SARS∼WHO 對門診/篩檢/住院的

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Hospital Infection Control Guidance for Severe Acute Respiratory Syndrome (SARS)

Revised 24 April 2003

※Outpatient/triage setting 門診/篩檢環境

  • Those presenting to health care facilities who require assessment for SARS should be rapidly diverted by triage nurses to a separate area to minimize transmission to others

  • Those patients should be given a face mask to wear, preferably one that provides filtration of their expired air.

  • Staff involved in the triage process should wear a face mask (see below) and eye protection and wash hands before and after contact with any patient, after activities likely to cause contamination and after removing gloves.

  • Wherever possible, patients under investigation for SARS should be separated from the probable cases.
    若有可能,接受評估是否染上SARS的病患,要與可能病例(probable cases)分開。

  • Soiled gloves, stethoscopes and other equipment have the potential to spread infection.

  • Disinfectants such as fresh bleach solutions, should be widely available at appropriate concentrations.

※Inpatient setting 住院環境
  Care for probable SARS cases 照顧 SARS 可能病例,
 see Case Definitions for Surveillance of Severe Acute Respiratory Syndrome (SARS)

  • Probable SARS cases should be isolated and accommodated as follows in descending order of preference:
    1. negative pressure rooms with the door closed
    2. single rooms with their own bathroom facilities
    3. cohort placement in an area with an independent air supply, exhaust system and bathroom facilities

  • Turning off air conditioning and opening windows for good ventilation is recommended if an independent air supply is unfeasible.
    Please ensure that if windows are opened they are away from public places.

  • WHO advises strict adherence to the barrier nursing of patients with SARS, using precautions for airborne, droplet and contact transmission.
    WHO 建議照護 SARS 病患要嚴格遵守防護措施,預防空氣、飛沫與接觸傳染。

  • All staff, including ancilliary staff should be trained in the infection control measures required for the care of such a patient.
    所有員工(包括非醫療人員)都應接受訓練,以了解照顧 SARS 病患所需的感染控制措施。

  • A member of staff must be identified who will have the responsibility of observing the practice of others and provide feedback on infection control.

  • Disposable equipment should be used wherever possible in the treatment and care of patients with SARS and disposed of appropriately. If devices are to be reused, they should be sterilized in accordance with manufacturers’ instructions. Surfaces should be cleaned with broad spectrum disinfectants of proven antiviral activity.

  • Movement of patients outside of the isolation unit should be avoided. If moved the patients should wear a face mask.

  • Visitors, if allowed by the health care facility should be kept to a minimum. They should be issued with personal protective equipment (PPE) and supervised.

  • All non-essential staff (including students) should not be allowed on the unit/ward.

  • Handwashing is crucial: therefore access to clean water is essential.
    Hands should be washed before and after contact with any patient, after activities likely to cause contamination and after removing gloves.

  • Alcohol-based skin disinfectants could be used if there is no obvious organic material contamination.

  • Particular attention should be paid to interventions such as the use of nebulizers, chest physiotherapy, bronchoscopy or gastroscopy; any other intervention which may disrupt the respiratory tract or place the healthcare worker in close proximity to the patient and potentially infected secretions.

  • PPE should be worn by all staff and visitors accessing the isolation unit.

  • The PPE worn in this situation should include: 個人防護裝備包括:
    • A face mask providing appropriate respiratory protection (see below)
    • Single pair of gloves 一副手套
    • Eye protection 眼睛保護裝置
    • Disposable gown 可棄式長袍
    • Apron 圍裙
    • Footwear that can be decontaminated 穿在腳上隔絕污染的東西

  • All sharps should be dealt with promptly and safely.

  • Linen from the patients should be prepared on site for the laundry staff. Appropriate PPE should be worn in this preparation and the linen should be put into biohazard bags.

  • The room should be cleaned by staff wearing PPE using a broad spectrum disinfectant of proven antiviral activity.

  • Specific advice concerning air conditioning units will be available soon.

  • Respiratory protection. This should where feasible be provided at
    • *P100/FFP3, or P99/FFP2 filter level (99.97% and 99% efficiency respectively).
      P100/FFP3 或 P99/FFP2 過濾等級(分別具有 99.97% 和 99% 的過濾效率)
    • *N95 filters (95% filter efficiency) also provide high levels of protection and could be worn where no acceptable higher protection alternatives are available for example staff working in triage areas, prior to isolation.
    Ideally, the masks used should be fit tested using an appropriate "fit test kit" in accordance with the manufacturing instructions.
    理想狀態,使用的口罩應依廠商指示,以 "fit test kit" 檢查是否貼合。
    Disposable masks should not be reused.

*N/R/P 95/99/100 or FFP 2/3 or an equivalent national manufacturing standard (NIOSH (N,R,P 95,99,100) or European CE EN149:2001(FFP 2,3) and EN143:2000 (P2) or comparable national/regional standards applicable to the country of manufacture.

2002/5/16 LYS

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