Combating COVID-19: Greatest Practices That Clinicians Have to Know

Because the variety of
international instances of coronavirus illness 2019 (COVID-19) rises, it’s crucial
that healthcare suppliers keep knowledgeable and ready with the perfect scientific
practices to fight the SARS-CoV-2 virus. Following applicable tips and
training correct approach will profit each sufferers and clinicians and
higher forestall the additional unfold of the virus.

It has been established that the virus principally spreads from individual to individual by way of shut contact or respiratory droplets. The Facilities for Illness Management and Prevention (CDC) defines shut contact with a affected person with COVID-19 as being inside 6 ft for an prolonged time period or having direct contact with the affected person’s bodily fluids (ie, sputum, blood, respiratory droplets).1 When treating sufferers in such shut proximity, it’s particularly essential to make use of private protecting tools (PPE), which may help to scale back the chance of buying the virus.

PPE and Isolation Precautions

In a podcast interview,
Betsey Todd, MPH, RN, a nurse epidemiologist and scientific editor of American Journal of Nursing, famous the
significance of correct PPE and the way it varies relying on the Four classes of
isolation precautions: normal, contact, droplet, and airborne precautions.2

In contrast to normal precaution, contact, droplet, and airborne precautions are all forms of transmission precautions that Ms Todd notes could also be utilized in mixture. Whereas contact precautions embody using gloves and robes to deal with circumstances similar to methicillin-resistant Staphylococcus aureus, different circumstances similar to influenza infections or tuberculosis might require extra PPE, similar to a face masks or defend (droplet precautions) or an N95 respirator and adverse stress rooms (airborne precautions), respectively.2

When discussing the remedy of sufferers with suspected or
confirmed COVID-19, Ms Todd famous that there’s relative certainty that the
virus spreads by droplets, which could counsel the necessity for a masks and face
cowl. Nonetheless, she notes that as a result of the virus continues to be so new, “the CDC
recommends for sufferers which are suspected of getting or have confirmed COVID-19,
that [health care providers] go forward and use, not droplet, however airborne
precautions, and place the affected person in a adverse stress room if accessible.”

Ms Todd went on to notice that “common surgical-type masks are made for holding droplets from [a clinician’s] personal mouth…whereas N95 respirators or different kinds of particulate respirators are made to guard what [clinicians are] inhaling.” Subsequently, she suggests using airborne precaution approach.

Correct PPE wouldn’t be as efficient if not worn accurately. When
carrying a masks, make sure that to fit-test by taking a second to ensure that the
masks suits appropriately. Take a couple of deep breaths to make sure there is no such thing as a leakage
round or close to the masks.2

When requested who needs to be carrying the N95 masks, Ms Todd replied, “the CDC and World Well being Group are actually attempting to strongly push again towards the concept everyone ought to go round carrying any sort of masks… . Folks suppose that it’ll shield them out in public, however the reality is that N95s should not applicable for carrying lengthy durations of time.”

The World Well being Group famous earlier this month in a information launch that the “shortages [in PPE] are leaving medical doctors, nurses, and different frontline employees dangerously ill-equipped to take care of COVID-19 sufferers, on account of restricted entry to provides similar to gloves, medical masks, respirators, goggles, face shields, robes, and aprons.”3

Practices for Healthcare
Suppliers and Sufferers

Amy Fuller, DNP, director of the Grasp’s Nurse Program at Endicott School in Beverly, Massachusetts, described steps nurse practitioners (NPs) and doctor assistants (PAs) can take to make sure the perfect prevention and remedy methods.

As a result of the 2019 coronavirus outbreak has overlapped with the
present influenza season, Dr Fuller famous that “it’s arduous to distinguish
as a result of they each have the identical sort of signs. However the incidence and
prevalence for the flu is a lot better than for the coronavirus.” For
nurses, NPs, and PAs, she famous that it needs to be “widespread sense” that if a
affected person is “coughing or sneezing, put a masks on.”

She continued by noting that each healthcare suppliers and sufferers needs to be “lifelike” and that the SARS-CoV-2 virus will “be right here with extra of a presence than it’s at present.” Healthcare suppliers ought to inform their sufferers to “keep away from crowded locations” and “keep away from shut contact with people who find themselves sick,” along with avoiding cruise journey and nonessential air journey and staying at residence as a lot as doable to additional cut back the chance of publicity.4

One other
suggestion was for healthcare suppliers to be aware of the sufferers who
current to their practices and ensure to triage them instantly. It’s
essential to be aware of their symptomology, their contact with others, and
their journey historical past.

Each clinicians and sufferers ought to keep away from touching their face, nostril, and eyes; make sure you wash their fingers usually with cleaning soap and water (for not less than 20 seconds) or with not less than 60% alcohol-containing hand sanitizer if cleaning soap and water should not accessible; and to scrub and disinfect widespread floor areas within the residence.4

When requested
whether or not a affected person needs to be self-quarantined or seen in a medical apply, Dr
Fuller famous that it is dependent upon the case. “I will surely suggest
self-quarantine if they’ve the chance elements…if [patient] signs are gentle,
and most instances are gentle, [the patients] don’t require any sort of

If a affected person
presents with signs, “the caveat may very well be that the nurse, NP, or PA can
verify on the affected person in 12 hours and see how they’re doing or instruct them to
name again if their signs worsen. But when they simply have cold-like signs
with no fever, I’m not completely invested in sending them to the hospital.”

at present no vaccine or antiviral to deal with this an infection. Present therapies
might embody fever-reducing medicines however “the very last thing we wish to do is
have an enormous rush of individuals to the hospital who solely have gentle, cold-like

Dangers and Signs to Look
Out For

In response to the CDC, it’s important for healthcare suppliers to concentrate to signs similar to fever, cough, and shortness of breath.4 Whereas human coronaviruses could cause illness just like a standard chilly, extra extreme instances could cause pneumonia, extreme acute respiratory syndrome, and even loss of life.5 People with a better danger for COVID-19 embody older adults and people with continual medical circumstances similar to coronary heart illness, diabetes, and lung illness. Emergency warning indicators that require quick medical consideration embody issue respiratory or shortness of breath, persistent ache or stress within the chest, new confusion or incapability to arouse, and/or bluish lips or face. Though these should not all inclusive, the CDC urges adults with these signs to contact their medical suppliers. 


Healthcare suppliers are on the forefront, caring for contaminated
sufferers and rising their very own danger of publicity to the virus. The
info surrounding COVID-19 is continually being up to date as we study extra
concerning the virus, the diseases it causes, and who’s in danger.

It’s crucial that clinicians proceed to learn new info and keep up to date, apply really useful hygiene, put on the suitable PPE, and ensure that their sufferers are educated. Following the suitable steps will assist to scale back the unfold of the virus and hopefully forestall additional publicity in uninfected people.


  1. What healthcare personnel ought to learn about caring for sufferers with confirmed or doable COVID-19 an infection. Facilities for Illness Management and Prevention.  Up to date February 29, 2020.
  2. Bonsall L, Todd B. COVID-19: what nurses have to learn about private protecting tools (PPE). Lippincott Nurs Cent. March 6, 2020. Accessed March 10, 2020.
  3. Scarcity of private protecting tools endangering well being employees worldwide. World Well being Group. March 3, 2020. Accessed March 11, 2020.
  4. Folks in danger for severe sickness from COVID-19.Facilities for Illness Management and Prevention. Up to date March 9, 2020. Accessed March 11, 2020.
  5. Coronavirus illness (COVID-19) outbreak: rights, roles and tasks of well being employees, together with key concerns for occupational security and well being. World Well being Group. Accessed March 11, 2020.

This text initially appeared on Scientific Advisor

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