Preventive and Therapeutic Approaches in Medical Departments During the COVID-19 Pandemic

Abstract

According to experimental and clinical investigations the incubation period of the n-CoV-SARS2 ranges from 3–14 days henceforth, every case presenting for treatment should be managed as a potential asymptomatic infected patient. History regarding respiratory illness, international travel and/or, contact with COVID-19 cases should be reported in every patient sheet separately. All cases, as well as their attendants, should be monitored for COVID-19 before entering the emergency department. Any cases suspected of COVID-19 should be immediately separated while emergency management is being performed. All physicians/nurses/paramedical personnel are suggested to use surgical scrubs along with a plastic apron, face masks, and other protective instruments as necessary while in the triage unit. They should use PPE, N95 masks as well as a face visor while evaluating/intubating suspected or proven COVID-19 cases in the emergency. A dedicated operating room (OR) and the same anesthesia machine should only be applied for COVID-19 positive patients for the duration of the epidemic. The risk of aerosol dispersion is maximum during intubation, therefore it has been proposed that the whole face skin may be covered by a transparent sheet and the hands may be inserted under the sheet to intubate the cases, while the edges should be stuck to the surface. Alternatively, the application of a transparent Perspex square box has been proposed which is placed over the patient's head and has two ports for the anesthesiologist to insert his/her arm so that the whole intubation may be conducted inside the box. A preferred guideline is the application of a separate room for intubation and then bringing the case to the OR, so the risk is reduced to the surrounding health care provider.