Health No. New Coronary Disease Poisonous Regional Measles and Infection Control

Edited by Anni, Yang Li-shen ; Commented by: Yuan Hongbin, World Health Organization (WHO), March 11, 2020, announced on March 11, 2020, the outbreak of a new type of coronary pneumonia (COVID-19) A global pandemic disease, caused by the disease-causing severe acute respiratory system coronary virulence type 2 (SARS-CoV-2), highly infectious (recent analysis showed R0 as high as 4.08), so it spreads quickly The global medical system has been created, and the global medical service has been suspended. The simultaneous presence of both the patient and the medical staff is associated with the susceptibility to disease, and this has a major impact on medical care.

In the 3rd year of the new corona virus infection, the 2nd edition of "Current Opinion in Anesthesiology" will be introduced this year. and medical personnel safety protection strategies, and medical equipment protection measures.

Covid-19 floor display, Chinese alcohol consumption

Comprehensive respiratory tract infection disease history for COVID-19, such as development, cough with or without cough, skin pain, sore throat, and one series of other symptoms, comprehensive olfactory loss, skin disease, eye symptoms, hypertension , middle wind and acute cardiovascular events. Various organ systems are involved in disease- and toxic-reducing kinetics and host immune responses. AEC2-induced hypochondriac-angiogenic dysfunction, increased pulmonary vascular permeability. Cellular hyperactivity and antibody-dependent enhanced inflammatory response, cellular factor aggravation, acute respiratory distress (ARDS) and multiorgan dysfunction disorder (MODS). The reason for this is that the patient's floor surface is very different from the patient's condition due to the drought and the surgical procedure, and may be asymptomatic.

Covid-19 needs-dependent nucleic acid analysis, e.g., real-time reaction (rtPCR, safety <5%). Rapid serology Immunoglobulin M (IgM) and IgM antibodies have a high cloaking rate (10-15%). Exactly like this, antibody detection is supported by rtPCR sensitivity, and a plan for highly suspected emergency patients is established. In the situation of limited resources and urgent medical needs, the best option is to treat patients with "suspected cases", and take sufficient preventive measures against COVID-19 cases.

SARS-CoV-2 main respiratory tract droplets, direct contact patients or contaminated materials (carrying toxic materials and equipment, such as clothing) spread. Gravity effect, limited airborne area (<2m), and gas-induced toxic behavior (such as coughing and blowing) will increase the spread of disease, this kind of long-distance airborne suspension in the air, contamination Reinforcement. After 2 to 3 weeks of contact with the patient, the disease was released by rubbing an object near the patient (such as a kimono with a handle). Drinking water tanks around the patient are the common culprits of disease.

It's just another kind of disease that is poisonous. Intravertebral canal hemp obstruction sympathetic nerve-induced defecation. Patients should be cleansed, use primary plastic thin film urinary cloth, and the minimum number of medical personnel in the area.

For patients with respiratory tract infections, the number of patients with respiratory tract infections is 6.6 times higher. It is possible to directly operate the alcohol-free airway in the capture area, reducing the exposure of personnel to the operating room. However, it is possible to immediately use the breathing system to produce a gas solution, which is one of the first small-scale research studies conducted in China. The infection rate of measles in protective clothing is increasing. Regional measles treatment period may create COVID-19 spread and other risk factors may include comprehensive medical staff, patient distance, exposure time, and patient presence or absence of COVID-19 symptoms.

The hospital is well known, for a group of patients with a few surgical procedures, it is better to treat regional measles after treatment, and it is possible to prefer comprehensive reduction after pulmonary development, emesis, cognitive impairment, and dementia. Patients with relative pending respiratory failure and pulmonary disease, especially those with COVID-19-associated pneumonia or ARDS. The American Association for Pain Medicine and the European Association for the Treatment of Asthma and Pain recently jointly published a proposal for the use of area medicine during the COVID-19 pandemic.

Asthma doctor and surgical room personnel protection

Even asymptomatic infected patients in the early stages can spread the disease. Minimize medical operation period due to on-site personnel.

Use personal protective equipment (PPE) to protect medical personnel and patients from COVID-19. There are 3 classes of PPE divided into 3 classes (Table 1). Theoretically, the period of treatment for patients receiving PPE is similar to that of possible viral spread.

Table 1. COVID-19 infectious personal protective equipment (PPE) grades

Unless you own aerosol-proof measures, you can use an electric pneumatic respirator (PAPR) under the situation of "gas-solution-prone-air-high", which is a high-pressure gas discharge vehicle. In this kind of situation, there is a large amount of leakage such as gas pipes, especially during the recovery period, patients who are anxious about treatment, incompatibility, or when there is no mechanical ventilation. Please put on PPE before entering the room, and remove PPE from the staff.

Pseudo-confirmation COVID-19 patient management optimal pressure indoor admission, comprehensive area dehydration operation and patient recovery period, later low cross-infection wind. Fifth refurbishment room air can be removed by removing the fusible material, but the warranty is completely removed. Regional measles period, limited contact time between patients and measles doctors. Possessing high-flow control equipment, which can be avoided during the period when the patient is in the hospital. During the procedure, a physical screen is provided between the patient and the surgeon, but it is of no use to the measles doctor. The transparent plastic material that can be added is provided at the same time as the physical screen, which does not affect the patients who are directly monitored by the doctor, and the avoidable anxiety disorder. Or, during the measles period in the area, the measles doctor can be away from the hospital or the patient will be monitored outside the operating room to minimize the number of people exposed.

Regional hemp base

A wealth of culture training is a prerequisite for successful implementation of COVID-19 patients and an effective regional clinical trial. It is a new technology that is not strong enough and has a high success rate. The author's local medical institution general area medical technical points, collateral assistance requests, patient management legal regulations available on the network, available to all staff, including detailed standard area medical procedures, technology, equipment, and local medicine selection for specific procedures . This standardized management has been effective during the COVID pandemic, minimizing variability as much as possible, and increasing regional drug utilization rates.

During the epidemic period, emergency and semi-urgent emergency procedures will be required. Reduces the amount of procedures to help a large number of COVID-19 patients in a better region, the Ministry of Defense equipment, and the demand for security workers. The author is located in a large reduction in bed load, mainly recommended for patients with functional disabilities to some extent. For example, a patient who needs to be treated with a heavy arm tube. Patients of this type are routinely obliged to receive regional measles. Patients who have equality and national guidance are routinely tested, major comprehensive nasal wipes are tested and PCR tested, and any possible infectious COVID-19 bedside symptoms (such as the outbreak).

Intravertebral canal malnutrition and peripheral dysentery obstruction are primary malnutrition in patients with PCR (24 hours before), and compulsory measures for patients with suspected COVID-19 infectious orthopedic extremity surgery. For example, if COVID-19 spreads in a patient's community, the test result is unknown or no law is obtained, even a symptom-free patient should expect COVID-19.

For patients infected with COVID-19 or suspected infection, it is best to enter the operating room for asthma. Must use ventilation device and pressure control device for indoor air flow in public areas. Compared to other hospital hospitals and other towers, the operating room capacity is higher. 15th gas exchange, removable 99% and 99.9% air pollutants. Avoid using public areas, less cross-infection winds, excluding these areas with negative pressure gas flow and rapid gas exchange device. In an ideal situation, you could either collect a number or take an electronic note and proceed outside the procedure room.

Regional measles periodical patient management

Information Consent Process Operational Response No COVID-19 Synopsis. In the current epidemic environment, the medical operation is the starting point for the best benefit to the patient. Exceptionally outside the pre-wind class, the COVID-19 severity is severe. Covid-19 infected patients' asthma measures are determined based on the degree of respiratory function impairment and the degree of blood flow dynamics, with or without specific organ dysfunction.

Covid-19 common thrombocytopenia, pre-existing platelet count. Thrombocytopenia can interfere with deep nerve stagnation, use as a guide or intravertebral canal drug. The platelet function is normal, the platelet count >75000, and the above-mentioned majority of the area can be treated with hemp. Intravertebral canal drug use in the presence of an existing systemic infection. However, COVID-19 patients (no symptoms or physical symptoms, no other intravertebral canal drug contraindications) small case study announced, this kind of patient is safe, non-induced leprosy / leptospirosis.

Similar to patient preparation and sterile operation. For patients with respiratory failure, the goal is to minimize respiratory failure in patients with regional asthma. For example, the axillary or the lower arm of the upper arm is superior to the upper arm of the upper arm.

Precautions for use of static chemicals. The author recommends avoiding respiratory depression and the use of small doses of S-drugs before use for dry air, which can be combined with a small amount of S-drink to help the patient feel less painful and cause no respiratory depression or coughing. .

Provided replenishment during the period of medication and gas injection, formation and formation of air-borne gas-solution, the type of air-borne illness, breathing-related toxic volume, ventilation in the operating room, and patient use The effect of the target mouth. Certainly partial factors are unlawful restraints, but the patient's breathing gas distance is fixed, and it is possible to be restrained. Use Hudson mask, flow rate 4l/min, shortest breathing gas distance (about 0.4m). At 5 l/min flow rate of nasal guide tube, air can be exhaled 1m. Because of this, the minimum horizontal flow rate is guaranteed to keep the flow rate low, and the output is reduced.

It is very difficult to get inside the medical unit when wearing a full-length jacket. Wireless communication system and whiteboard support for COVID-19 patient management period. If the author is located in a machine that passes through the operating room (such as a TV monitor), it can be used as a contaminant, such as a mobile phone or a mobile device.

Caution Minimizing the number of personnel in the operating room, plastic shielding between the patient and the medical personnel. In addition, the patient should be placed on the floor of the operating room, and the patient should be placed in the operating room, and should not be cross-contaminated.

If there is a failure or a problem with the procedure, please switch to full body alcohol as soon as possible. Owned by the surgical room staff wearing a full coat protective equipment.

After surgery, patients with regional measles are not allowed to enter the Post-Recovery Unit (PACU), which is directly transferred to the designated airborne infection isolation room. The PACU can be greatly enhanced to facilitate patient mobility management during pandemics. In general, COVID-19 patients from remote hospitals to operating rooms can be processed to create an environment where people are polluted. During the patient's operating period, the patient must not be required to undergo surgery, and must travel along the road, so that there will be minimal contact with other facilities to avoid exhaustion and environmental pollution. Suitable N95 respirator for operating personnel and accompanying medical personnel. During the patient's care and driving period, it is necessary to wear eye protection (eyeglasses or full face screen), hats, protective clothing and gloves.

Regional Measles Equipment Protection

In the epidemic period, the construction effort is reduced. The same applies to primary plastic jackets for use during the procedure. Ready-to-use emergency medical equipment and supplies, general-purpose plastic bag sealed. Ultra-sounding equipment is fully covered with a plastic jacket to avoid staining. The same applies to the use of a full-body protective coat for ultrasonic sound detection. Hand-held ultrasonic equipment is easy to remove, excellent for large equipment. All-in-one use, area recommended cars and equipment, as well as voice recorders, etc., non-response return blocking area, stay in the treatment room before leaving.

In addition, the use of super-voice guidance under the guidance of the surrounding gods to avoid blockage, avoid vascular injury and systemic local anesthetic poisoning, high blockage success rate, avoidance operation failure due to systemic analgesia. However, it is very important to take preventive measures against infectious diseases when using ultrasonic equipment. Associated bedside medical staff with advanced ultrasonic disinfection standards to ensure the safety of patients and medical personnel.

1.

① Cleaning: Removal of foreign matter on the object (such as mud and organic matter), completion of the usual hydrating detergent or quenching agent.

(2) Disinfection: Eliminates most or all pathogenic microorganisms.

③ Low-level Disinfection (LLD): Destruction of most bacteria, partial virulence and partial fungi. LLD possible dissociated branched bacilli or bacterial buds of tuberculosis.

④ Intermediate-level disinfection (ILD): tuberculosis branching bacilli, bacteria, mostly pathogenic, mostly fungi and partial bacterial buds.

⑤　High-level disinfection (HLD): Destruction/removal of proprietary microorganisms.

⑥ Sterilization: The biological process of microbial life that is destroyed or destroyed by physical or chemical methods through medical institutions. Pressurized steam, dry heat, dehydrated gas, dehydrated gas, etc. are the main sterilization methods used by medical institutions. When this chemical agent is used to destroy the microbial life form, it can be called a chemical bactericidal agent. Homologous bactericidal agents are also available for short-term exposure, immediate disinfection process (HLD).

Except for the above-mentioned, pathogen spreading wind associated with the use of root medical equipment, general medical equipment divided into three categories, comprehensive primitive sprouting classification: non-related key, semi-related key and key, also known as low wind, medium wind and high wind .

1. Related equipment: Perforating skin or membrane equipment, or equipment for sterile body compartments (eg, intraluminal). Infectious wind in this facility is the highest. No super voice search.

(2) Semi-key equipment: Surgical membrane contact but non-penetration probing (e.g., intracavitary/cavitary probing, esophageal probing). This equipment allows for incomplete skin or skin contact, high infection rates. It is recommended to use various chemical agents against this equipment to progress HDL, destroy/remove microbes and all external microorganisms.

③ Non-relevant equipment: complete skin contact, non-skin contact equipment. Lowest infection rate for this equipment. This is not related to this equipment, which is located on the main line, convexity, and side control. The reason for this is to use LLD or ILD, eradicate most bacteria (non-encompassing bacterial buds) and fungi, including some HIV resident virulence. As a result, it is possible to reach ILD (viable bacteria, most pathogenic fungi, tuberculosis branched bacilli). Japanese partial microscopic buds).

2. Pre-existing standards for cleaning and disinfecting the area's ultrasonic voice detection

When you are in the super voice guidance area, please follow the sterile principle. It is imperative to thoroughly clean and prepare, and protect patients to avoid latent infection. For skin interventional ultrasound, including comprehensive lumbar puncture and ultrasound-guided area medicine, use LLD standard cleaning (eg, 70-90% clean), and use a temporary sterile mantle during the operation. The operator must always complete the LLD standard hand cleaning, wearing sterile hand gloves. Adopting HLD standard for manned skin operation, but the practical high-effective LLD technology and sterile screen are effective for interrogator-related infection. Stationary stabbing aids should be re-used for ongoing sterilization, but aseptic primary equipment should be refurbished due to disease epidemics.

After each operation is completed, there will be residuals such as cleaning and decondensation. Usable small brush cleaning gaps and corners, specific design for investigation. Scrape own residual condensate. During the patient's treatment period, once the patient is examined for blood or body fluid contamination, it is recommended that tuberculosis branched bacillus and hematogenous pathogens (comprehensive B liver disease, C liver disease, and human immunodeficiency disease) are effective for LLD cleansing. Figure 4 shows the usual cover screen, this kind of incomplete screen cover without cover screen, the latter can be a disease-prone car body. It's a breeze to search through and use a second package. Ultra-voice search is based on the root installation of the house, cleans and disinfects.

3.

Super-voice convergence is a necessary element for guaranteeing super-voice image quality. However, it is possible to find the source of the infection in the hospital because of the combination of ultrasound and voice therapy. For the super voice guidance area, the sterile primary concentration is applied to the patient's contact side. A sterile condensate or sterile sanitary water can be used at the search for a protective cover (no patient contact), but this may or may not be necessary. Because every time you use it, you usually don't need to disinfect it, because it's sterile. An internal surface adhesive with a somewhat ingenious design, which can be formed under this type of situation, can be combined and combined.

The operator should be aware of the need for ultrasound detection and consolidation is the pathogen spreading latent body, especially if the immune system is weakened and the patient population is at high risk. After each probe and damaged skin contact, wipe with a paper towel to clean the naked eye. Pathogenic microorganisms such as ultra-sound-searching surface-harmonizing condensate-resistant staphylococcus aureus staphylococcus aureus staphylococcus aureus staphylococcus aureus staphylococcus aureus staphylococcus aureus staphylococcus aureus staphylococcus aureus staphylococcus aureus staphylococcus aureus staphylococcus aureus staphylococcus aureus staphylococcus aureus staphylococcus aureus staphylococcus aureus staphylococcus aureus staphylococcus aureus staphylococcus aureus staphylococcus staphylococcus aureus staphylococcus staphylococcus staphylococcus staphylococcus aureus staphylococcus aureus, silver nucleus β-internal pneumococcus pneumoniae β-internal pneumococcus pneumoniae β-internal pneumonia. Recently, I found a guide to using super voice guidance, and after removing the surface block residue, I applied LLD disinfection. It is a method for assisting surface pathogens with a small number of surface pathogens using UV C-stage light.

In-floor medical care has been confirmed, sterile detection is possible during production, it has been contaminated during the use process, and it has been discovered since it was passed through. Possible pathogen contamination within the ultrasound probe. Avoidance of condensed skin is possible during the period of skin puncture site.

4.

For COVID-19 cases, avoid pollution-free multiple devices, reduce multiple devices for deep cleaning and removal. Because the ultrasound machine occupies a large area, there are many possible surfaces, and the phase ratio of the large ultrasound machine is suitable for COVID-19 patients. Any type of super-voice machine, transfer-excluded extras, any kind of stamping machine. Adopted plastic cover protects the super voice machine from staining, super voice search (comprehensive line) applies to cover the primary protection. If you have not purchased the first-order security package, you can search for it, and you can use it together. Ultra-voice control unit can pass through plastic or transparent steel. The operator responds to manual operation, and also ensures that the tactile sensitivity indicator is capable of responding to incoming calls.

Exhaust COVID-19 toxins in plastics for 72 hours, but most low-grade antiseptics, such as 70% thick, 0.5% oxygenated, 0.1% sodium hypochlorite, 0.05~0.2% oxygenated Effective against SARS-CoV-2. After disinfecting and wiping with a damp cloth for construction, first before entering the room, before removing the dirty mantle, again after leaving the room, after removing the dirty PPE and after the new mantle. It is important to ensure that the disinfectant for use in the security office is approved for use with a specific ultrasonic search and has a certificate that is active and toxic. Such as unmatched correlation mechanism guidance, feeling controllers can help advance operation and training.

Osteoporosis

In the midst of the global epidemic of the new epidemic, nationally uniform intensive care resources are used to treat COVID-19 patients, and early intervention strategies are recommended to reduce nosocomial infections. Cross-infection is one of the most important maneuvers.

Preliminary medical guidance during the COVID-19 pandemic period, completed for patients with active COVID-19 infection. It is recommended that a wealth of medical practitioners practice area measles for the first choice of measles plan, and then reduce the exposure of the operating room medical personnel, and reduce the cross-infected wind. Immediate implementation of comprehensive medical examinations and compliance with general health and safety measures and personal safety precautions, maximum coverage for patients and hospitals during the period of hospitalization yielded the best results (Table 2). It should be noted that there are a few points in the text that should be considered for the operation of the mechanism, but for emergency use, and possibly other mechanisms. However, a medical guideline for COVID-19 and similar epidemics that may emerge in the future has been established since the first step in demand research and certification guidelines.

Table 2. Regional measles safety operations during the COVID-19 pandemic

In addition, the application of the super-visible super-voice guidance technology has greatly improved the success rate of the localization, and has reduced the overall wind speed. In the ultrasound guidance area, the period of treatment, must be properly processed ultrasound detection and related materials, so as to ensure sterile conditions. It is especially important to follow the recommended guidelines and ensured high standard infection prevention measures under the increasing circumstances of exposure to pathogens. For protected patients and medical personnel free from viral infections and nosocomial cross-infections, demand is established and used ultrasound equipment systemic, standard infectious disease prevention system. In summary, during the COVID-19 pandemic period, the standardization of infectious disease prevention process for preventing pathogens from forming the epidemic.

Edited by: Anni, Yang Lixian Commented by: Yuan Hongbin

Original article: Heijnen T, Vandebergh V, Vandepitte C, Buck R. Regional anesthesia in coronavirus disease 2019 pandemic. Curr Opin Anaesthesiol. 2021 Oct 1;34(5):609-615. PMID: 34402477.

Murata H, Vanegas C, Ogami-Takamura K. Ultrasound-guided regional anesthesia in COVID-19 and future pandemics: infection control. Curr Opin Anaesthesiol. 2021 Oct 1;34(5):648-653. doi: 10.1097 /ACO.0000000000001034. PMID: 34231548.

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