The patients who are on a hemodialysis represent risk group concerning COVID-19. To increase safety of sessions of a hemodialysis for such patients, it is necessary to follow a number of rules.
It is necessary to inform all dialysis patients on signs and symptoms of a koronavirusny infection and on general measures of precaution, including such measures as observance of rules of conduct at respiratory cough, hygiene of hands and social distancing.
In zones of expectation of the dialysis centers it is necessary to place posters with the description of symptoms of infection with a koronavirusny infection and the list of measures for minimization of contact with an infection.
It is necessary to analyse the patient's route to the dialysis center. In particular, to make sure available a way of transportation in the dialysis center of the patients with symptoms of a respiratory infection who do not have the individual transport. In case of receipt in the center of the patient with symptoms of a respiratory disease the algorithm of actions on an urgent intake of biomaterial and test for COVID-19 coronavirus has to be ready. Whenever possible it is necessary to avoid appeals to other centers for the help for the purpose of restriction of contact with an infection and reduction of terms of expectation of test results.
It is also necessary to analyse the patient's route in the dialysis center and to provide to the patient the isolated place for passing of the procedure of a hemodialysis.
In the dialysis center it is necessary to provide access to disinfectants on a spirit basis and to tissues.
Whenever possible it is necessary to provide patients with surgical masks in order that they had a necessary stock of the house and could use them in need of visit of the dialysis center in case of symptoms of a respiratory disease in them. At absence at patients of symptoms of a respiratory disease daily use of surgical masks by them at visit of the NE dialysis center is recommended.
The patient without symptoms of a respiratory disease can undergo the procedure of a hemodialysis regularly, applying standard precautionary measures. The patient without symptoms of a respiratory disease who had close contact with the person at whom infection with COVID-19 coronavirus is confirmed has to undergo the procedure of a hemodialysis, being at distance not less than one meter from other patients. At the same time it is necessary to observe standard precautionary measures. Despite the fact that usually the distance in 1 meter is considered sufficient for minimization of direct contact with droplet infection, at present, according to definition of bodies of public health care "close contact" stay at distance of 2 meters from COVID-19 infected with a coronavirus is considered. Therefore it is necessary to observe whenever possible a distance more than 1 meter.
The patient with symptoms of a respiratory disease with suspicion on infection or with the coronavirus of COVID-19 confirmed with infection should be placed in separate chamber. Whenever possible it is necessary to hold a door in chamber closed. Need to isolate the patient in chamber with negative pressure can arise only when holding procedures during which performance aerosol is formed (see the list of procedures during which implementation there is a formation of aerosol). On outer side of a door it is necessary to hang up the plate with the inscription "insulator". To apply standard measures of protection from infection with a contact and airborne way. If necessary it is necessary to allocate the patients needing a hemodialysis with COVID-19 coronavirus confirmed with infection in a separate stream.
In case of emergence in the dialysis patient of clinical symptoms of infection with a coronavirus of COVID-19 who is at home it is necessary to instruct the patient to stay at home. For the purpose of acceptance of necessary measures it is necessary to notify on it the nephrological center which branch is the dialysis office in which the patient undergoes treatment. In case of existence by the dialysis patient who arrived to dialysis office, clinical symptoms of infection with COVID-19 coronavirus it is necessary to place it in separate chamber and to notify on it the nephrological center which branch is this dialysis office. If there is no opportunity to isolate the patient, it is necessary to give him a surgical mask, to provide him access to disinfectant and napkins and to track that it was at distance not less than 1 meter from other people.