Early identification
Probability of early identification of COVID-19 among patients can be increased as follows:
Visual estimate of a state and sorting of patients for identification of the persons having symptoms of the acute respiratory disease (ARD);
Point of primary survey and sorting it is necessary to arrange on an entrance to reception and also on all entrances to the building of medical institution;
Specially trained nurse or the doctor has to work at collection point. Employees should be trained in poll technique and also an operations procedure depending on the received answers and at again revealed disease;
It is necessary to print alarm plates for simplification of the overview of symptomatic patients;
To provide existence of enough surgical masks and an antiseptic agent for processing of hands in reception;
All patients with symptoms of acute respiratory diseases should offer wearing a surgical mask if it does not worsen their state, and to process hands;
All who contacted to suspicious patients also have to put on surgical masks and process hands;
It is not necessary to allow patients with suspicion on COVID-19 to the general room where there are other patients;
To have patients with suspicion on COVID-19 of the room specially allotted for this purpose at distance of at least one, and it is better than two meters;
It is possible to estimate a condition of all patients coming to reception on existence of symptoms of ORZ, using the form questionnaire developed in establishment for a visual estimate of COVID-19;
During a visual estimate it is necessary to carry out also the assessment of risk of spread of an infection.
Actions for control of spread of an infection in medical institutions
1. Training
All medical the workers having access to point of primary survey should be trained in instructions for use of SIZ and to execute for them individual selection of respirators of N95 or similar;
It is necessary to be convinced that patients and visitors obtain full information on the applied security measures; durations of their use; prevention of spread of an infection and use of the corresponding SIZ;
To be convinced that the health workers who are on the first line of contact and also other employees of risk group, namely radiologists, pulmonologists, room cleaners were trained on measures of prevention of COVID-19;
It is necessary to remember that ways of distribution of COVID-19 are finally not known.
2. General recommendations
Apply standard security measures to all patients at any time, paying special attention to hygiene of hands (follow WHO recommendations) and also availability and the correct use of SIZ;
Follow the principles of respiratory hygiene;
Patients with suspicion on COVID-19 should offer wearing a surgical mask if it does not worsen their state;
Train patients and visitors it is correct to behave at cough and sneezing, namely to cover a nose and a mouth with a napkin or an elbow bend;
To avoid touches to eyes, a mouth and a nose;
It is necessary to make visual aids by rules of conduct at cough and sneezing, hygiene of hands and the first symptoms of an infection;
Assessment of risk is crucial when holding all actions, namely for each kind of activity it is necessary to define the SIZ list, necessary for adequate protection;
During the work with suspicious cases use measures of protection for a drop and contact way of spread of an infection.
3. For suspicious cases
Patients have to be placed in separate chambers with own bathroom;
Realize measures of protection from spread of an infection aerosol (if it is possible), a drop and contact way in suspicious cases (put on a surgical mask, eye protections, points or a front guard, gloves and a waterproof scrub);
Realize special measures of protection at implementation aerosol - the generating procedures: bronkhoskopiya, sanitation of respiratory tracts, inhalations via the nebulizer, a fence of a phlegm, an intubation and extubation, performing cardiopulmonary resuscitation, autopsy (put on individually picked up N95 mask or similar).
4. For the confirmed cases
Place the patient in the infectious isolation center / boxing;
If the room providing negative pressure is required, but there is no such opportunity, organize transfer of the patient to boxing for patients with the infections which are transmitted in the airborne way;
If it is impossible, place the patient in separate chamber with a personal toilet;
Provide existence in chamber of means for air disinfection.