新型冠状病毒肺炎院外医疗转运特点分析

目的 探讨新型冠状病毒肺炎(简称新冠肺炎)患者院外医疗转运的临床特点.方法 对2020年1月20日0时—2月27日0时期间北京急救中心防控转运组转运新冠肺炎疫情相关任务的出车数据进行统计和回顾性分析.结果 从2020年1月20日0时—2月27日0时29 d内北京急救中心防控转运组总出车数为556次,按任务类别和占比依次...     

运用ECMO支持重症新型冠状病毒肺炎患者的成功转运

目的 结探讨通过负压救护车转运,运用ECMO辅助治疗院间转运重症新型冠状病毒肺炎患者的方法和效果,提高今后类似重症患者呼吸衰竭的救治率.方法 回顾性分析总结武汉2020年初6例新型冠状病毒肺炎患者利用静脉-静脉(V-V)ECMO支持的呼吸衰竭患者院外转运的流程、方法及管理经验.结果 因准备充分,转运过程顺利,防护传染病...     

新型冠状病毒肺炎危重症患者的焦虑抑郁及相关因素分析

目的了解新型冠状病毒肺炎危重症患者的焦虑抑郁状况及相关因素,为采取针对性心理干预提供参考依据。方法在2020年3月对94例新型冠状病毒肺炎危重症患者采用焦虑自评量表及抑郁自评量表进行调查。结果焦虑得分43.30±11.56,发生率为22.34%;抑郁得分45.34±13.35,发生率为25.53%。经Pearson相关分析,新型冠状病毒肺炎危重症患者焦虑与抑郁(P<0.001)、女性(P=0.010)、学历(P<0.001)、住院天数(P=0.003)相关;抑郁与焦虑(P<0.001)、年龄(P=0.009)、职业(P=0.049)、家庭人均月收入(P=0.034)相关。最终回归方程显示性别、年龄、学历、住院天数、家人感染、家人住院是焦虑、抑郁的相关因素c结论新型冠状病毒肺炎危重症患者的焦虑与抑郁情绪明显,需要根据不同的相关因素进行有效的心理干预,以促进患者康复。     

新型冠状病毒肺炎疫情期间银屑病患者使用生物制剂的指导意见

【摘要】 新型冠状病毒肺炎疫情对银屑病患者使用生物制剂可能产生一定的影响,生物制剂的免疫抑制作用可能改变患者对病毒的易感性或造成感染者病情加重,甚至影响预后。参考国际银屑病学术组织和专家的建议,结合我国实际情况,分别针对正在进行生物制剂治疗和拟进行生物制剂治疗的银屑病患者、高风险和低风险患者以及合并或不合并新型冠状病毒感染的患者提出了使用生物制剂的指导性建议,供临床实践中参考。     

抗击新型冠状病毒肺炎疫情期间4种医用护目镜防雾方法效果对比

目的对比防雾剂涂抹镜片、碘伏涂抹镜片、贴膜封闭口罩上缘、洗洁剂涂抹镜片4种预防护目镜起雾方法的效果。方法统计2020年2月50名在武汉同济医科大学协和医院西院区支援的北京医疗队员防止护目镜起雾方法使用情况,针对憋闷感有无加重,连续工作4 h后血氧饱和度变化,失效时长、防雾效果、人均使用次数,舒适度等方面进行评价。结果4种不同防雾方法间对比结果显示,不同方法的使用次数(P=0.0292),增加憋闷感评分(P=0.0002)、原防护条件下不适感加重评分(P=0.0024)具有统计学意义(P<0.05);而血氧饱和度的最低值(P-0.2134)和最高值(P=0.3875)、开始起雾时间(P=0.0758)和防雾等级(P=0.066)不存在统计学差异。组间两两比较中,贴膜组相对于防雾剂组(P=0.0031),洗洁精组(P=0.0007)和碘伏组(P=0.0007)均会增加憋闷感,并且贴膜组相对于防雾剂组(P=0.0325),洗洁精组(P=0.0204)和碘伏组(P=0.0019)均会加重原有防护条件下不适感,结果具有统计学意义。结论洗洁剂、碘伏方便临床取用,成本较低且使用过程中对憋闷感、不适感影响较小。防雾剂也有以上优势但需专门购置,在紧急医疗条件下未必能够及时取用。贴膜虽然属于医疗用品,方便取用,但对于已经采取三级防护的医务人员来说弊端大于防雾优势,在其他3种资源无法获取时可以选择性使用。     

在新型冠状病毒肺炎疫情肆虐的条件下如何做好银屑病患者的诊疗管理

2019年12月以来,新型冠状病毒肺炎迅猛袭来并呈现快速蔓延之势,全国各地都在积极主动地筹集医疗资源,有条不紊地针对疫情进行防控。在这种特定的情况下,如何做好慢性皮肤病的控制与随访,尤其是银屑病患者病程缓慢,需要不断地指导及治疗。另外大多数患者存在皮肤屏障功能受损情况,保护不当会增加对病毒的易感性,诱发或加重疾病。由于防控的需要,在各种限制出行的倡议下,增加了人群的精神紧张,银屑病本身的焦虑、抑郁等心理反应进一步产生情绪紧张从而加重病情。因此,在特殊时期下如何指导银屑病患者进行不间断的有效治疗,调整情绪建立良好的心态,做好银屑病患者的个人健康防护工作,维持患者的疗效,提高生活质量也是不可忽略的重要工作。     

新型冠状病毒肺炎伴发的皮肤表现

【摘要】 新型冠状病毒肺炎可伴有多种皮肤表现,主要包括血管性病变如冻疮样皮损、网状青斑、紫癜、瘀斑、肢端紫绀、坏疽以及炎性病变如弥漫性红斑、麻疹样皮损、急性荨麻疹、水痘样疹。部分皮损类型可能是新型冠状病毒感染的首发症状或唯一临床表现。     

综合医院急诊科新型冠状病毒感染肺炎的预防和控制

目的探讨综合医院急诊科新型冠状病毒感染肺炎预防和控制的方法和对策。方法通过成立新型冠状病毒肺炎工作小组、制定新型冠状病毒肺炎防控应急工作预案、开展接诊疑似患者流程演练、不断学习和更新诊疗知识、实施防控知识和方法培训与考核、加强预检分诊、实时医患心理干预、医疗安全沟通管理、专家组会诊、相关科室防控一体联动、工作人员健康管理、感染控制相互监督机制、优化工作流程等方法,防止出现院内患者交叉感染、医护人员感染以及已感染患者因漏诊入住普通病房,确保疫情得到有效控制。结果2020年1月22日—2月22日,医院急诊和发热门诊就诊患者总量2654人,疑似病例34人,确诊病例4人,交叉感染0例,医务人员感染0例,医务人员严重心理应激反应0例,医疗投诉和纠纷及安全事故0例。结论急诊科实施的各项预防和控制措施,促进了医院感染控制措施的落实,实现了“感染患者零漏诊、医务人员零感染、院内感染无交叉”的目标,保证了医务人员良好的心理状态,确保了医疗安全,为综合医院急诊科有效预防和控制新型冠状病毒感染肺炎提供了参考。     

援鄂抗击新型冠状病毒肺炎医护人员的皮肤损伤和皮肤病调查

目的：对援鄂抗击新型冠状病毒肺炎医护人员的皮肤损伤和皮肤病发生情况进行调查分析。方法：利用问卷网制作调查问卷,通过微信群发放二维码在线填写。内容包括受访者的基本情况、皮肤症状和皮肤病发生情况。结果：共155名医护人员完成调查,其中医生52名（33.55%）,护士103名（66.45%）;男64名（41.29%）,女91名（58.71%）,平均年龄35.32岁。援鄂期间每天洗手大于10次的140名（90.32%）。最常见的皮肤症状为压痕（88.39%）、皮肤干燥（63.23%）、多汗（50.97%）。压痕和压疮最常见的部位是鼻梁（83.94%）。最常见的皮肤病为湿疹（24.52%）、痤疮（21.94%）和毛囊炎（21.29%）。结论：援鄂医护人员皮肤损伤和皮肤病发生率高,需要进行干预。     

新型冠状病毒肺炎防控中防护用品诱发面部皮肤问题的预防及护理

新型冠状病毒肺炎疫情期间,由于医护人员长时间佩戴医用口罩及护目镜等防护用品,导致出现压力性损伤和痤疮等面部皮肤问题。该文重点阐述抗击疫情过程中,一线医护人员面部压力性损伤和面部痤疮的现状及预防和护理方案。     

Body care activities and its consequences related to COVID-19 pandemic

Background

Symptoms of illnesses related to COVID-19 disease include also dermatological changes. Moreover, modification of cosmetic and hygenic habits are widely noted.

Aim

The aim of this paper is to review the literature focused on skin manifestations related to COVID-19 disease.

Materials and Methods

In order to obtain information contained in this review article electronic databases, such as Google Scholar and PubMed, was searched. Only peer-reviewed articles published in the past two years have been studied.

Results and Discussion

People have changed their cosmetics and hygenic habits, what has an impact on spreading COVID-19 disease, as well as on the beauty industry and human health.

Conclusion

More emphasis should be placed on increasing knowledge about skin lesions, which may appear in course of the disease or are associated with changes in hygenic and cosmetics habits.     

COVID-19 related pressure injuries in patients and personnel: A systematic review

BackgroundCoronavirus disease 2019 (COVID-19) is causing a rapid and tragic health emergency worldwide. Because of the particularity of COVID-19, people are at a high risk of pressure injuries during the prevention and treatment process of COVID-19.ObjectivesThis systematic review aimed to summarize the pressure injuries caused by COVID-19 and the corresponding preventive measures and treatments.MethodsThis systematic review was according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed, Web of science and CNKI (Chinese) were searched for studies on pressure injuries caused by COVID-19 published up to August 4, 2020. The quality of included studies was assessed by the Newcastle-Ottawa Quality Assessment Scale (NOS) and the CARE guidelines.ResultsThe data were extracted from 16 studies involving 7,696 participants in 7 countries. All studies were published in 2020. There are two main types of pressure injuries caused by the COVID-19: 1) Pressure injuries that caused by protective equipment (masks, goggles and face shield, etc.) in the prevention process; 2) pressure injuries caused by prolonged prone position in the therapy process.ConclusionsIn this systematic review, the included studies showed that wearing protective equipment for a long time and long-term prone positioning with mechanical ventilation will cause pressure injuries in the oppressed area. Foam dressing may need to be prioritized in the prevention of medical device related pressure injuries. The prevention of pressure injuries should be our particular attention in the course of clinical treatment and nursing.     

北京市276612例院外急救病例分析

目的了解北京市院外急救病例特点,提高应财与处置能力。方法对北京市2008年8月～2009年7月276612例院外急救资料进行回顾性分析。结果在北京“120”急救网络全年出诊276612次中,男女比例2．05：1;20～49岁、60～89岁为两个高发年龄段;院外急救病种和急症前6位的依次为：创伤、脑血管病、心血管病、昏迷、消化及呼吸系统疾病。结论北京市院外急救病例仍以创伤和心脑血管疾病最为常见,高发年龄段为青壮年及老年人。     

Determination of medical device-related pressure injury in COVID-19 patients: A prospective descriptive study

BackgroundCOVID-19 patients are at risk for the development of pressure injuries (PI).AimThe aim of this study was to determine the incidence of medical device-related pressure injury (MDRPI) in patients treated in the COVID-19 Intensive Care Unit (ICU)s.MethodsThe sample of the study consisted of 132 patients, and each with a maximum follow-up of 7 days. Data were collected in the COVID-19 ICU of a university hospital between January and May 2021 by using a Patient Characteristics Form, the MDRPI Follow-up Form, the Braden Pressure Ulcer Risk Assessment Scale, and the Pressure Ulcer Staging Form.ResultsOf the patients, 59.1% (n = 78) developed at least one MDRPI. MRDPI was observed in those with a mean age of 65.45 ± 2.462 years who were invasively ventilated (51.3%), enterally fed (46.2%), placed in the prone position (78.2%), and had a Braden score ≤12 (50%). The most common medical devices that caused MDRPIs included endotracheal tube (ET) (31.2% n = 44), non-invasive mechanical ventilation (NIVM) (23.4% n = 33), nasal high-flow (11.3% n = 16), nasogastric tube (10.6% n = 15), the ET connection (8.5% n = 12), respectively. The most common sites for pressure injuries were the nose (28.8% n = 34), mouth (25.8% n = 34), ear (12.9% n = 17), lip (9.1% n = 12), and cheek (8.3% n = 11). The most common gradings of MDRPIs were stage 2 (28.8% n = 38), stage 1 (19.7% n = 26), stage 3 (9.1% n = 12) mucous membrane injuries (12.9% n = 17) and suspected deep tissue injuries (9.1% n = 12), respectively. The time to PI was 3 days (25.7% n = 36).ConclusionsMDRPI was common among COVID-19 patients. It was found that the most common cause of pressure injury was ventilators, and PI developed in the mouth and lip sites most frequently in patients in prone position, stage 2 and suspected deep tissue damage was the most common grade. It is important to evaluate the skin in contact with medical devices in COVID-19 patients and to take the necessary interventions to prevent PI.     

Impact of the COVID-19 pandemic on children with psoriasis

BackgroundChildren with psoriasis may have been directly impacted by the COVID-19 pandemic and their illness may also have affected their ability to follow preventive measures.ObjectiveTo investigate the impact of the COVID-19 pandemic on children with psoriasis.MethodsA survey of children (< 18 years) with psoriasis, conducted from June 10 to June 29, 2020.ResultsIn total, 92 children were included: 71.7% had psoriasis lesions at the time of home lockdown while 45.2% were receiving systemic treatments, and two contracted COVID-19. During lockdown, psoriasis worsened in 47.3% of the children and 18.8% stopped their systemic treatments, mainly for reasons linked to the pandemic. A total of 41.3% had a consultation for psoriasis during lockdown (71.1% by teleconsultation): 39.5% due to worsening of their psoriasis and 21.1% for pandemic-related issues. Among patients not having a consultation during lockdown, 27.5% had a cancellation by the doctor and 9.3% had concerns over going to see the doctor. Finally, 22.8% of patients reported finding it difficult to respect hygiene measures because of their psoriasis, e.g., application of alcohol-based hand sanitizers (47.6%), handwashing routines (42.9%), and wearing a mask (28.6%).ConclusionsThis study demonstrates the major clinical impact of the COVID-19 pandemic on children with psoriasis. Teleconsultations played a key role in patient management as regards patient monitoring, provision of information, and renewal of treatments. It is vital that we learn from these data to improve and adapt the monitoring of chronic dermatoses in both children and adults in the event of a future health crisis.