Advice for Healthcare Professionals

Making Your Health First Priority

For ICU


Considerations while selecting and purchasing equipment for the ICU

A continuously updated selection policy should be applied with medical, nursing and other concerned ICU staff to give suggestions and feedback on any new equipment required and also on the existing equipment in the ICU. This may avoid poorly considered last minute equipment selections. Technical advice and end user feedback should be sought from the hospital biomedical engineers, end users and from other departments within the hospital/other hospitals having similar equipment, who may be able to advise on the performance and service of the equipment. In addition to cost, end user comfort, storage space required, compatibility with existing equipment, compatibility for up gradation,

sterilization compatibility with the existing hospital policy, maintenance requirements and service record of the vendor should be considered before purchasing equipment. Several equipments are now offered at no cost, for commitment of purchase of a minimum number of associated disposable items, over a specified period of time and this option should be considered. The advantages of bulk purchase with allied departments and purchase of similar equipment from the same vendor should also be considered. For example: selecting the same ventilator model from one company. This not only reduces cost, but will make it easy for the end user with uniform equipment, in terms of training and utilization and in

addition similar equipment will be available for temporary use in case any equipment mal function.


Maintenance of ICU equipment

A policy for maintenance of equipment in ICU is of utmost importance considering the number of users, uses, wear and tear of the equipment in a busy, highly stressed area such as the ICU. A culture of responsible utilization of equipment with accountability, from all end users should be inculcated in the unit. Nevertheless, designated staff should be assigned, with accountability for the proper maintenance, including sterilization /disinfection, calibration and regular servicing of the equipment, to improve its life and thereby save on the cost of frequent replacement and repair.


For General Outdoor clinics:


With enough evidence that India’s COVID cunt being on a rise OPDs of general physicians, internal medicine consultants and chest physicians need to be modified to avoid putting HCWs at risk of getting infected and also to avoid the situation where these setups were portrayed as hotspots of transmission of the virus in some media reports.


With most of the western countries switched to e-data base for OPDs and e-prescription, many of OPDs in India still use physical paper prescription format this being a potential fomite .

Most of the patients with GPs are walk-ins and triage is difficult.


Here are some suggestions for out-patient departments,


  • Make your OPDs door less.. keep the doors of consulting rooms permanently open so nobody needs to touch them while opening or closing.


  • Keep a separator or rope to avoid people touching the registration counter.

  • Patients with respiratory symptoms need not approach the counter directly go to a separate room spacious and airy and sit on a stool in the centre of the room where they cannot touch anything in the surrounding. You can quickly examine the patient and come out, you can discuss the condition with their relatives in another room


  • Do not issue OPD paper in the hands of the patient or relative... Give it in their hand after you write  the prescription when they are exiting e-prescription better 


  • No patient or relative enters the hospital premises without wearing a mask/ handkerchief and sanitizing hands


  • Examine the patient with his face turned away... preferably from behind after each examination sanitize your hands and stethoscope diaphragm.


  • Don't touch the currency given by the patients. keep a box on the counter asks patients to drop the notes into the box; keep a separate arrangement for returning the change.


  • Keep dedicated staff at the entrance to segregate respiratory patients and guide them. No respiratory patient sits on the chair of the waiting room. preferably directly goes to the examination room quick in and out.


  • Only one relative with the patient and he can also be made to stand to remove chairs in consultation room also; only examination stool for the patient enough.


  • Once you come to the hospital avoid going back home without taking bath or changing clothes ..take a shower in Hospital only if possible...discard disposable PPE 

  • Wash your clothes separately


  • Regulate the patient inflow.. new appointments on phone are call patients after every 15 minutes to avoid crowding.


  • you can actually remove the chairs in the waiting room and mark lines at 6 feet where the patient relative will stand away from each other.


  • keep minimum contact with the patient, digital blood pressure better,  measuring blood pressure only when indicated, pulse oximeter to be sanitized after every patient


  • Recommended PPE At least 

    • MASK ( TRIPLE LAYER SURGICAL MASK OR N95)

    • EYE PROTECTION OR FACE SHIELD

    • CAP

    • Full sleeves Apron 

    • GLOVES

    • FULL PPE in COVID suspect case


  • Remove mask and PPE only after you finish your duty. Never touch the face. avoid using toilet or drinking water. Keep OPD time short for that

  • Refer suspected cases to government authorities and maintain its record.

  • The person who examines the patient need not be the one who writes the prescription. Keep a dedicated person for that.

  • Don’t create an extra fomite by using a pen

  • Always do a chest x-ray if chest findings indicating a suspicion of LRTI 


DO YOUR PART - STAY SAFE


Considerations while selecting and purchasing equipment for the ICU

Prophylaxis with CHQ or HCQ

Two controlled studies have already been published with the use of HCQ in COVID-19. A more rapid viral clearance was noted in a French study (2), while a pilot study from China revealed no difference between the HCQ-treated and control groups regarding the time to defervescence or progression of changes on CT imaging. However, recently many countries including India, US and others adopting it safely for prophylaxis in Health care workers along with contact prophylaxis.


For further information on team building, approach to a ventilated patient with COVID-19, prognostic markers in COVID-19 follow us on FB, twitter or CAV Global Solutions blog.

 

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