , Trombectomia , Resultado do Tratamento
19.
J Stroke Cerebrovasc Dis ; 29(12): 105419, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33254379

RESUMO

INTRODUCTION: Apnea testing remains essential for the clinical evaluation of brain death determination. In patients who test positive for SARS-CoV-2, disconnecting the patient from the ventilator and introducing high flow oxygen into the endotracheal tube increases the risk for aerosolization of airway secretions and exposure of the examiner. METHODS: Case report of a patient with an intracerebral hemorrhage that evolved to significant cerebral edema and herniation, who underwent apnea test using a method involving a t-piece and an HME filter. RESULTS: Patient successfully pronounced brain dead using a safe method to minimize exposure to SARS-CoV-2. CONCLUSION: At a time where healthcare workers are at high risk of exposure to COVID-19, the above described method is a safe process for apnea testing in declaration of brain death.


Assuntos
Apneia/diagnóstico , Morte Encefálica/diagnóstico , Edema Encefálico/etiologia , Hemorragia Cerebral/etiologia , Encefalocele/etiologia , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Saúde do Trabalhador , Apneia/etiologia , Edema Encefálico/diagnóstico , /transmissão , Hemorragia Cerebral/diagnóstico , Encefalocele/diagnóstico , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-Idade
20.
G Ital Nefrol ; 37(6)2020 Dec 07.
Artigo em Italiano | MEDLINE | ID: mdl-33295703

RESUMO

The SARS-CoV-2 pandemic has forced a reshaping of economic, productive, commercial and healthcare systems. The last one had the dual mandate to limit intra-hospital infections and strengthen its ability to deal with the ongoing emergency. In this paper we report the experience gained by the staff of the Nephrology and Dialysis Unit of the AULSS7 Pedemontana (Vicenza - Veneto region) and the organizational model pursued during the first wave of the pandemic.


Assuntos
/prevenção & controle , Falência Renal Crônica/epidemiologia , Pandemias , Diálise Renal/estatística & dados numéricos , /diagnóstico , Comorbidade , Terapia de Substituição Renal Contínua , Cuidados Críticos , Humanos , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Itália/epidemiologia , Falência Renal Crônica/terapia , Diálise Peritoneal , Utilização de Procedimentos e Técnicas
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