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安全拔管 COVID-19 患者以减少气溶胶飞沫。

Safe Extubation of Patients with COVID-19 for Minimizing Aerosolized Droplets.

机构信息

Obihiro Kosei Hospital, Hokkaido, Japan.

出版信息

J Prim Care Community Health. 2021 Jan-Dec;12:21501327211013291. doi: 10.1177/21501327211013291.

Abstract

BACKGROUND

Healthcare workers must be protected during extubation of patients with coronavirus disease 2019 (COVID-19) owing to the presence of aerosolized droplets. Herein, we report a technique for extubating a patient with COVID-19 while minimizing aerosol dispersion.

CASE REPORT

We retrospectively identified a total of 79 patients admitted to our hospital from February 2020 to January 2021. Six of these patients were intubated for mechanical ventilation, 2 of whom had to be extubated. We prepared a clear vinyl sheet in the shape of a tent to place over the patient, and 2 staff members, both well experienced in airway management, stood outside the tent on either side of the patient. Before extubation, we confirmed that the patient's consciousness level was good and the patient had no distress by adjusting the dose of sedative drugs. After extubation, a surgical mask was placed on the patient's face.

CONCLUSION

Our experience indicates that this method of extubation in a patient with COVID-19 could be safely implemented to protect healthcare workers.

摘要

背景

由于存在气溶胶化飞沫,医护人员在为新型冠状病毒病 2019(COVID-19)患者进行拔管时必须受到保护。在此,我们报告一种在尽量减少气溶胶扩散的情况下为 COVID-19 患者进行拔管的技术。

病例报告

我们回顾性地确定了 2020 年 2 月至 2021 年 1 月期间我院收治的总共 79 名患者。其中 6 名患者因机械通气而插管,其中 2 名需要拔管。我们准备了一个透明的乙烯基帐篷形状的罩子盖在患者身上,2 名经验丰富的气道管理工作人员站在帐篷外患者的两侧。在拔管前,我们通过调整镇静药物的剂量来确认患者的意识水平良好且没有呼吸困难。拔管后,在患者面部放置一个外科口罩。

结论

我们的经验表明,这种对 COVID-19 患者的拔管方法可以安全实施,以保护医护人员。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3051/8114317/db4e96be56cc/10.1177_21501327211013291-fig1.jpg

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