Fighting against coronavirus disease 2019 outbreak: improvement in anesthesia-related infection control / 中华麻醉学杂志

ABSTRACT

The coronavirus disease 2019(COVTD-19)epidemic has caused wide concern all over the world, including China. In order to fight against epidemic situation, the professional knowledge and practice of anesthesiologists in standard prevention, disinfection and isolation, hand hygiene, environmental sanitation, aseptic operation, occupational protection and other aspects of infection control need to be improved and standardized. Aiming at solving the main problems existing in anesthesia-related infection control in China, we put forward the following suggestions after considering COVID-19 epidemic situation deeply and sorting out the relevant laws, regulations and normative requirements.(1) In terms of standard prevention, during the diagnosis and treatment of suspected or confirmed COVID-19 patients, anesthesia practioners should wear protective equipment according to the tertiary protective measures, including wearing N95 medical respirator, goggles or protective screen, wearing protective clothing, etc.(2) In terms of hand hygiene, hand washing or hand sanitization should be carried out in strict accordance with the hand hygiene regulations when anesthetizing confirmed or suspected COVID-19 cases. Double gloves are essential, after contact with the patient, remove and discard the outer gloves if you need to touch the anesthetic machine or other areas.(3) In terms of environmental sanitation, anesthesiologists should promptly clean and disinfect small areas of patients′ blood and other contamination when performing operations for suspected or confirmed COVID-19 cases. After the operation, the person in charge of infection control in the operating room should strictly implement the technical specification for disinfection of medical institutions, clean and disinfect the operating room (air, object surface, ground, etc.), medical instruments, and objects used by patients, especially the surfaces frequently touched by anesthesiologists.(4) In terms of anesthesia machine disinfection, it is recommended to combine the use of anesthesia internal circuit disinfection machine with the use of artificial nose at the expiratory end and inspiratory end. High efficiency and low capacity hydrophobic filter are preferred in order to make bacteria and virus clearance rate>99.999%. The respiratory pathway filter should be replaced every 3-4 h. (5) In term of isolation, confirmed or suspected COVID-19 cases should be operated in the negative pressure operating room. Medical personnel should inform laminar flow engineering technical personnel to check in time, when necessary to replace the hepa filter for negative pressure operating room.(6) In other aspects, when anesthesia is performed for COVID-19 patients, sharp instruments in anesthesia operation should be carefully handled to prevent stabbing. Latrogenic occupational exposure treatment process should be initiated immediately after stabbing occurs.