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关于为新型冠状病毒(2019-nCoV)患者提供重症监护和麻醉护理的实用建议。

Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients.

机构信息

Department of Critical Care Medicine, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.

Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

出版信息

Can J Anaesth. 2020 May;67(5):568-576. doi: 10.1007/s12630-020-01591-x. Epub 2020 Feb 12.

Abstract

A global health emergency has been declared by the World Health Organization as the 2019-nCoV outbreak spreads across the world, with confirmed patients in Canada. Patients infected with 2019-nCoV are at risk for developing respiratory failure and requiring admission to critical care units. While providing optimal treatment for these patients, careful execution of infection control measures is necessary to prevent nosocomial transmission to other patients and to healthcare workers providing care. Although the exact mechanisms of transmission are currently unclear, human-to-human transmission can occur, and the risk of airborne spread during aerosol-generating medical procedures remains a concern in specific circumstances. This paper summarizes important considerations regarding patient screening, environmental controls, personal protective equipment, resuscitation measures (including intubation), and critical care unit operations planning as we prepare for the possibility of new imported cases or local outbreaks of 2019-nCoV. Although understanding of the 2019-nCoV virus is evolving, lessons learned from prior infectious disease challenges such as Severe Acute Respiratory Syndrome will hopefully improve our state of readiness regardless of the number of cases we eventually manage in Canada.

摘要

世界卫生组织宣布 2019 年新型冠状病毒爆发在全球范围内蔓延为全球卫生紧急事件,加拿大已确认有患者感染。感染 2019 年新型冠状病毒的患者有发生呼吸衰竭并需要入住重症监护病房的风险。在为这些患者提供最佳治疗的同时,需要谨慎执行感染控制措施,以防止医院内传播给其他患者和提供护理的医护人员。虽然目前传播的确切机制尚不清楚,但人与人之间可能会发生传播,在特定情况下,在产生气溶胶的医疗程序中空气传播的风险仍然令人关注。本文总结了在为可能出现的新输入病例或本地 2019 年新型冠状病毒爆发做准备时,关于患者筛查、环境控制、个人防护设备、复苏措施(包括插管)和重症监护病房操作计划的重要考虑因素。尽管对 2019 年新型冠状病毒的了解还在不断发展,但从严重急性呼吸系统综合征等先前传染病挑战中吸取的经验教训有望提高我们的准备状态,而无论我们最终在加拿大管理多少病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff04/7091420/d480f6f09e8f/12630_2020_1591_Fig1_HTML.jpg

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