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拉丁美洲神经外科部门应对非 COVID-19 指定的 SARS-CoV-2 大流行。

Response to SARS-CoV-2 Pandemic in a Non-COVID-19 Designated Latin-American Neurosurgery Department.

机构信息

Department of Neurosurgery, Fray Antonio Alcalde Civil Hospital of Guadalajara, Guadalajara, Jalisco, Mexico.

Department of Neurosurgery, Fray Antonio Alcalde Civil Hospital of Guadalajara, Guadalajara, Jalisco, Mexico.

出版信息

World Neurosurg. 2020 Oct;142:506-512. doi: 10.1016/j.wneu.2020.05.019. Epub 2020 May 11.

Abstract

BACKGROUND

Mexico declared the first case of novel coronavirus disease (COVID-19) in February 2020. At the time we write this article, our country is facing a community spread phase, expecting a rapid increase in the number of cases and fatalities. The Fray Antonio Alcalde Civil Hospital of Guadalajara has been declared a non-COVID-19 hospital with the mission of providing care to patients already registered and also those transferred from neurosurgical departments of neighboring centers, which have been converted into COVID-19 only hospitals.

METHODS

An organized response regarding personnel, surgical case selection, operating room behavior, and facility reorganization were designed to prevent an internal coronavirus outbreak in the neurosurgery department at the Fray Antonio Alcalde Civil Hospital of Guadalajara.

RESULTS

Distancing actions by the staff and residents, including ward case discussions, neurosurgery rounds, and classes, will be carried out virtually. We classified neurosurgical patients into 4 groups depending on whether their condition demands care in 0-6 hours, 6-48 hours, 48 hours to 14 days, and >14 days. Subsequently, a questionnaire with epidemiologic, radiologic, clinical, and serologic criteria will be applied to determine the risk of COVID-19 infection to define to which area they are going to be transferred according to the different risk zones in our facility.

CONCLUSIONS

Despite not being a COVID-19 center, we consider all patients at the neurosurgical ward and staff members as asymptomatic carriers or infected in the preclinical period. Specific measures must be taken to ensure the safety and care of neurosurgical patients and medical staff during the community spread phase.

摘要

背景

墨西哥于 2020 年 2 月宣布首例新型冠状病毒病(COVID-19)病例。在我们撰写本文时,我国正处于社区传播阶段,预计病例和死亡人数将迅速增加。瓜达拉哈拉的 Fray Antonio Alcalde 民用医院已被宣布为非 COVID-19 医院,其使命是为已经登记的患者以及从附近中心神经外科部门转来的患者提供护理,这些中心已被改为仅收治 COVID-19 的医院。

方法

针对人员、手术病例选择、手术室行为和设施重组,制定了有组织的应对措施,以防止瓜达拉哈拉的 Fray Antonio Alcalde 民用医院神经外科部门内部爆发冠状病毒。

结果

工作人员和住院医师将采取隔离措施,包括病房病例讨论、神经外科查房和课程将在线上进行。我们根据患者的病情是否需要在 0-6 小时、6-48 小时、48 小时至 14 天和>14 天内进行护理,将神经外科患者分为 4 组。随后,将应用具有流行病学、影像学、临床和血清学标准的问卷来确定 COVID-19 感染的风险,以根据我们设施中的不同风险区域来确定将患者转移到哪个区域。

结论

尽管不是 COVID-19 中心,但我们认为神经外科病房的所有患者和工作人员都是无症状携带者或在临床前期感染。在社区传播阶段,必须采取具体措施来确保神经外科患者和医务人员的安全和护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d45e/7211578/bf45181353e3/gr1_lrg.jpg

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