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拉美地区在 COVID-19 大流行期间对内镜操作建议的遵守情况:我们做得如何?

Adherence to recommendations for endoscopy practice during COVID-19 pandemic in Latin America: how are we doing it?

机构信息

Endoscopy Department, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Mexican Social Security Institute, Mexico City, Mexico

Endoscopy Department, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Mexican Social Security Institute, Mexico City, Mexico.

出版信息

BMJ Open Gastroenterol. 2021 Jan;8(1). doi: 10.1136/bmjgast-2020-000558.

Abstract

BACKGROUND AND AIMS

Digestive endoscopy is considered a high-risk procedure for COVID-19. Recommendations have been made for its practice during the pandemic. This study was conducted to determine adherence to recommendations for endoscopy practice during the COVID-19 pandemic in Latin America (LA).

METHODS

A survey was conducted of endoscopists from LA consisting of 43 questions for the evaluation of four items: general and sociodemographic features, and preprocedure, intraprocedure and postprocedure aspects.

RESULTS

A response was obtained from 338 endoscopists (response rate 34.5%) across 15 countries in LA. In preprocedure aspects (hand washing, use of face masks for patients, respiratory triage area, training for the placement/removal of personal protective equipment (PPE) and availability of specific area for the placement/removal of PPE), there was adherence in <75%. Regarding postprocedure aspects, 77% (261/338) had reused PPE, mainly the N95 respirator or higher, and this was with a standardised decontamination procedure only in 32% (108/338) of the time. Postprocedure room decontamination was carried out by 47% on >75% of occasions. In relationship to intraprocedure aspects (knowledge of risk and type of endoscopic procedures, use of PPE, airway management in patients and infrastructure), there was adherence in >75% for all the parameters and 78% of endoscopists only performed emergencies or time-sensitive procedures.

CONCLUSIONS

Adherence to the recommendations for endoscopy practice during the COVID-19 pandemic is adequate in the intraprocedure aspect. However, it is deficient in the preprocedure and postprocedure aspects.

摘要

背景和目的

消化内镜被认为是 COVID-19 的高风险操作。已经针对其在大流行期间的操作提出了建议。本研究旨在确定拉丁美洲(LA)在 COVID-19 大流行期间内镜操作实践对建议的遵守情况。

方法

对来自 LA 的内镜医生进行了一项调查,调查包括 43 个问题,用于评估四个项目:一般和社会人口统计学特征,以及术前、术中、术后方面。

结果

在来自 LA 的 15 个国家的 338 名内镜医生中获得了回复(回复率为 34.5%)。在术前方面(洗手、为患者使用口罩、呼吸分诊区、放置/取下个人防护设备(PPE)的培训以及放置/取下 PPE 的特定区域),遵守率<75%。关于术后方面,77%(261/338)重复使用了 PPE,主要是 N95 呼吸器或更高,并且只有 32%(108/338)的时间使用标准化的消毒程序。仅 47%的时间在>75%的情况下对术后房间进行了消毒。在术中方面(了解风险和内镜操作类型、使用 PPE、患者气道管理和基础设施),所有参数的遵守率>75%,并且 78%的内镜医生仅进行紧急或时间敏感的程序。

结论

在 COVID-19 大流行期间,内镜操作实践对建议的遵守情况在术中方面是充分的。但是,在术前和术后方面存在不足。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb39/7804823/ddddfb6e9cb9/bmjgast-2020-000558f01.jpg

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