Sud Sohil R
Department of Pediatrics, University of California, San Francisco, San Francisco, California
Hosp Pediatr. 2020 Jul;10(7):570-576. doi: 10.1542/hpeds.2020-0135. Epub 2020 May 8.
Identifying the optimal amount of personal protective equipment (PPE) is a formidable challenge when faced with a new contagion such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Unequivocally, there are dangers to health care workers (and by extension, their patients, colleagues, and communities) if not enough equipment is donned to safeguard them. And yet, there are also dangers to patients, colleagues, and the community if resources are overconsumed and result in hoarding, shortages, and inequitable distribution, all of which are occurring as the worldwide coronavirus disease 2019 (COVID-19) pandemic continues.Research to ascertain the precise PPE required to defend specifically against SARS-CoV-2 encompasses an area of active investigation that will likely remain unresolved for some time. While awaiting more definitive conclusions, we must look to past evidence to provide a reasonable basis on which protocols and policies might be refined. What follows is a narrative review of PPE efficacy and how existing evidence might apply to protecting health care workers against COVID-19. Findings are extrapolated from investigations in 4 general domains: early investigations into SARS-CoV-2, retrospective studies about severe acute respiratory syndrome coronavirus 1, prospective studies of influenza and other common respiratory viruses, and laboratory PPE studies.Available evidence suggests that contact and droplet precautions, in addition to eye protection and standard hygiene measures, should be adequate in the vast majority of clinical settings when caring for patients with SARS-CoV-2. Adherence to guidelines promoting appropriate levels of PPE should safeguard practitioners while mitigating against resource overuse.
面对新型传染病,如严重急性呼吸综合征冠状病毒2(SARS-CoV-2)时,确定个人防护装备(PPE)的最佳用量是一项艰巨挑战。毫无疑问,如果医护人员没有穿戴足够的防护装备来保护自己,他们(以及间接的患者、同事和社区)会面临健康风险。然而,如果资源过度消耗导致囤积、短缺和分配不均,患者、同事和社区同样会面临风险,而在全球2019冠状病毒病(COVID-19)大流行持续期间,这些情况都在发生。确定专门针对SARS-CoV-2所需的精确个人防护装备的研究是一个活跃的调查领域,可能在一段时间内仍无法解决。在等待更明确的结论时,我们必须参考过去的证据,为完善协议和政策提供合理依据。以下是对个人防护装备功效以及现有证据如何应用于保护医护人员免受COVID-19感染的叙述性综述。研究结果是从4个一般领域的调查中推断出来的:对SARS-CoV-2的早期调查、关于严重急性呼吸综合征冠状病毒1的回顾性研究、对流感和其他常见呼吸道病毒的前瞻性研究以及实验室个人防护装备研究。现有证据表明,在绝大多数临床环境中,护理SARS-CoV-2患者时,除了眼部防护和标准卫生措施外,接触和飞沫预防措施应该足够。遵守促进适当个人防护装备水平的指南应能保护从业者,同时避免资源过度使用。