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[医院为应对大流行而准备个人防护装备]

[Provisioning of personal protective equipment in hospitals in preparation for a pandemic].

作者信息

Pfenninger E G, Kaisers U X

机构信息

Stabsstelle Katastrophenschutz, Klinikum der Universität Ulm, Albert-Einstein-Allee 29, 89081, Ulm, Deutschland.

Universitätsklinikum Ulm, Ulm, Deutschland.

出版信息

Anaesthesist. 2020 Dec;69(12):909-918. doi: 10.1007/s00101-020-00843-1.

Abstract

BACKGROUND

At the beginning of the SARS-CoV‑2 outbreak, personal protective equipment (PPE) was scarce worldwide, leading to the treatment of patients partially without sufficient protection for the medical personnel. In order to be prepared for a new epidemic or pandemic or a "second wave" of COVID-19 outbreak and to meet a renewed deficiency of PPE, considerations were made on how personnel and patients can be better protected by appropriate provisioning.

OBJECTIVE

The aim of this study was to develop a tool to predict the necessary amount of PPE to be in stock at a transregional university hospital for a certain period of time during a pandemic.

MATERIAL AND METHODS

The consumption of PPE needed for every patient was calculated based on the following data of the Ulm University Hospital: the total consumption of healthcare workers' PPE for April 2020 recorded by the materials management department and the number of patients suffering from COVID-19 and their treatment days. From the amount of PPE necessary for every patient in the intensive care unit (ICU) or in an infection ward, a PPE calculator was created in which the estimated amount of PPE can be calculated with the input variables "patients in intensive care unit", "patients in infection ward" and "treatment days". To validate the PPE calculator, the actual consumption of PPE for May 2020 at the Ulm University hospital was compared to the theoretically calculated demand by the PPE calculator.

RESULTS

In April 2020 PPE consisting of 18 different items were kept in stock at Ulm University Hospital and in total 1,995,500 individual items were used. 22 intensive care patients with 257 nursing days and in the infection ward 39 patients with 357 nursing days were treated for COVID-19 disease, leading to a total of 603.2 man-days. A total of 34,550 KN95 masks, 1,558,780 gloves and 1100 goggles or protective visors were used, with a daily average of 49 NK95 masks and 2216 gloves required per ICU patient. In May 2020, 6 ICU patients and 19 patients in infection wards were treated for COVID-19 with 34 nursing days in intensive care and 201 nursing days in infection wards. The use of PPE material was 39% lower than in the previous month but in absolute terms 82% and on average 39% higher than calculated.

CONCLUSION

The developed tool allows our hospital to estimate the necessary amount of PPE to be kept in stock for future pandemics. By taking local conditions into account this tool can also be helpful for other hospitals.

摘要

背景

在严重急性呼吸综合征冠状病毒2(SARS-CoV-2)疫情爆发初期,全球个人防护装备(PPE)短缺,导致部分患者的治疗过程中,医护人员未得到充分保护。为应对新的流行病或大流行,或新冠疫情的“第二波”爆发,并应对个人防护装备再次短缺的情况,人们对如何通过适当的物资供应更好地保护人员和患者进行了思考。

目的

本研究的目的是开发一种工具,用于预测在大流行期间,跨地区大学医院在某一时间段内所需储备的个人防护装备的数量。

材料与方法

根据乌尔姆大学医院的以下数据计算每位患者所需的个人防护装备消耗量:物资管理部门记录的2020年4月医护人员个人防护装备的总消耗量,以及感染新冠病毒疾病的患者数量及其治疗天数。根据重症监护病房(ICU)或感染病房中每位患者所需的个人防护装备数量,创建了一个个人防护装备计算器,通过输入变量“重症监护病房患者数量”、“感染病房患者数量”和“治疗天数”,可以计算出个人防护装备的估计数量。为验证个人防护装备计算器,将乌尔姆大学医院2020年5月个人防护装备的实际消耗量与个人防护装备计算器理论计算的需求量进行了比较。

结果

2020年4月,乌尔姆大学医院库存了18种不同的个人防护装备,共使用了1995500件。共治疗了22名重症监护患者,护理天数为257天,感染病房有39名患者,护理天数为357天,导致总护理天数为603.2天。共使用了34550个KN95口罩、1558780副手套和1100个护目镜或防护面罩,每位ICU患者每天平均需要49个NK95口罩和2216副手套。2020年5月,治疗了6名ICU患者和19名感染病房患者的新冠病毒疾病,重症监护护理天数为34天,感染病房护理天数为201天。个人防护装备的使用量比上月降低了39%,但绝对数量比计算值高出82%,平均高出39%。

结论

所开发的工具使我院能够估计未来大流行期间所需储备的个人防护装备数量。考虑到当地情况,该工具对其他医院也可能有帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45e5/7493059/380ec1945752/101_2020_843_Fig1_HTML.jpg

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