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[呼吸道与面部防护:COVID-19大流行背景下的当前观点]

[Respiratory and Facial Protection: Current Perspectives in the Context of the COVID-19 Pandemic].

作者信息

Peres David, Boléo-Tomé José Pedro, Santos Gilda

机构信息

Unidade de Saúde Pública. Agrupamento de Centros de Saúde do Grande Porto IV - Póvoa de Varzim/ Vila do Conde.. Vila do Conde; Comissão de Controlo de Infeção e Resistência aos Antimicrobianos. Unidade Local de Saúde de Matosinhos. Matosinhos. Portugal.

Serviço de Pneumologia. Hospital Prof. Doutor Fernando Fonseca. Amadora. Portugal.

出版信息

Acta Med Port. 2020 Sep 1;33(9):583-592. doi: 10.20344/amp.14108. Epub 2020 Jun 19.

Abstract

The new SARS-CoV-2 pandemic is an example of an international public health emergency, which is associated with considerable social and economic challenges. At the healthcare level there is the risk that nosocomial outbreaks can be local amplifiers. Adequate infection control practices are of critical importance, which include proper use of personal protective equipment. This equipment must be appropriate to the pathogen transmission route that, in the case of SARS-CoV-2, occurs through droplet and contact routes. The infected individual, when talking, coughing or sneezing, spreads droplets containing the virus, directly contaminating other individuals within one to two meters of distance, as well as the surrounding environment. Airborne transmission may occur when aerosol-generating procedures are performed. Concerning respiratory protection, there is currently weak evidence that the use of respirators provides better protection than surgical masks for SARS-CoV-2 or other viruses (with the exception of aerosol-generating procedures, in which case the use of a respirator is recommended). Eye protection should be guaranteed whenever there is a risk of splashes, droplets or aerosols. The use of different, or higher than necessary, level of personal protective equipment, for the transmission route of the agent, is a form of misuse and can affect its supply for situations when it is clearly indicated. The adequate provision of protective equipment, as well as training of healthcare professionals in its correct use, is highly recommended to ensure safety of care.

摘要

新型严重急性呼吸综合征冠状病毒2(SARS-CoV-2)大流行是国际公共卫生紧急事件的一个例子,它带来了巨大的社会和经济挑战。在医疗层面,存在医院感染暴发成为局部传播源的风险。充分的感染控制措施至关重要,这包括正确使用个人防护装备。这种装备必须适合病原体的传播途径,就SARS-CoV-2而言,其传播途径为飞沫传播和接触传播。受感染个体在说话、咳嗽或打喷嚏时会传播含有病毒的飞沫,直接污染距离在一到两米内的其他人以及周围环境。在进行产生气溶胶的操作时可能会发生空气传播。关于呼吸防护,目前证据不足,表明对于SARS-CoV-2或其他病毒,使用呼吸器比外科口罩能提供更好的防护(产生气溶胶的操作除外,在这种情况下建议使用呼吸器)。只要存在飞溅物、飞沫或气溶胶的风险,就应确保眼部防护。对于病原体的传播途径,使用不同等级或高于必要等级的个人防护装备属于滥用,可能会影响在明确需要时的装备供应。强烈建议充分提供防护装备,并对医护人员进行正确使用的培训,以确保医疗安全。

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