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Handbook of COVID-19 Prevention and Treatment (Part Two Diagnosis and…
Handbook of COVID-19 Prevention and Treatment
Part Two Diagnosis and Treatment
I. Personalized, Collaborative and Multidisciplinary Management
II. Etiology and Inflammation Indicators
Laboratory Safety
Detection of Secondary Bacterial or Fungal Infections
Detecting Indicators of Inflammatory Response
Detection of Serum Antibody
Virus Isolation and Culture
Detection of SARS-CoV-2 Nucleic Acid
Nucleic Acid Detection
Specimen Collection
III. Imaging Findings of COVID-19 Patients
IV. Application of Bronchoscopy in the Diagnosis and Management of COVID-19 Patients
V. Diagnosis and Clinical Classification of COVID-19
Clinical Classifications
Mild Cases
Moderate Cases
Severe Cases
Critical Cases
Early stage
Middle stage
Late stage
VI. Antiviral Treatment for Timely Elimination of Pathogens
Antiviral Treatment
Course of Treatment
VII. Anti-shock and Anti-hypoxemia Treatment
Usage of Glucocorticoids when Necessary
Indication for Corticosteroids
Application of Corticosteroids
Special Consideration during Treatment
Artificial Liver Treatment for Suppression of Cytokine Cascade
Indication for The artificial liver support system (ALSS)
Contraindications
Oxygen Therapy for Hypoxemia
Oxygen therapy
Continual oxygen saturation monitoring during oxygen therapy
Oxygen therapy as soon as possible
Treatment goal of oxygen therapy
Control oxygen therapy
Mechanical Ventilation
Noninvasive Ventilation (NIV)
Invasive Mechanical Ventilation
Principles of invasive mechanical ventilation in critically ill patients
Lung Recruitment
Prone Position Ventilation
Prevention of Regurgitation and Aspiration
Fluid Management
Strategies to Prevent Ventilator-Associated Pneumonia (VAP)
Weaning of Ventilation
VIII. The Rational Use of Antibiotics to Prevent Secondary Infection
IX. The Balance of Intestinal Microecology and Nutritional Support
Microecologics Intervention
Nutrition Support
X. Extracorporeal Membrane Oxygenation (ECMO) Supportfor COVID-19 Patients
ECMO Intervention Timing
Salvage ECMO
Replacement ECMO
Early Awake ECMO
Cathetering Methods
Mode Selection
Flux Set-value and Target Oxygen Supply
Ventilation Setting
Anti-Coagulation and Bleeding Prevention
Weaning from ECMO and Mechanical Ventilation
Plasma collection
Donors
Collection Method
Post-Collection Testing
Clinical Use of the Convalescent Plasma
Indication
Contraindication
XII. TCM Classification Therapy to Improve Curative Efficacy
Classification and Stage
Therapy Based on Classification
XIII. Drug Use Management of COVID-19 Patients
Identification of adverse drug reactions
Therapeutic Drug Monitoring
Paying attention to the potential drug interactions
Avoiding medical damage in special populations
XIV. Psychological Intervention with COVID-19 Patients
The psychological stress and symptoms of COVID-19 patients
Establishing a dynamic mechanism for evaluation and warning of
psychological crisis
Intervention and treatment based on the assessment
Principles of intervention and treatment
The recommendation of psychotropic medications in elderly patients
XV. Rehabilitation Therapy for COVID-19 Patients
Rehabilitation therapy for severe and critically ill patients
Rehabilitation assessment
Rehabilitation therapy
XVI. Lung Transplantation in Patients with COVID-19
Pre-transplantation assessment
Contraindications
XVII. Discharge Standards and Follow-up Plan for COVID-19 Patients
Discharge standards
Medication after discharge
Home isolation
Follow-up
Management of patients tested positive again after discharge
Part One Prevention and Control Management
I. Isolation Area Management
Fever Clinic
Layout
Zone Arrangement
Patient Management
Screening, Admission, and Exclusion
Isolation Ward Area
Scope of Application
Layout
Ward Requirements
Patient Management
II. Staff Management [2]
Workflow Management
Health Management
III. COVID-19 Related Personal Protection Management [2]
Protection Level
Protective Equipment
Scope of Application
IV. Hospital Practice Protocols during COVID-19 Epidemic [2]
Guidance on Donning and Removing Personal Protective Equipment (P.P.E) to manage COVID-19 Patients
Protocol for Donning !'PE
Protocol for Removing PPE
Disinfection Procedures for COVID-19 Isolation Ward Area
Disinfection for Floor and Walls
Disinfection of Object Surfaces
Air Disinfection
Disposal of Fecal Matter and Sewage
Disposal Procedures for Spills of COVID-19 Patient Blood/Fluids
For spills of a small volume(< 10 ml) of blood/bodily fluids
For spills of a large volume(> 10 ml) of blood and bodily fluids
Disinfection of COVID-19 Related Reusable Medical Devices
Disinfection of powered air-purifying respirator
Cleaning and Disinfection Procedures for Digestive Endoscopy and Bronchofibroscopy
Pre-treatment of Other Reusable Medical Devices
Disinfection Procedures for Infectious Fabrics of Suspected or Confirmed Patients
Infectious fabrics
Collection methods
Storage and washing
Disinfection of transport tools
Disposal Procedures for COVID-19 Related Medical Waste
Procedures for Taking Remedial Actions against Occupational Exposure to COVID-19
Surgical Operations for Suspected or Confirmed Patients
Requirements for Operation Rooms and Staff PPE
Procedures for Final Disinfection
Procedures for Handling Bodies of Deceased Suspected or
Confirmed Patients
V. Digital Support for Epidemic Prevention and Control
Reduce the Risk of Cross Infection when Patients Seek Medical Care
Lower Work Intensity and Infection Risk of Medical Personnel
Rapid Response to Emergency Needs of COVID-19 Containment
[FAHZU lnternet + Hospital - A Model for Online Healthcare]
[Establishing the International Medical Expert Communication Platform of the First Affiliated Hospital, Zhejiang University School of Medicine]
Part Three Nursing
I. Nursing Care for Patients Receiving High-Flow Nasal Cannula (HFNC) Oxygen Therapy
Assessing
Monitoring
Treatment of Secretions
II. Nursing Care for Patients with Mechanical Ventilation
Intubation Procedures
Analgesia, Sedation and Delirium Management
Prevention of Ventilator-Associated Pneumonia (VAP)
Sputum Suction
Disposal of Condensation from Ventilators
Nursing Care for the Prone Position Ventilation (PPV)
Ill. Daily Management and Monitoring of ECMO (Extra Corporeal Membrane Oxygenation)
ECMO equipment should be managed by ECMO perfusionists and the following items should be checked and recorded every hour
The following items during every shift should be monitored and recorded
Daily monitoring
Anticoagulation management
Implement the "ultra-protective lung ventilation" strategy
Closely observe the vital signs of patients
Transfuse through the post membrane
According to the monitoring records, evaluate the ECMO oxygenator function during every shift.
IV. Nursing Care of ALSS {Artificial Liver Support System)
Nursing Care during Treatment
Operator's own preparation
Patient assessment
Installation and pre-flushing
Running
Parameter Adjustment
Weaning
Recording
Intermittent Care
Observation and treatment of delayed complications
ALSS Intubation Care:
ALSS Intubation and Extubation Care
V. Continuous Renal Replacement Treatment {CRRT) Care
Preparation before CRRT
In-treatment Care
Postoperative Care
VI. General Care
Monitoring
Aspiration Prevention
Implement strategies to prevent catheter-related bloodstream infection and catheterrelated
urinary tract infection.
Prevent pressure-induced skin injuries, including device-related pressure-induced injuries, incontinence-associated dermatitis and medical adhesive-related skin injuries. Identify patients at a high risk with the Risk Assessment Scale and implement preventive strategies
Assess all patients upon admission and when their clinical conditions change with the VTE
risk assessment model
Assist eating for patients who are weak, short of breath or those with an obvious fluctuating
oxygenation index