Peculiarities of care for patients with coronavirus infection. Important safety issues for health care workers

Abstract

Background. In case of coronavirus disease (COVID-19), contact persons include, but are not limited to, health care workers (HCW) and caregivers of COVID-19 patients. Personal protective equipment is required for HCW working with patients or individuals with suspected COVID-19. Correct sequence and the correct technique of putting them on is very important. Objective. To describe the safety measures for HCW in care of patients with COVID-19. Materials and methods. Analysis of literature sources on this topic. Results and discussion. Contaminated environmental surfaces take part in the contact route of transmission. To reduce the role of fomites in the transmission of the new SARS-CoV-2 coronavirus, special recommendations of the Ministry of Health on surface cleaning and disinfection have been developed. After cleaning, disinfectants must be used to reduce the viral load on the surface. These disinfectants are also effective against other pathogens that are important in health care settings. Such agents include ethanol 70-90 %, chlorine-based agents, and hydrogen peroxide >0.5 %. The register of disinfectants of Ukraine contains more than 200 brands. The vast majority of them are represented by alcohol- and chlorine-containing solutions of various concentrations, colors and odors. The use of these solutions is limited to the torso and extremities. These solutions have a number of limitations and caveats in their use. For instance, in case of contact with mucous membranes, they have an irritating effect and require rinsing with plenty of water. Vapors of some of them should not be inhaled, so they should be used in well-ventilated areas or with protective equipment. Alcohol-based products should not be applied to damaged areas of the skin due to protein denaturation. The Food and Drug Administration (FDA) recommends to use the chlorine- and alcohol-based solutions with caution due to the lack of evidence of their safety. The decamethoxine-based solution Yusept (“Yuria-Pharm”) is intended for disinfection of hands and other parts of the body, including the face; for disinfection of HCW gloves and gloves in other places; for disinfection and pre-sterilization cleaning of all medical devices from various materials; for disinfection of hairdresser’s, manicure, pedicure and cosmetic accessories; for disinfection of rooms, furniture, patient care items, hygiene products, utensils, containers, sanitary equipment, rubber carpets; for current, final and preventive disinfection; for use in aerosol disinfection systems such as Yu-box and other disinfection systems. Proper hand washing technique is also an important preventive measure. The effectiveness of prevention of HCW infection during their professional duties depends on how serious the problem is taken by the management of the health care institution and the HCW, who work with infectious patients, themselves. Conclusions. 1. For HCW working with patients or persons with suspected COVID-19, the use of personal protective equipment is mandatory. 2. Contaminated surfaces take part in the implementation of the contact route of infections’ transmission. 3. The vast majority of disinfectant solutions are alcohol- and chlorine-containing ones, which have a number of limitations and precautions in use. 4. Yusept solution is intended for disinfection of hands and other parts of the body, including the face; for disinfection and pre-sterilization cleaning of all medical devices; for disinfection of rooms, furniture, patient care items; for use in aerosol disinfection systems.