Oropharyngeal suctioning and nasogastric tube insertion with a new mask for reduction of droplet dispersion: a proposal for a new preventive strategy during the coronavirus disease pandemic.
Oropharyngeal suctioning and nasogastric tube insertion with a new mask for reduction of droplet dispersion: a proposal for a new preventive strategy during the coronavirus disease pandemic.
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DOI：
10.1016/j.jhin.2022.01.022
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发表时间：
2022-05
期刊：
影响因子：
--
通讯作者：
Sato K
中科院分区：
文献类型：
--
作者：
Okachi S;Ito T;Yasui H;Fukatsu N;Sato K
冠状病毒病（COVID-19）由严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）引起，通过密切接触的呼吸道飞沫传播。与普通社区相比，卫生保健工作者（HCWs）感染COVID-19的风险更高。在住院部和疗养院工作的人风险最高，因为他们的工作需要与SARS-CoV-2患者密切接触。使用个人防护装备（PPE），包括手套、口罩、护目镜或面罩和防护服，可以减少院内传播，而个人防护装备不足被认为是感染COVID-19的一个风险因素[2,3]。气道吸痰是维持气道通畅的重要保健干预措施，气道通畅可能直接产生气溶胶，或间接引起咳嗽。Jackson等人在他们的系统综述bbb中将气道吸引分为主动或被动产生气溶胶的过程。鼻胃管（NGT）放置是另一种常见的程序，可能会增加医护人员接触SARS-CoV-2的风险，因为它需要与患者近距离接触一段时间，并可能引起咳嗽。至少有一项关于COVID-19患者营养的指南认为NGT放置是一个产生气溶胶的过程，并建议在将管插入鼻腔时覆盖患者的口腔。
Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spread via respiratory droplets in close contact [1]. Healthcare workers (HCWs) are at increased risk of COVID-19 as compared with the general community. The risk is highest among those working in the inpatient setting and nursing homes because their work requires close personal exposure to patients with SARS-CoV-2 [2]. Use of personal protective equipment (PPE), including gloves, masks, goggles or face shields, and gowns, can reduce nosocomial transmission, whereas inadequate PPE is considered to be a risk factor for acquiring COVID-19 [2, 3].Airway suctioning is an important healthcare intervention to maintain airway patency that may generate aerosols directly, or indirectly by inducing coughing [4]. Jackson et al. classified airway suctioning as an active or passive aerosol-generating procedure in their systematic review [5]. Nasogastric tube (NGT) placement is another common procedure that may increase the risk of exposure of HCWs to SARS-CoV-2, because it requires close proximity to the patient for some time and can induce coughing [6]. At least one guideline on nutrition for COVID-19 patients considers NGT placement to be an aerosol-generating procedure and recommends covering the patient's mouth during insertion of the tube in the nasal cavity [7].
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