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一名患有穿孔性阑尾炎并合并 COVID-19 的儿童的麻醉挑战:病例报告。

Anaesthetic challenges in a child with perforated appendicitis and COVID-19 Co-Infection: A case report.

作者信息

Maxwell Annie, Teah Kai Ming, Soe May Zaw, Yeap Boon Tat

机构信息

Department of Anaesthesiology and Intensive Care, Hospital Queen Elizabeth, 88350, Kota Kinabalu, Sabah, Malaysia.

Department of Anaesthesiology and Intensive Care, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia.

出版信息

Ann Med Surg (Lond). 2021 Nov;71:102931. doi: 10.1016/j.amsu.2021.102931. Epub 2021 Oct 12.

Abstract

BACKGROUND

The deadly coronavirus disease 2019 (COVID-19) wreaked havoc globally in early 2020 and caused lives to a standstill. Healthcare workers (HCW) handling patients infected with COVID-19 wore protective equipment to defend themselves from cross infection and curbing further spread. Nevertheless, these do hamper their dexterity, especially during surgical procedures.

CASE PRESENTATION

A child presented to our centre needing an emergency open appendicectomy during the coronavirus disease 2019 (COVID-19) pandemic in June 2021. Prior to the surgery, her initial test for COVID-19 was negative but subsequently became positive on the second test. Fortunately, all HCW during the care for the patient, donned full personal protective equipment (PPE), and avoided cross-infection.

DISCUSSION

HCW handling patients with COVID-19 should wear adequate PPE to. However, these pose detrimental effects to their dexterity during routine care of such patients. Good teamwork and communication among HCW and parents are important during the safe management of a young child with COVID-19.

CONCLUSION

HCW should have low index of suspicion of COVID-19 in children with upper respiratory tract infection. Prompt and pro-active measures should be rapidly taken to prevent exposure and co-infection. Wearing multi layers of PPE do negatively affect the mood and agility of HCW handling young children with COVID-19. Thus, they should practice good team work, receive regular simulation and scenario-based training to be better prepared for pressurised situations.

摘要

背景

2020年初,致命的2019冠状病毒病(COVID-19)在全球肆虐,使生活陷入停滞。照顾感染COVID-19患者的医护人员穿戴防护装备以保护自己免受交叉感染并遏制进一步传播。然而,这些装备确实会妨碍他们的灵活性,尤其是在外科手术过程中。

病例介绍

2021年6月冠状病毒病(COVID-19)大流行期间,一名儿童被送到我们中心,需要进行紧急开放性阑尾切除术。手术前,她的首次COVID-19检测呈阴性,但随后第二次检测呈阳性。幸运的是,在护理该患者期间,所有医护人员都穿戴了全套个人防护装备(PPE),并避免了交叉感染。

讨论

照顾COVID-19患者的医护人员应穿戴适当的个人防护装备。然而,这些装备在对这类患者的常规护理中会对他们的灵活性产生不利影响。在安全管理感染COVID-19的幼儿时,医护人员与家长之间良好的团队合作和沟通很重要。

结论

医护人员对患有上呼吸道感染的儿童应保持对COVID-19的低怀疑指数。应迅速采取及时且积极主动的措施以防止暴露和共同感染。穿戴多层个人防护装备确实会对照顾感染COVID-19幼儿的医护人员的情绪和敏捷性产生负面影响。因此,他们应开展良好的团队合作,接受定期的模拟和情景培训,以便为压力情境做好更好的准备。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/417c/8521125/e0f8c4f1aa10/gr1.jpg

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