Diferencia entre revisiones de «COVID-19»

Revisión del 01:48 15 mar 2020

The CDC has expanded testing beyond the initial travel to china recommendations^[1]

Test any person who has fever or respiratory illness AND had close contact with a known COVID-19 patient
Test any person who has fever or respiratory illness AND a history of travel to CDC-classified high risk areas or areas with recent significant community spread
Test any person who has severe respiratory illness AND is being admitted to the hospital
Test any hospitalized person who has respiratory illness AND no alternative diagnosis
Consider testing any person who has respiratory illness AND lives in a residential facility such as a nursing home or recently returned from a cruise

N95 or PAPR
Surgical Mask over N95
Goggles that surround eyes with facial contact, face shield, or full joint-replacement-hood with visor
Bunny suit, preferably with hood or disposable fluid-proof gown
- If no hooded suit available, sterile disposable cap
2 pairs gloves, 1 under sleeves of bunny suit or gown and 1 over, under-layer gloves would ideally be long cuffed

The video below indicates the proper order for donning and doffing PPE for clinical evaluation of a patient {{#widget:YouTube|id=exV5hEG62CY}}

NIPPV may increase the spread of viral particles via droplets making early intubation the preferred airway management strategy in patients with respiratory distress/failure
Using 2 viral filters attached to a 2 tube NIPPV circuit in a negative pressure room may sufficiently prevent viral spread
During BVM, if needed, use a viral filter
The endotracheal tube should also have a viral filter attached

Supportive care is mainstay of therapy for patients with mild viral symptoms
Most patients will do well enough for discharge home
Discuss with Dept of Public Health, who will guide testing and, if discharging, help patient remain in isolation at home

Usually home, but decision needs to be made in conjunction with the local Public Health Dept
If admitting, needs to be placed in negative pressure isolation room with airborne and droplet precautions

Authors:

@@ Línea 35: / Línea 35: @@
 ==Management==
-===Airway Managment===
+===Respiratory failure===
-Due to the risk of viral spread via droplets, early intubation is preferred over noninvasive ventilation
+*[[NIPPV]] may increase the spread of viral particles via droplets making early [[intubation]] the preferred airway management strategy in patients with respiratory distress/failure
+*Using 2 viral filters attached to a ''2 tube NIPPV circuit'' in a negative pressure room may sufficiently prevent viral spread
+*During [[BVM]], if needed, use a viral filter
+*The endotracheal tube should also have a viral filter attached
 ===Mild Cases===
 *Supportive care is mainstay of therapy for patients with mild viral symptoms