COVID-19 Kesin ve Olası Tanılı Erişkin Hastalarda Acil Servis Yaklaşım Stratejileri

Yıl 2020, Cilt: 5 Sayı: 2, 203 - 209, 30.06.2020

Yasemin Tokem Selda Turhan Gülay Oyur Çelik

Öz

Özet

Tüm dünyayı etkisi altına alan COVID-19, bulaştırıcılığı yüksek, spesifik bir tedavisi olmayan bir virüstür. Henüz COVID-19 enfeksiyonu tanısı konmamış veya enfeksiyon şüphesi olan hastaların acil durumları nedeniyle günün 24 saati hizmet sunan acil servis başvurularında; hem diğer hastaları hem de sağlık çalışanlarını korumaya yönelik özel tedbirlerin alınması gereklidir. Bu anlamda hastalarla ilk temas yeri olan acil servis hizmetlerinin niteliği önem taşımaktadır. COVID-19 etkenine ilişkin hala birçok bilinmeyenin olduğu günümüzde, koruyucu önlemlerin alınması için tasarlanmış ve Sağlık Bakanlığı tarafından hazırlanmış, sağlık çalışanlarına kılavuzluk eden ve tüm ülkede aynı şekilde hareket etmeyi sağlayan kılavuzlar sürece önemli şekilde yol göstermektedir. Acil servise başvuran hastaların öncelikle COVID-19 açısından ekarte edilmesi çok önemlidir. COVID-19 negatif veya pozitif olan hastalara yönelik farklı yaklaşımlar bulunmaktadır. Bu yazı; hastanelerin acil servis birimine başvuran tüm hastaların COVID-19 açısından ön değerlendirmesinin yapılmasında ve COVID-19 pozitif çıkmış farklı hasta gruplarına yaklaşımda dikkate alınacak girişimleri içermektedir.

Anahtar Kelimeler: COVID-19, acil servis, acil tedavi, kardiyopulmoner resusitasyon.

Abstract

COVID-19, which affects the whole World, is a highly infectious virus that has no specific treatment. In emergency applications, which are available 24 hours a day due to the emergency of patients who have not yet been diagnosed with COVID-19 infection or who are suspected of infection; special measures must be taken to protect both other patients and health professionals. Therefore, the quality of emergency services which is the first place of contact with patients, is important. At the present time, where there are still many unknowns related to the COVID-19 factor, the guidelines which was designed for taking precautions and was prepared by the Ministry of Health guiding all health professionals and resulting to act invariably throughout the country, lead the process greatly . It is particularly important to exclude patients in terms of COVID-19 when they are applying to the emergency department. There are different approaches to patients with COVID-19 negative or positive. The present paper includes the interventions to consider for performing pre-evaluation of all patients admitted to the emergency department of hospitals related to COVID-19 and for approaching to different patient groups that have been diagnosed positive for COVID-19.

Keywords: COVID-19, emergencies, emergency treatment, cardiopulmonary resuscitation

Anahtar Kelimeler

COVID-19, Acil Servis, Acil Tedavi

Kaynakça

• American College of Surgeons Committee on Trauma [ACS COT] (2020). Maintaining Trauma Center Access & Care during the COVID-19 Pandemic: Guidance Document for Trauma Medical Directors. Retrieved June 1, 2020, from https://www.facs.org/qualityprograms/ trauma/maintaining-access
• American Heart Association [AHA] (2020). ACLS cardiac arrest algorithm for suspected or confirmed COVID-19 patients.
• Casanova, L. M., Rutala, W. A., Weber, D. J., & Sobsey, M. D. (2012). Effect of single-versus double-gloving on virus transfer to health care workers’ skin and clothing during removal of personal protective equipment. American Journal of Infection Control, 40(4), 369-374.
• Center of Disease Control and Prevention. (2020). CDC COVID Testing and PPE recommendation. Retrieved June 1, 2020, from https://www. cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html
• Cheung J.C., Ho L.T., Cheng J.V., Cham E.Y.K., & Lam K.N. (2020) Staff safety during emergency airway management for COVID-19 in Hong Kong. The Lancet Respiratory Medicine, 8(4), 19.
• Christian, M. D., Sprung, C. L., King, M. A., Dichter, J. R., Kissoon, N.,Devereaux, A. V., & Gomersall, C. D. (2014). Triage: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement. Chest, 146(4), e61S-e74S. (2014). Triage: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement. Chest, 146(4), e61S-e74S.
• European Resuscitation Council [ERC] (2020). COVID-19 Guidelines. Retrieved June 1, 2020, from https://www. erc.edu/sites/5714e77d5e615861f00f7d18/content_ entry5ea884fa4c84867335e4d1ff/5eb294e64c84867421e4d217/ files/ERC_COVID19_spreads.pdf?1588941006
• Guan, W. J., Ni, Z. Y., Hu, Y., Liang, W. H., Ou, C. Q., He, J. X., ... & Du, B. (2020). Clinical characteristics of coronavirus disease 2019 in China. New England journal of medicine, 382(18), 1708-1720.
• Joseph, T., & Moslehi, M.A. (Eds). (2020). International pulmonologist’s consensus on COVID-19. Second Edition. India. Retrieved June 1, 2020, from http://turkpedo.org/wp-content/uploads/2020/04/ pulmonologist.pdf
• Memikoğlu, O., & Genç, V. (Eds). (2020). COVID-19. Ankara Üniversitesi Basımevi. ISBN:978-605-136-477-3.
• Namendys-Silva S. (2020) Respiratory support for patients with COVID-19 infection. The Lancet Respiratory Medicine, 8, 17-18.
• Sağlık Bakanlığı (2020). COVID-19 (SARS-CoV2 enfeksiyonu) rehberi, bilim kurulu çalışması. (https://COVID19.saglik.gov.tr/). Erişim Tarihi: 01.06.2020
• Scales D.C., Green K., Chan A.K., Poutanen S.M., Foster D., Nowak K., ... & Stewart, T. E. (2003). Illness in intensive care staff after brief exposure to severe acute respiratory syndrome. Emerging Infectious Diseases, 9 (10): 1205-10.
• Statista (2020). Coronavirus (COVID-19) death rate in countries with confirmed deaths and over 1,000 reported cases as of May 29, 2020, by country. Retrieved, May 29, 2020, from https://www.statista.com/ statistics/1105914/coronavirus-death-rates-worldwide/
• Worldometer (2020). COVID-19 Coronavırus Pandemıc. Retrieved May 28, 2020, from https://www.worldometers.info/coronavirus/ Yürümez Y., & Alaçam M. (2020) Acil serviste COVID-19 ve yönetimi. Journal of Biotechnology and Strategic Health Research, (4), 116-122.