HCDCP

Infection from new coronavirus SARS-CoV-2 (COVID-19) – Guidance for Healthcare settings

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17.04.2020

All healthcare personnel working in the Accident & Emergency Dept (A&E) must wear a STANDARD SURGICAL MASK while at the A&E, according to NPHO’s guidelines (www.eody.gov.gr). Moreover, healthcare personnel outside the A&E, who may potentially handle a patient with a respiratory infection, regardless of its cause, must wear a STANDARD SURGICAL MASK. Doctors and all healthcare personnel must be up-to-date with the new coronavirus case definition, as provided in NPHO’s website (www.eody.gov.gr).

 

  1. Triage, recognition and isolation of suspected cases of COVID-19 infection

Triage aims at the early recognition of cases that fall into the definition of COVID-19 case, the assessment of infection severity and the restriction of virus spread to other patients, visitors and healthcare workers. Triage also safeguards health services provided to citizens.

Triage must be carried out before entrance to A&E, and specifically, at the hospital’s main gate office (container). A suitable poster with information to incoming individuals must be placed at the triage area. Trained personnel shall ask questions based on the definition of COVID-19 case. Patients who meet the suspected case criteria will be given a standard surgical mask and will be transferred to a separate waiting and examination area (isolation) with available infrastructure and materials for hand hygiene and respiratory hygiene practice, and, if possible, without going through A&E, while adhering to all necessary measures against virus spreading. Moreover, for best triage and early identification of suspected cases, we advice hospitals to keep only one entrance open for incoming patients.

 

  1. Handling of suspected case of new coronavirus SARS-CoV-2 infection

 

If a suspected case is identified, the following measures should be adopted:  

 

  1. Measures for prevention and control of SARS-CoV-2 infection

3.1. Standard precautions

 

Standard precautions include hand hygiene and respiratory hygiene, the use of personal protective equipment according to risk assessment, good handling of sharp objects, safe contaminated waste management, cleaning and disinfection of surfaces as well as sterilization of medical equipment and linen used by the patient.

 

Implementation of the following measures of respiratory hygiene is particularly important:

 

Of note, good and systematic use of the appropriate personal protective equipment along with hand hygiene practice is critical for reducing the spread of pathogens.

 

Furthermore, cleaning and disinfecting all surfaces with detergent and water as well as common disinfectants (e.g. sodium hypochlorite solution) is sufficient. Handling of linen, tableware and contaminated waste must be carried out according to standard, established safety procedures.

 

3.2 Additional precautions for handling a suspected case of SARS-CoV-2 infection

Contact and droplet precautions

 

Airborne precautions

 

Certain aerosol-generating procedures (e.g. tracheal intubation, non-invasive ventilation, tracheotomy, cardiopulmonary resuscitation, bronchoscopy, AMBU bag use) have been associated with an increased risk of transmission of coronaviruses.

 

Healthcare professionals performing aerosol-generating procedures must:

All procedures above must be carried out in an adequately ventilated room or in a negative-pressure room, if feasible. The number of persons present in the room must be limited to the absolute minimum.

 

Duration of spread control and prevention measures

Standard precautions must be applied systematically and in all cases. Additional contact and droplet precautions should continue until the patient is symptomatic.

 

Note: This guidance may be revised based on new epidemiological and clinical data on the new coronavirus infection.         

 

References

  1. World Health Organization (WHO). Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected. Interim guidance 25 January 2020 (12 February 2020)
  2. Centers for Disease Control and Prevention. Interim infection prevention and control recommendations for patients with confirmed 2019 novel coronavirus (2019-nCoV) or persons under investigation for 2019-nCoV in healthcare settings – updated February 3, 2020 (12 February 2020)
  3. European Centre for Disease Prevention and Control (ECDC). Personal protective equipment (PPE) needs in healthcare settings for the care of patients with suspected or confirmed novel coronavirus (2019-nCoV) (12 February 2020)
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