Best H R, Clayton A J
Can Med Assoc J. 1980 Nov 8;123(9):867-71.
Advance planning can facilitate the care of a patient with an exotic disease who is admitted to a hospital that lacks facilities for high-security isolation. The Department of National Health and Welfare contingency plan for dealing with such patients lacks specific information in a number of areas of medical care, as described in this paper. Consideration must be given to the number of personnel trained and readied for employment, the criteria for selection and special preparation. The protective clothing generally used for hospital isolation procedures is inadequate. Several types of special clothing, including a respirator, are available for total protection of personnel; the clothing may be uncomfortable when worn for long periods, and does restrict movement, vision and communication. All persons entering the isolation suite must change into fully protective clothing, and double layers of clothing are required for direct patient care. All personnel must shower and change before leaving the isolation suite. Suitable facilities for dressing and showering, together with entry and exit routines, must be considered. Hand washing, daily cleaning procedures and disposal of liquid and solid wastes all require special procedures. The social and psychologic problems of patients and their families must also be considered. Preplanning is required to decrease the risks involved in monitoring vital signs and implementing emergency procedures requiring contact with the patient's blood.
提前规划有助于照顾收治到缺乏高安全隔离设施医院的患有罕见疾病的患者。本文所述，国家卫生与福利部应对此类患者的应急计划在一些医疗领域缺乏具体信息。必须考虑受过培训并准备上岗的人员数量、选拔标准和特殊准备情况。医院隔离程序通常使用的防护服并不充分。有几种特殊服装，包括呼吸器，可用于全面保护人员；长时间穿着可能会不舒服，而且确实会限制行动、视力和沟通。所有进入隔离病房的人员必须换上全套防护服，直接护理患者时需要穿两层衣服。所有人员离开隔离病房前必须淋浴并更换衣服。必须考虑合适的穿衣和淋浴设施，以及进出程序。洗手、日常清洁程序以及液体和固体废物的处理都需要特殊程序。还必须考虑患者及其家属的社会和心理问题。需要预先规划以降低监测生命体征和实施需要接触患者血液的紧急程序时所涉及的风险。
