Sensitization program on COVID 29/SARS-CoV-2.pptx

sensitization program on COVID19

1. Sensitization Program On Covid 19 / SARS-CoV-2 Dr. H. Anand Singh M.O. ENT Specialist CHC Wangoi

2. Introduction India Scenario : 3,54,000 Infected 1,87,000 Recovered 11,903 Dead Worldwide 84,00,129 Infected 44,14,991 Recovered 4,51,263 Dead

3. Why we need to stop it? Average incubation period = 5.2 days Doubling time of epidemic = 11 days Basic regeneration index (R0) = 2.2 - 3.8

4. How does it spread? Droplet transmission Indirect contact transmission Faeco -oral transmission Aerosol transmission Mother to child transmission

5. How medical workers may get infected? Mucosal or skin contact Blood or body fluids Indirect contact with object or people Hospital lift, beds, trolley, examination chairs, raillings , etc. Entering isolation ward without protection

6. How long they survive? Different environments Temperature Survival time Air 50 ~ 59 F 4 hours 77 F 2- 3 minutes Droplets <70 F 24 hours Nasal mucus 132.8 F 30 minutes Liquid 167 F 15 minutes Hands 68-86 F <5 minutes Non-woven fabric 50-59 F <8hours Wood 50-59 F 48 hours Stainless steel 50-59 F 24 hours 75 % Alcohol Any temperature <5 minutes Bleach Any temperature <5 minutes

7. Disinfection UV rays and heat Sustained heat at 132.8 F/ 56 C for 30 min. 75% alcohol Chlorine-containing disinfectants Chlorhexidine

8. Prevention 1 meter distance : ensure patients too Wearing personal protective equipment Avoid direct contact Hand hygiene Respiratory hygiene/ cough practices Avoid touching face & eyes

9. Indication for HCQS prophylaxis Asymptomatic healthcare workers involved in care of suspected/ confirmed cases Asymptomatic household contacts of lab confirmed cases Doses : 400 mg BID stat 400 mg weekly for 7 weeks HCW 400 mg weekly for 3 weeks for household contacts

10. Diagnostic test sensitivity in the days after symptoms onset Days after symptom ONSET SARS- CoV – 2 Test 1-7 8-14 15-39 RNA by RT-PCR 67% 54% 45% Total Antibody 38% 90% 100% IgM 29% 73% 94% IgG 19% 54% 80%

11. FLU Clinic Sampling & Observation Ward

12. Hand Hygiene Don and doff PPE Ensure all documents for next shift Communication with patient Hand sanitization & Mask for patients Disinfection with hypochlorite solution Fumigation : Baccishield Disposal of waste in double layered polythene wraps / bags

13. Steps of donning PPE Donning of PPE - designated area. 1. Remove home clothes, jewellery, watches, electronic etc. and wear clean hospital scrubs . 2. Wash hands with soap and water. 3. Wear shoe covers. 4. Wear first set of gloves smaller than second pair. 5. Suit – arm sleeves should cover the gloves at the wrists zip up without wearing the hood. Decontaminate suit if soiled.

14. 7 . N-95 respirator – cup mask in hand lower strap behind the neck, below ears upper strap over back of head, above ear. Check for snug fit no minimal air leak from sides. 9. Wear the hood – without leaving any open space. 8. Wear eye piece – adjust the strap, open ports at upper end to prevent fogging upper end N-95 mask should be covered by eye piece. 10. Wear 3rd pair of the gloves – larger size than previous , should cover free end of arms of suit. 11 . Suit fitness check : Take help of companion.

15. Steps of doffing PPE: Doffing - only in the designated area, check for any leak or soiling in PPE before doffing. If any, disinfect. Two chairs , labelled “ dirty ” and the other “ clean ”. Hand hygiene MUST be performed after every step. 1. Disinfect - hand hygiene procedure. 2. Remove shoe covers only by touching the outer surface, and perform hand hygiene. 3. Remove outer gloves and perform hand hygiene. 4. Remove eye piece by holding the straps, and perform hand hygiene. 5.Unzip & Remove hood and perform hand hygiene. 6 . Remove suit slowly by holding and pullling at arm. Without touching the outer surface, remove with a rolling inside out technique . Perform hand hygiene again.

16. 7. Remove inner gloves and perform hand hygiene. 8. Wear another pair of sterile /unsterile gloves. 9. Remove mask – Do not touch exposed surface of mask. First remove lower strap of mask, remove mask holding upper strap in a slow and steady pace 10. Perform hand hygiene 11. Sit over clean chair and clean your shoes with alcohol swabs 12. Remove last pair of gloves and perform hand hygiene

17. Cleaning agents and disinfectants: 1. 1% Sodium Hypochlorite can be used as a disinfectant for cleaning and disinfection 2. The solution should be prepared fresh. 3. Leaving the solution for a contact time of at least 10 minutes is recommended. 4. Alcohol (e.g. isopropyl 70% or ethyl alcohol 70%) can be used to wipe down surfaces where the use of bleach is not suitable, e.g. metals.

18. AIIMS Guidelines : Nasal swabs and Oropharyngeal swabs. CDC Guidelines : Nasopharyngeal swabs, Nasal mid turbinate swabs/ deep nasal swabs, anterior nare swabs.

19. Nasopharyngeal Swabs Pass the swab stick along the floor near the septum at the angle between the sputum and floor of the nasal cavity for about 4-6 cm in children and about 8-10 cm in adults till you touch the nasopharyngeal posterior wall. Guidance of the length of insertion will be roughly equal to the distance from anterior nares to the external auditory meatus . Turn /twirl the swab around its length to gather some secretion after reaching the posterior nasopharyngeal wall and pull off slowly without touching the walls of the nasal cavity.

20. Nasal swab collection For taking nasal swab, pass the swab stick for about 2 to 3 cm beyond the anterior nares and twirl the swab to collect some secretion and gently removed without touching the walls of the nasal cavity.

21. Oropharyngeal swab collection For collection of oropharyngeal swab, tell the patient to open the mouth and say “ aahh ” and while the patient is saying, the swab is inserted till the posterior wall of the oropharynx is touched and gently twirl the swab to collect some secretion and removed without touching the buccal / oral mucosa or tongue.

22. Sl no. LABELLING 1. SMART PHONE 2. VIRAL TRANSPORT MEDIUM 3. CRYO LABEL 4. CD WRITER MARKER & PEN 5. SRF (Specimen Referral ) FORM 6. Register book Sl no. Primary receptacles 1. VTM 2. Nylon flocked nasopharyngeal swab 3. Throat swab 4. Tongue depressor 5. Cotton roll 6. Paraffin film 7. Zip lock clear bag small 8. Zip lock clear bag big 9. Scissor Sl no. Secondary receptacles 1. Vaccine carrier or cold box 2. Brown tape or cellotape 3. Scissor

23. Documents to accompany Specimen Referral Form List of samples summary Vaccine Carrier as an outer covering

24. Before you go home Hand hygiene Decontaminate personal belongings Change your dress Keep shoes outside Tell your kids to stay away from you Take another bath Keep your dress in detergent overnight Wash it in morning

25. Lets fight C orona V irus together Thank You