Chee Victor Wei Ter, Khoo Mark Li-Chung, Lee Sow Fong, Lai Yeow Choy, Chin Ngek Mien
Department of Anaesthesiology, Tan Tock Sang Hospital, Singapore.
Anesthesiology. 2004 Jun;100(6):1394-8. doi: 10.1097/00000542-200406000-00010.
Singapore reported its first case of Severe Acute Respiratory Syndrome (SARS) in early March 2003 and was placed on the World Health Organization's list of SARS-affected countries on March 15, 2003. During the outbreak, Tan Tock Seng Hospital was designated as the national SARS hospital in Singapore to manage all known SARS patients. Stringent infection control measures were introduced to protect healthcare workers and control intrahospital transmission of SARS. Work-flow processes for surgery were extensively modified.
The authors describe the development of infection control measures, the conduct of surgical procedures, and the management of high-risk procedures during the SARS outbreak.
Forty-one operative procedures, including 15 high-risk procedures (surgical tracheostomy), were performed on SARS-related patients. One hundred twenty-four healthcare workers had direct contact with SARS patients during these procedures. There was no transmission of SARS within the operating room complex.
Staff personal protection, patient risk categorization, and reorganization of operating room workflow processes formed the key elements for the containment of SARS transmission. Lessons learned during this outbreak will help in the planning and execution of infection control measures, should another outbreak occur.
新加坡于2003年3月初报告了首例严重急性呼吸综合征(SARS)病例,并于2003年3月15日被列入世界卫生组织的SARS受影响国家名单。疫情爆发期间,新加坡樟宜综合医院被指定为该国的SARS医院,负责管理所有已知的SARS患者。为保护医护人员并控制SARS在医院内的传播,采取了严格的感染控制措施。手术的工作流程也进行了大幅修改。
作者描述了SARS疫情期间感染控制措施的制定、手术操作的实施以及高风险手术的管理情况。
对SARS相关患者进行了41例手术,其中包括15例高风险手术(外科气管切开术)。在这些手术过程中,有124名医护人员直接接触了SARS患者。手术区域内未发生SARS传播。
工作人员的个人防护、患者风险分类以及手术室工作流程的重新组织是遏制SARS传播的关键要素。此次疫情中吸取的经验教训将有助于在未来再次爆发疫情时制定和实施感染控制措施。