阿里-新冠肺炎防治手册（英）-2020.3-68页_33mb

Summary of the Handbook of COVID-19 Prevention and Treatment

Core Content

This Handbook of COVID-19 Prevention and Treatment is a comprehensive guide compiled by the First Affiliated Hospital, Zhejiang University School of Medicine, based on clinical experience gained during the fight against the novel coronavirus. It emphasizes the importance of collaboration, sharing, and multidisciplinary approaches in combating the pandemic. The Handbook is made possible through the support of the Jack Ma Foundation and AliHealth, and is freely available to all healthcare professionals globally.

Main Views

• Global Collaboration: The Handbook highlights the necessity of global cooperation in the face of a pandemic, stating that sharing knowledge and resources is the best way to overcome the virus.
• Prevention and Control: Emphasis is placed on isolation and infection control as critical measures to protect both patients and medical staff.
• Clinical Experience Sharing: The Handbook serves as a guide for medical workers in other areas, offering practical advice and reference based on China's early experience with the virus.
• Comprehensive Care: It includes detailed protocols for diagnosis, treatment, nursing, and rehabilitation, covering a wide range of medical procedures and patient management strategies.
• Safety and Hygiene: Strict personal protection and disinfection procedures are outlined to ensure the safety of healthcare workers and the environment.

Key Information

Part One: Prevention and Control Management

• Isolation Area Management:

  • Healthcare facilities must establish independent fever clinics with one-way passage and three zones and two passages to prevent cross-contamination.
  • Patients with fever and respiratory symptoms are separated into different zones for triage and management.
  • Patient management includes wearing masks, limiting visits, and educating patients on prevention.

• Staff Management:

  • Staff must undergo training and examination before working in isolation areas.
  • Team rotation is recommended to reduce exposure risk.
  • Isolation accommodations are provided for frontline workers to prevent community spread.
  • Regular health monitoring (temperature, symptoms) and psychological support are essential for staff.

• Personal Protection Management:

  • Three levels of protective equipment (PPE) are defined based on the risk of exposure:
    • Level I: Surgical mask, cap, work uniform, gloves.
    • Level II: N95 mask, goggles, protective clothing, and gloves.
    • Level III: Full-face respiratory protection, powered air-purifying respirator, and additional gear for high-risk procedures.
  • Specific PPE donning and removing protocols are provided, including step-by-step procedures and disinfection guidelines for each stage.

• Disinfection Procedures:

  • Floor and walls: Disinfected with 1000 mg/L chlorine-containing disinfectant for at least 30 minutes, three times daily.
  • Object surfaces: Disinfected with 1000 mg/L chlorine-containing disinfectant, wiping from less contaminated to more contaminated areas.
  • Air disinfection: Use plasma air sterilizers or ultraviolet lamps for 1 hour, three times daily.
  • Fecal matter and sewage: Disinfected with chlorine-containing disinfectant at 40 mg/L for 1.5 hours before disposal.
  • Spill management: Different protocols are used based on the volume of spill (small or large), including the use of disinfecting wipes and powder.
  • Infectious fabrics: Collected in three layers of bags, labeled with an infection label, and washed at 90°C for 30 minutes.
  • Medical waste: Must be double-bagged, labeled, and disposed of as medical waste using approved providers.

Part Two: Diagnosis and Treatment

• Clinical Management:

  • Emphasizes personalized, collaborative, and multidisciplinary care.
  • Includes etiology, inflammation indicators, imaging findings, and clinical classification of the disease.
  • Offers guidance on antiviral treatment, anti-shock, anti-hypoxemia, antibiotic use, and nutritional support.

• Advanced Therapies:

  • ECMO support, convalescent plasma therapy, and TCM classification therapy are detailed for managing severe cases.
  • Drug use management is outlined to ensure safe and effective treatment.
  • Psychological and rehabilitation interventions are recommended for patient recovery and mental well-being.

• Lung Transplantation:

  • Considered as an option for patients with severe respiratory failure and multi-organ dysfunction.

• Discharge and Follow-up:

  • Patients must meet discharge standards and have a follow-up plan to monitor recovery and prevent relapse.

Part Three: Nursing

• High-Flow Nasal Cannula (HFNC) and Mechanical Ventilation:
  • Specific nursing care protocols are provided for patients on HFNC and ventilators.
• ECMO and ALSS Care:
  • Includes daily monitoring, care procedures, and management of complications.
• General Care:
  • Covers basic hygiene, communication, and prevention of further transmission.

Appendix

• Medical Advice Examples and online consultation procedures are provided for diagnosis and treatment guidance.
• References are listed to support the clinical recommendations and protocols.

Conclusion

The Handbook of COVID-19 Prevention and Treatment is a vital resource for healthcare professionals worldwide, offering practical, evidence-based guidelines on prevention, diagnosis, treatment, and nursing care. It underscores the importance of strict infection control, team collaboration, and technology application in managing the pandemic effectively. The Handbook is a free and open-access resource, reflecting the global commitment to sharing knowledge and fighting the virus together.