As the epidemic situation continues medical staff must master the graded protection standard _ isolation

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Original title: As the epidemic continues, medical staff must master the graded protection standards. Prompt: "Medical Law Online" ↑ Easy to follow us Let the Law Know More About Medical Care Let Medical Care Know More About the Law In the process of medical practice, medical staff need to protect themselves according to different diseases and different modes of transmission, and at the same time, they need to ensure the safety of patients to avoid two-way transmission, so medical workers need to do a good job of corresponding protection to block the occurrence and development of diseases. Move forward and implement standard prevention and graded protection standards. 01 Standard prevention knowledge points Standard precautions mean that the patient's blood, body fluids, secretions, and excretions are considered to be infectious and need to be isolated, regardless of whether there is obvious blood, contamination, or contact with incomplete skin and mucous membranes. Precautionary measures must be taken in case of contact with the above substances. 1. Standard precautionary principle It is the basis of medical staff protection and is applicable to all medical staff in different working areas and posts. 2. Standard Prevention Core It refers to a group of prevention and control measures taken to reduce the risk of nosocomial infection based on the principle that the patient's blood, body fluids, secretions (excluding sweat), excreta, incomplete skin and mucosa may contain infectious factors. Including hand hygiene, use of personal protective equipment, cough etiquette and so on. 3. Standard precautions include the following : (1) The blood, body fluids, secretions, and excretions of all patients are considered infectious and must be isolated, and protective measures must be taken for contact with substances with obvious blood, body fluids, secretions, and excretions, or contact with incomplete skin and mucous membranes. (2) It is necessary to prevent the spread of blood-borne diseases and the spread of non-blood-borne diseases. (3) Two-way protection is emphasized. It is necessary to prevent the transmission of diseases from patients to medical staff, and to prevent the transmission of diseases from medical staff to patients. 4. Specific measures of standard prevention include : (1) Hand cleaning and disinfection is an important measure to cut off contact transmission. Hand cleaning and disinfection should meet the requirements of the Hand Hygiene Standards for medical staff. (2) Gloves should be worn when contacting blood, body fluids, secretions, excreta and other substances and articles contaminated by them. (3) Wash hands immediately after removing gloves. (4) When the work clothes, face and eyes of medical staff may be splashed by blood, body fluids, secretions and other substances, they should wear surgical masks, protective glasses or masks, and wear isolation clothes or waterproof aprons. (5) When handling all sharp instruments, special attention should be paid to prevent being stabbed. (6) Correct disinfection and sterilization measures shall be taken for medical devices and appliances used by patients. 02 Expand the full text Exposure risk classification of medical staff 1. Exposure Risk Classification Standard Take protective measures of droplet isolation, contact isolation and air isolation, and take appropriate personal protection according to different exposure risks: (1) Low risk: indirect contact with patients, such as guidance, inquiry, general outpatient and ward rounds, etc. (2) Moderate risk: direct contact with patients, such as physical examination, puncture, injection, etc. (It is recommended to have physical examination with mucous membrane or body cavity contact, and invasive operation without the risk of body fluid splashing, such as ultrasound-guided breast puncture, deep vein puncture, etc.). (3) High risk: operation or surgery with splashing of blood, body fluid, secretion,Quickly Delivery Disposable Protective Clothing, etc. Or that may produce aerosol, such as throat swab collection, sputum suction, oral care, tracheal intubation, non-invasive ventilation, tracheotomy, cardiopulmonary resuscitation, manual ventilation before intubation, endoscopy, etc. 2. Protection selection based on risk level (1) Low-risk operation: work clothes or wear isolation clothes, surgical mask, work cap and hand hygiene. (2) Medium risk operation: work clothes plus isolation clothes, medical surgical mask/medical protective mask, work cap, protective face screen/goggles, gloves and hand hygiene. (3) High-risk operation: medical protective suit (disposable), isolation clothing,Medical Disposable Coverall, medical protective mask, work cap, protective face screen/goggles, double-layer gloves and hand hygiene. The procedure should be performed in a well-ventilated room with the number of people in the room limited to the minimum number of patients requiring care and support. 03 Classification of medical staff protection The protection of medical staff should take different protective measures according to the different patients, and meet the following requirements: 1. General protection It is applicable to medical staff in general outpatient (emergency) clinics and general wards. (1) Strictly abide by the principle of standard prevention. (2) Work clothes and surgical masks shall be worn during work. (3) Carefully implement hand hygiene. 2. Level one protection It is suitable for the medical staff of fever (emergency). (1) Strictly abide by the principle of standard prevention. (2) Strictly abide by the rules and regulations of disinfection and isolation. (3) Work clothes, isolation clothes, work caps and surgical masks shall be worn during work, and latex gloves shall be worn if necessary. (4) Strictly implement hand hygiene. (5) Carry out personal hygiene disposal after work, and pay attention to the protection of respiratory tract and mucosa. 3. Secondary protection : It is applicable to the medical staff who enter the respiratory isolation ward and the isolation ward; the staff who contact the specimens collected from the patients, handle their secretions, excretions, used articles and dead bodies of patients, and the medical staff and drivers who transport patients. (1) Strictly abide by the principle of standard prevention. (2) Take droplet isolation and contact isolation according to the transmission route. (3) Strictly abide by the rules and regulations of disinfection and isolation. (4) medical staff entering isolation wards and isolation wards must wear medical protective masks, work clothes, isolation clothes or protective suit, shoe covers, gloves and work caps. In strict accordance with the division of clean area, potential contaminated area and contaminated area, wear and take off protective equipment correctly, and pay attention to the hygiene and protection of respiratory tract, oral cavity, nasal mucosa and eyes. 4. Level 3 protection : Suitable for medical staff for the performance of aerosol-inducing operations. Aerosol-inducing procedures include endotracheal intubation, nebulization, examination of induced sputum, bronchoscopy, aspiration of respiratory sputum, nursing of tracheal incision, thoracic physiotherapy, nasopharyngeal aspiration, mask positive pressure ventilation (such as BiPAP and CPAP), high-frequency oscillatory ventilation, resuscitation procedures, and postmortem lung biopsy. In addition to secondary protection, masks or full-face respirators should be worn. 04 Procedure for wearing protective equipment when entering the isolation area (1) medical staff enter the clean area through the special passage for employees, wear medical protective masks, disposable hats or cloth hats, Medical Disposable Coverall ,KN95 Face Mask, change work shoes and socks in turn after washing hands carefully, and change hand-brushing clothes and trousers if conditions permit. (2) Wear work clothes before entering the potentially contaminated area, and wear gloves to enter the potentially contaminated area if the hand skin is damaged or suspected to be damaged. (3) Before entering the contaminated area, take off the work clothes and wear protective suit or isolation clothes, and wear disposable hats and disposable surgical mask (two layers of hats and masks), protective glasses, gloves and shoe covers. 05 Procedures for taking off protective equipment after leaving the isolation area (1) Before leaving the contaminated area, medical staff shall first disinfect their hands, take off their protective glasses, outer disposable surgical mask and outer disposable hats, protective suit or isolation clothes, shoe covers, gloves and other articles in turn, put them in special containers, disinfect their hands again, enter the potentially contaminated area and change their work clothes. (2) Before leaving the potentially contaminated area and entering the clean area, wash and disinfect hands, take off work clothes, wash and disinfect hands. (3) Before leaving the cleaning area, wash and disinfect hands, remove the inner disposable hat or cloth cap, the inner medical protective mask, take a bath and change clothes, and clean the oral cavity, nasal cavity and external auditory canal. (4) Wash and disinfect hands immediately after each contact with patients. (5) Protective articles such as disposable surgical mask, medical protective masks, protective suit or isolation clothes shall be replaced immediately when they are contaminated by blood, body fluids and secretions of patients. (Six) personal hygiene disposal should be carried out before work, and attention should be paid to the protection of respiratory tract and Mucosa. 06 Precautions for wearing and taking off protective equipment ① The medical protective mask can be used continuously for 6 to 8 hours, and should be replaced in time in case of contamination or dampness. ② Disinfect the glasses before leaving the isolation area. ③ When the medical staff contacts multiple patients with the same infectious disease, the isolation clothing or protective suit can be used continuously. ④ In case of contact with suspected patients, the isolation clothing or protective suit should be changed between each patient contact. ⑤ When the isolation clothing or protective suit is contaminated by the patient's blood, body fluid and dirt, it should be replaced in time. ⑥ Face tightness test shall be carried out when wearing medical protective mask or full-face respirator. ⑦ The medical staff working in the isolation area should monitor the body temperature twice a day, and see a doctor in time when the body temperature exceeds 37.5 ℃. 07 Carry out different protection according to different posts (1) Medical and nursing personnel 1. Medical staff of general departments. Implement the pre-examination and triage system, wear work clothes and surgical mask during the diagnosis and treatment activities, and change them regularly, select work caps (disposable) according to the situation, and pay attention to hand hygiene. 2. Fever clinic The respiratory department, emergency department, pediatrics department and other medical staff should implement the pre-examination and triage system, wear work clothes, sex work caps (once), surgical mask, and personal protective equipment depending on the risk of exposure, such as isolation clothing (disposable), medical protective masks (N95 and above), protective face screens/goggles, shoe covers/boot covers, etc., and pay attention to hand hygiene. 3. Surgical personnel Except for the emergency operation, the historical epidemiology of the operation patients should be understood in detail during the epidemic period. It is advisable to monitor the body temperature and observe for 14 days before arranging the selective operation. The protection of the operator is the same as that of the daily operation. It is recommended to wear the anti-liquid leakage surgical gown (disposable). Medical protective mask (N95 and above) and protective face screen/goggles can be worn for emergency operation according to the risk of operation, and hand hygiene should be paid attention to. 4. Case Transportation/accompanying personnel of (suspected cases, confirmed cases) and infected persons (mild cases, asymptomatic infected persons) are recommended to wear work clothes, work caps (disposable), gloves, medical protective suit (disposable), medical protective masks (N95 and above), and choose protective face screens/goggles, work shoes/rubber boots, shoe covers/boot covers according to whether there is splashing operation. Pay attention to hand hygiene. 5. Specimen collectors are advised to wear work clothes. , work cap (disposable), double-layer gloves, medical protective suit (disposable), medical protective mask (N95 and above), protective face screen/goggles. If necessary, waterproof apron/waterproof isolation clothing can be added, shoe covers/boot covers, pay attention to hand hygiene. (II) Laboratory staff It is recommended to wear work clothes, work caps (disposable), surgical mask and gloves, and pay attention to hand hygiene. When testing suspected samples, wear medical protective masks (N95 and above) and waterproof aprons/waterproof isolation clothes on the basis of routine testing of personal protection, and pay attention to hand hygiene. When carrying out virus nucleic acid detection, on the basis of routine detection of personal protection, choose to wear medical protective masks (N95 and above), wear medical protective suit (disposable), double-layer gloves, protective face screens/goggles, if necessary, wear waterproof aprons/waterproof isolation clothing, shoe covers/boot covers, and pay attention to hand hygiene. (3) Medical and auxiliary personnel 1. Environmental cleaning and disinfection personnel It is recommended to wear work clothes, work cap (disposable), disposable gloves and long-sleeved thickened rubber gloves, medical protective suit (disposable), medical protective mask (N95 and above), protective face screen/goggles. If necessary, wear waterproof apron/waterproof isolation clothing, shoe covers/boot covers, and pay attention to hand hygiene. 2. Specimen transport personnel and distribution personnel are recommended to wear work clothes. Work cap (disposable), medical surgical mask, use specimen transfer box to transport specimens, pay attention to hand hygiene. Drivers of transfer vehicles should wear surgical mask, pay attention to hand hygiene and do a good job of personal safety protection. 3. Body disposal personnel It is recommended to wear work clothes, work caps (disposable), gloves and long-sleeved thickened rubber gloves, medical protective suit (disposable), medical protective masks (N95 and above), protective face screens/goggles, waterproof aprons/waterproof isolation clothes, shoe covers/boot covers, etc., and pay attention to hand hygiene. Source: Health Talent Network (copyright belongs to the original author, if there is infringement, please contact WeChat: Yifa _ 2016 to delete, do not quote for commercial purposes, thank the original author!) Medical Law Online: Focus on medical law, spread the voice of doctors and patients,KN95 Face Mask with Five Layers, look forward to your attention! (Submission (consultation): yifa_online@163.com. Medical Law Online (Pay attention to medical treatment, pay attention to law, pay attention to medical law online!) Return to Sohu to see more Responsible Editor:. zjyuan-group.com

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