Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.
Center for Infectious Disease Research and Policy, University of Minnesota, Minneapolis, MN, USA.
Br J Anaesth. 2024 Jul;133(1):19-23. doi: 10.1016/j.bja.2024.03.025. Epub 2024 Apr 26.
The COVID-19 pandemic has transformed our understanding of aerosol transmissible disease and the measures required to minimise transmission. Anaesthesia providers are often in close proximity to patients and other hospital staff for prolonged periods while working in operating and procedure rooms. Although enhanced ventilation provides some protection from aerosol transmissible disease in these work areas, close proximity and long duration of exposure have the opposite effect. Surgical masks provide only minimal additional protection. Surgical patients are also at risk from viral and bacterial aerosols. Despite having recently experienced the most significant pandemic in 100 yr, we continue to lack adequate understanding of the true risks encountered from aerosol transmissible diseases in the operating room, and the best course of action to protect patients and healthcare workers from them in the future. Nevertheless, hospitals can take specific actions now by providing respirators for routine use, encouraging staff to utilise respirators routinely, establishing triggers for situations that require respirator use, educating staff concerning the prevention of aerosol transmissible diseases, and providing portable air purifiers for perioperative spaces with low levels of ventilation.
新冠疫情改变了我们对气溶胶传播疾病的认识,以及为最大限度减少传播所需采取的措施。麻醉师在手术室和操作室工作时,通常会长时间近距离接触患者和其他医护人员。虽然在这些工作区域,加强通风可提供一些针对气溶胶传播疾病的防护,但近距离和长时间接触则会产生相反的效果。外科口罩只能提供最小程度的额外保护。手术患者也面临病毒和细菌气溶胶的风险。尽管最近经历了 100 年来最严重的大流行,但我们对手术室中遇到的气溶胶传播疾病的真实风险以及未来保护患者和医护人员免受这些疾病的最佳行动方案仍缺乏足够的了解。尽管如此,医院现在可以采取一些具体措施,如常规提供呼吸器,鼓励医护人员常规使用呼吸器,为需要使用呼吸器的情况设定触发条件,对员工进行气溶胶传播疾病预防教育,并为通风水平较低的围手术期空间提供便携式空气净化器。