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新冠疫情期间烧伤治疗中的 SARS-CoV-2 职业暴露:特定诊断与治疗方案。

Occupational exposure to SARS-CoV-2 in burns treatment during the COVID-19 epidemic: Specific diagnosis and treatment protocol.

机构信息

Department of Burns and Wound Repair Surgery, Guangdong Provincial People's Hospital, Guangdong Academy Medical Sciences, Guangzhou 510080, People's Republic of China; Guangdong Cardiovascular Institut, Guangdong Provincial People's Hospital, Guangdong Academy Medical Sciences, Guangzhou 510080, People's Republic of China; Shantou University Medical College, Shantou 515063, People's Republic of China.

Shantou University Medical College, Shantou 515063, People's Republic of China; Guangdong Cardiovascular Institut, Guangdong Provincial People's Hospital, Guangdong Academy Medical Sciences, Guangzhou 510080, People's Republic of China.

出版信息

Biomed Pharmacother. 2020 Jul;127:110176. doi: 10.1016/j.biopha.2020.110176. Epub 2020 Apr 23.

Abstract

Epidemic prevention and control measures for the new coronavirus disease 2019 (COVID-19) has achieved significant results. As of 8 April 2020, 22,073 infection cases of COVID-19 among healthcare workers from 52 countries had been reported to WHO. COVID-19 has strong infectivity, high transmission speeds, and causes serious infection among healthcare worker. Burns are an acute-care condition, and burn treatment needs to be initiated before COVID-19 infection status can be excluded. The key step to infection prevention is to identify risk points of infection exposure, strengthen the protection against those risk points, and formulate an appropriate diagnosis and treatment protocol. Following an in-depth study of the latest literature on COVID-19 diagnosis and treatment, we reviewed the protocols surrounding hospitalization of patients with extensive burns (area≥50 %) in our hospital from February 2009 to February 2019 and, in accordance with the epidemiological characteristics of COVID-19, developed an algorithm for protection during diagnosis and treatment of burns. Therefore, the aspects of medical protection and the diagnosis and treatment of burns appear to be particularly important during the prevention and control of the COVID-19. This algorithm was followed for 4 patients who received emergency treatment in February 2020 and were hospitalized. All healthcare worker were protected according to the three-tiered protective measures, and there was no nosocomial infection. During the COVID-19 epidemic, the early stages of emergency treatment for patients with extensive burns requiring the establishment of venous access for rehydration, endotracheal intubation or tracheostomy, wound treatment, and surgery are the risk points for exposure to infection. The implementation of effective, appropriate-grade protection and formulation of practical treatment protocols can increase protection of healthcare worke and reduce the risk of COVID-19 infection exposure.

摘要

新型冠状病毒病(COVID-19)的疫情防控措施已取得显著成效。截至 2020 年 4 月 8 日,向世卫组织报告了来自 52 个国家的 22073 例医护人员 COVID-19 感染病例。COVID-19 具有很强的传染性、传播速度快,会导致医护人员发生严重感染。烧伤是一种急症,在排除 COVID-19 感染之前,需要进行烧伤治疗。感染预防的关键步骤是识别感染暴露的风险点,加强对这些风险点的防护,并制定适当的诊断和治疗方案。在深入研究 COVID-19 诊断和治疗的最新文献后,我们回顾了我院 2009 年 2 月至 2019 年 2 月期间广泛烧伤(面积≥50%)患者的住院治疗方案,并根据 COVID-19 的流行病学特征,制定了烧伤诊断和治疗过程中的防护算法。因此,在 COVID-19 防控期间,医疗防护和烧伤诊治显得尤为重要。该算法于 2020 年 2 月对 4 名接受紧急治疗并住院的患者进行了应用。所有医护人员均按照三级防护措施进行了防护,未发生医院感染。在 COVID-19 疫情期间,需要建立静脉通路补液、气管插管或气管切开、伤口处理和手术的广泛烧伤患者的早期紧急治疗是感染暴露的风险点。实施有效、适宜级别的防护和制定实用的治疗方案,可以提高医护人员的防护水平,降低 COVID-19 感染暴露的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be1e/7177133/4a9c37a76a59/ga1_lrg.jpg

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