scholarly journals Trauma Care in COVID-19 Pandemic

2020 ◽  
Vol 26 (2) ◽  
pp. 9-14
Author(s):  
A. A. Sitnik ◽  
A. E. Murzich ◽  
P. A. Volotovski ◽  
M. A. Gerasimenko
Keyword(s):  
Surgical Treatment ◽  
Trauma Care ◽  
Infection Prevention ◽  
Remote Work ◽  
Prevention Measures ◽  
Personal Protection Equipment ◽  
Protection Measures ◽  
Care Systems ◽  
Oscillating Saw ◽  
Spread Of Infection

The development of COVID-19 pandemic is the serious challenge for trauma care systems across the world. Recommendations on general principles of trauma care in the settings of pandemic, medical stuff protection and prevention of the spread of infection based on the data from international centers are presented in the article. Delay of all elective cases, restriction of surgical treatment of fractures with relative indications for surgery are recommended. The segregation of cases into COVID-19 confirmed or suspected and COVID-19 negative patients is important. When possible before the admission to in-patient department the patient shall be tested on COVID-19. When the COVID-19 status of the patient is unclear all possible protection measures shall be used: patient isolation and medical stuff protection. To prevent the spread of infection it is recommended to split the stuff of the traumacenter into 2 or 3 groups. Each of the groups is working during the week with subsequent period of the self-isolation (remote work) for the period of 1-2 weeks (according to the duration of incubation period of the COVID-19). During the surgical treatment the most dangerous stages of the surgery are endotracheal intubation / extubation and also aerosol-generative procedures: electrocoagulation, pulsed wound lavage, drilling, the use of oscillating saw and medullary reaming. The stuff in the OP-theatre has to be accordingly equipped (personal protection equipment). The risk factors for the medical stuff are fatigue from overwork, the absence of real-time training in infection-prevention measures and non-compliance with PPE.

scholarly journals Healthcare workers as a sentinel surveillance population in the early phase of the COVID-19 pandemic

2021 ◽  
Author(s):  
I Venkatachalam ◽  
EP Conceicao ◽  
MK Aung ◽  
MKB How ◽  
LE Wee ◽  
...  
Keyword(s):  
At Risk ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Clinical Status ◽  
Sentinel Surveillance ◽  
Contact Tracing ◽  
Close Monitoring ◽  
Prevention Measures ◽  
Protection Measures ◽  
Singapore General Hospital

Introduction: Healthcare workers (HCWs) are a critical resource in the effort to control the COVID-19 pandemic. They are also a sentinel surveillance population whose clinical status reflects the effectiveness of the hospital’s infection prevention measures in the pandemic. Methods: This was a retrospective cohort study conducted in Singapore General Hospital (SGH), a 1,822-bed tertiary hospital. Participants were all HCWs working in SGH during the study period. HCW protection measures included clinical workflows and personal protective equipment developed and adapted to minimise the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. HCW monitoring comprised staff contact logs in high-risk locations, twice-daily temperature monitoring, assessment of HCWs with acute respiratory illnesses (ARIs) in the staff clinic and, in the event of an exposure, extensive contact tracing, detailed risk assessment and risk-based interventions. HCW surveillance utilised monitoring data and ARI presentations and outcomes. Results: In the ten-week period between 6 January 2020 and 16 March 2020, 333 (17.1%) of 1,946 HCWs at risk of occupational COVID-19 presented with ARI. 32 (9.6%) screened negative for SARS-CoV-2 from throat swabs. Five other HCWs developed COVID-19 attributed to non-clinical exposures. From the nine COVID-19 exposure episodes investigated, 189 HCW contacts were identified, of whom 68 (36.2%) were placed on quarantine and remained well. Conclusion: Early in an emerging infectious disease outbreak, close monitoring of frontline HCWs is essential in ascertaining the effectiveness of infection prevention measures. HCWs are at risk of community disease acquisition and should be monitored and managed to prevent onward transmission.

Local hospital experience of emergency management in the response to SARS (Preprint)

2020 ◽  
Author(s):  
Ying Yan
Keyword(s):  
Emergency Management ◽  
Infection Prevention ◽  
Public Health Emergency ◽  
The Novel ◽  
Prevention Measures ◽  
Hospital Emergency ◽  
Local Hospital ◽  
Referral Network ◽  
Novel Coronavirus ◽  
Hospital Transmission

UNSTRUCTURED The ongoing outbreak of SARS-CoV-2 infection was first identified in Wuhan, China at the late of 2019. Following the acceleration of the novel coronavirus spreading, person-person transmissions in family residences, hospitals and other public environments have led to a major public hazard in China. Currently, the SARS-CoV-2 outbreak has been further developed into a public health emergency of international concern. In response to an occurring pandemic, hospitals need an emergency strategy and plan to manage their space, staff, and other essential resources, therefore, to provide optimum care to patients involved. In addition, infection prevention measures urgently need to be implemented to reduce in-hospital transmission and avoid the occurrence of virus super-spreading. For hospitals without capacity to manage severe patients, a referral network is often needed. We present our successful field experience regarding hospital emergency management and local hospitals network model in response to SARS-CoV-2 emerging epidemic.

scholarly journals Universal Masking to Control Healthcare-Associated Transmission of SARS-CoV-2

2021 ◽  
pp. 1-24
Author(s):  
Eliza R. Thompson ◽  
Faith S. Williams ◽  
Pat A. Giacin ◽  
Shay Drummond ◽  
Eric Brown ◽  
...  
Keyword(s):  
Large Scale ◽  
Infection Prevention ◽  
Index Patient ◽  
Field Investigation ◽  
Point Prevalence ◽  
Control Measures ◽  
Prevention Measures ◽  
Infection Control Measures ◽  
Va Health Care System ◽  
Healthcare Associated

Abstract Objective: To assess extent of a healthcare-associated outbreak of SARS-CoV-2 and evaluate effectiveness of infection control measures, including universal masking Design: Outbreak investigation including 4 large-scale point-prevalence surveys Setting: Integrated VA Health Care System with 2 facilities and 330 beds Participants: Index patient and 250 exposed patients and staff Methods: We identified exposed patients and staff and classified them as probable and confirmed cases based on symptoms and testing. We performed a field investigation and assessment of patient and staff interactions to develop probable transmission routes. Infection prevention interventions implemented included droplet and contact precautions, employee quarantine, and universal masking with medical and cloth facemasks. Four point-prevalence surveys of patient and staff subsets were conducted using real-time reverse-transcriptase polymerase chain reaction for SARS-CoV-2. Results: Among 250 potentially exposed patients and staff, 14 confirmed cases of Covid-19 were identified. Patient roommates and staff with prolonged patient contact were most likely to be infected. The last potential date of transmission from staff to patient was day 22, the day universal masking was implemented. Subsequent point-prevalence surveys in 126 patients and 234 staff identified 0 patient cases and 5 staff cases of Covid-19, without evidence of healthcare-associated transmission. Conclusions: Universal masking with medical facemasks was effective in preventing further spread of SARS-CoV-2 in our facility in conjunction with other traditional infection prevention measures.

The impact of a multimodel approach to designing a new orthopedic department

2020 ◽  
pp. 1-6
Author(s):  
Elad Keren ◽  
Abraham Borer ◽  
Lior Nesher ◽  
Tali Shafat ◽  
Rivka Yosipovich ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Antibiotic Stewardship ◽  
Infection Prevention ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Antibiotic Use ◽  
Prevention Measures ◽  
Orthopedic Department ◽  
Before And After ◽  
The Impact

Abstract Objective: To determine whether a multifaceted approach effectively influenced antibiotic use in an orthopedics department. Design: Retrospective cohort study comparing the readmission rate and antibiotic use before and after an intervention. Setting: A 1,000-bed, tertiary-care, university hospital. Patients: Adult patients admitted to the orthopedics department between January 2015 and December 2018. Methods: During the preintervention period (2015–2016), 1 general orthopedic department was in operation. In the postintervention period (2017–2018), 2 separate departments were created: one designated for elective “clean” surgeries and another that included a “complicated wound” unit. A multifaceted strategy including infection prevention measures and introducing antibiotic stewardship practices was implemented. Admission rates, hand hygiene practice compliance, surgical site infections, and antibiotic treatment before versus after the intervention were analyzed. Results: The number of admissions and hospitalization days in the 2 periods did not change. Seven-day readmissions per annual quarter decreased significantly from the preintervention period (median, 7 days; interquartile range [IQR], 6–9) to the postintervention period (median, 4 days; IQR, 2–7; P = .038). Hand hygiene compliance increased and surgical site infections decreased in the postintervention period. Although total antibiotic use was not reduced, there was a significant change in the breakdown of the different antibiotic classes used before and after the intervention: increased use of narrow-spectrum β-lactams (P < .001) and decreased use of β-lactamase inhibitors (P < .001), third-generation cephalosporins (P = .044), and clindamycin (P < .001). Conclusions: Restructuring the orthopedics department facilitated better infection prevention measures accompanied by antibiotic stewardship implementation, resulting in a decreased use of broad-spectrum antibiotics and a significant reduction in readmission rates.

scholarly journals Impact of joint management of a COVID-19 mother and her newborn on the virus transmission: a case report

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Maria Chiara De Nardo ◽  
Anna Rita Bellomo ◽  
Francesca Perfetti ◽  
Francesco Antonino Battaglia ◽  
Miriam Lichtner ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Virus Transmission ◽  
The Novel ◽  
Transplacental Transmission ◽  
Prevention Measures ◽  
Infected Mother ◽  
Case Presentation ◽  
Joint Management ◽  
Healthy Neonate

Abstract Background Since last year, COVID-19, the disease caused by the novel Sars-Cov-2 virus, has been globally spread to all the world. COVID-19 infection among pregnant women has been described. However, transplacental transmission of Sars-Cov-2 virus from infected mother to the newborn is not yet established. The appropriate management of infants born to mothers with confirmed or suspected COVID-19 and the start of early breastfeeding are being debated. Case presentation We report a case of the joint management of a healthy neonate with his mother tested positive for Covid-19 before the delivery and throughout neonatal follow-up. The infection transmission from the mother to her baby is not described, even after a long period of contact between them and breastfeeding. Conclusion It may consider an appropriate practice to keep mother and her newborn infant together in order to facilitate their contact and to encourage breastfeeding, although integration with infection prevention measures is needed.

Trauma care systems in Australia

Injury ◽  
2003 ◽  
Vol 34 (9) ◽  
pp. 649-651 ◽  
Author(s):  
John L Croser
Keyword(s):  
Trauma Care ◽  
Care Systems

246: Trauma Care Systems: A Comparison of Trauma Care in Victoria, Australia and Hong Kong, China

2008 ◽  
Vol 51 (4) ◽  
pp. 546 ◽  
Author(s):  
N. Cheung ◽  
C.H. Cheng ◽  
C.A. Graham ◽  
B.J. Gabbe ◽  
J.H. Yeung ◽  
...  
Keyword(s):  
Hong Kong ◽  
Trauma Care ◽  
Care Systems

scholarly journals How do we change practice?

2021 ◽  
Vol 3 (2(May-August)) ◽  
pp. e932021
Author(s):  
John Kestle
Keyword(s):  
Infection Rate ◽  
Infection Prevention ◽  
Shunt Infection ◽  
Current Data ◽  
Research Network ◽  
Csf Shunt ◽  
Prevention Measures ◽  
Skin Preparation ◽  
Prevention Protocol ◽  
Csf Shunt Infection

OBJECT: The goal of this video lecture was to show the importance to research group organizing protocols to reduce cerebrospinal fluid (CSF) shunt infection at Hydrocephalus Clinical Research Network (HCRN) centers (from 8.7% to 5.7%). Antibiotic-impregnated catheters (AICs) were not part of the protocol but were used off protocol by some surgeons. The authors therefore began using a new protocol that included AICs in an effort to reduce the infection rate further. The improvement of quality was related to reduce variation and improve outcome. METHODS The previous protocol was implemented at HCRN centers on January 1, 2012, for all shunt procedures (excluding external ventricular drains [EVDs], ventricular reservoirs, and subgaleal shunts). Compliance with the protocol and outcome events up to March 30, 2014, were recorded. The actual protocol is based on 7 points (HCRNq centers): intravenous antibiotics, skin preparation, hand scrub, double gloves, iodophoretic surgical field, catheter and antibiotics, and vancomycin irrigation RESULTS. Before protocol implementation in 30 participating centers, and 1318 subjects (1571 surgical cases) enrolled the overall infection rate was 6.0% (95% CI 5.1%-7.2%). The actual infection rate when using this new protocol has been analyzed. CONCLUSIONS CSF shunt procedures performed in compliance with a new infection prevention protocol at HCRNq centers had a lower infection rate than noncompliant procedures. Based on the current data, HCRNq centers the role of AICs compared with other infection prevention measures is still under analysis.

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