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[根据当前建议、法律法规及作者自身经验,新冠疫情期间耳鼻喉科门诊的患者情况]

[Patient in the otolaryngology office in the time of the COVID-19 pandemic in the light of current recommendations, legal regulations and authors' own experience].

作者信息

Obrębski Jakub, Skorek Piotr, Tretiakow Dmitry, Narożny Waldemar, Skorek Andrzej

机构信息

Gdański Uniwersytet Medyczny / Medical University of Gdansk, Gdańsk, Poland (Katedra i Klinika Otolaryngologii / Department of Otolaryngology).

Akademia Pomorska w Słupsku / Pomeranian University, Słupsk, Poland (Instytut Prawa i Administracji / Law and Administration Institute).

出版信息

Med Pr. 2021 Jun 30;72(3):327-334. doi: 10.13075/mp.5893.01081. Epub 2021 Mar 18.

DOI:10.13075/mp.5893.01081
PMID:33783435
Abstract

Generally, COVID-19 is an acute contagious disease caused by the SARS‑CoV-2 virus. The main route of human-to-human transmission is through contact with infectious secretions from the respiratory tract. Clinical manifestations vary from mild non-specific symptoms to life-threatening conditions. Since WHO declared COVID-19 a pandemic in March 2020, it has affected many medical, legal, social and economic aspects of everyday life in countries around the world. In this article, the authors present a summary of recommendations for taking care of otorhinolaryngology patients in outpatient settings and the legal basis referring to a risk of infection in doctor's office. In the selection of articles, the authors used English- and Polish-language online medical databases, typing the following keywords: SARS‑CoV-2, COVID-19, otolaryngology, endoscopy, personal protective equipment, and legal responsibility of the physician. The mucosa of the upper respiratory tract is a potential site of virus replication. The specificity of an ear, nose and throat (ENT) examination and a direct patient-doctor contact favor the transmission of the infection. The authors discussed the elements of self-protection of medical personnel and the legal aspects a risk of the patient contracting the infection in the otolaryngology office. In the case of a direct contact with the patient, the following medical personal protective equipment is required: a cap, a mask with an FFP-2 filter, goggles, an apron and gloves. If, during the visit, exposure to secretions or aerosol from the respiratory tract is expected, the personnel should additionally wear a visor and a waterproof apron. The patient's visit in the clinic should be preceded by telemedicine consultation. Patients should be screened prior to having a direct contact with a physician, using a short patient questionnaire. The questionnaire may consist of simple questions about the characteristic symptoms of the SARS‑CoV-2 infection and exposure to a sick person in the past 14 days. The question of staying in the areas of a high infection risk appears of little importance in view of the whole of Poland being perceived as constituting such an area. Due to the spread of the SARS‑CoV-2 virus, new procedures for providing medical services have been introduced. In the case of claims on the part of the patient, the only protection the medical personnel or facility can provide is confirmation of scrupulous compliance with medical procedures . Med Pr. 2021;72(3):327-34.

摘要

一般来说,新型冠状病毒肺炎(COVID-19)是由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)病毒引起的急性传染病。人际传播的主要途径是通过接触呼吸道的传染性分泌物。临床表现从轻微的非特异性症状到危及生命的状况不等。自世界卫生组织于2020年3月宣布COVID-19为大流行以来,它已经影响到世界各国日常生活的许多医学、法律、社会和经济方面。在本文中,作者总结了在门诊环境中照顾耳鼻喉科患者的建议以及涉及医生办公室感染风险的法律依据。在文章的选择过程中,作者使用了英文和波兰文的在线医学数据库,输入了以下关键词:SARS-CoV-2、COVID-19、耳鼻喉科、内窥镜检查、个人防护装备以及医生的法律责任。上呼吸道黏膜是病毒复制的潜在部位。耳鼻喉(ENT)检查的特殊性以及医患之间的直接接触有利于感染的传播。作者讨论了医务人员自我保护的要素以及患者在耳鼻喉科办公室感染风险的法律方面。在与患者直接接触的情况下,需要以下医用个人防护装备:帽子、带FFP-2过滤器的口罩、护目镜、围裙和手套。如果在就诊期间预计会接触到呼吸道分泌物或气溶胶,工作人员应额外佩戴面罩和防水围裙。患者在诊所就诊前应先进行远程医疗咨询。在患者与医生直接接触之前,应使用简短的患者问卷对患者进行筛查。问卷可能包括关于SARS-CoV-2感染特征症状以及过去14天内接触过病人的简单问题。鉴于整个波兰都被视为高感染风险地区,询问是否去过高感染风险地区似乎不太重要。由于SARS-CoV-2病毒的传播,已经引入了新的医疗服务程序。在患者提出索赔的情况下,医务人员或医疗机构能够提供的唯一保护是确认严格遵守医疗程序。《医学实践》。2021年;72(3):327 - 34。

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