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SARSinfectioncontrolguidelinesforRadiologyDepartment AnexampleofTaipeiMedicalUniversity WanFangHospital WingChan MDDept ofRadiology SchoolofMedicine TaipeiMedicalUniversityandTMU WanFangHospital Taipei Taiwan RepublicofChina SARSandX rays SARSisaformoflunginjurycharacterizedbyepithelial cellproliferationandanincreaseinmacrophagesinthelung ChestradiographyhasacrucialroleindiagnosisandmonitoringofdiseaseprogressinthetreatmentofpatientswithSARS Thiscausesmajorproblemsforaradiologydepartmentthathastoofferaservicetoallpatients sometimesusingthesameequipment inthesameroom bythesamestaff SARSinfectioncontrolguidelinesforRadiologyDepartment ThispresentationisanaccountofourguidelinesthathavebeenpublishedinChineseJournalofRadiologyinJuneof2003 ChanWP LiaoY M ChinJRadiol2003 28 167 173 Wehaveputtheguidelinesinplacewiththecloseinvolvementtothehospitalinfectioncontrolteamtotryourbesttodecreasetherisks Policies RadiologyDepartmenthasbeencategorizedas highriskarea forSARSinfectioncontrolinhospitals ThemajorroleinSARScontrolissegregationofSARSfromnon SARSpatientsbyequipments examinationroomsandtime ThegoalsinSARScontrolaretoreducetheriskofinfectionasmuchaspossibletoourstaffsaswellascrossinfectionbetweenpatients Value Tomaintainhighqualityofpatientcareandprofessionalrespect especiallyforourfront linestaffs SARSinWanFangHospital TillJune1 03 atotalof43patientswithSARSwasadmittedinourhospital OurradiologicaltechniciansperformedportableX raysinnegative pressureroomsfor423times Noin hospitalinfectionstoourstaffsorcrossinfectionsbetweenpatientswerenoted SARSInfectionControlTeaminRadiology Chief StaffRadiologists ChiefTechnician AdministrativeAssistant 1 Nurse 1 Seniortechnician 1 Supervisortechnician SARSInfectionControlTeaminRadiology GoalsZeroin hospitalinfectionstoourstaffsZerocrossinfectionsbetweenpatientsMaintainhighqualityofpatientscare SARSInfectionControlTeaminRadiology StrategiesFullsupporttoourfront linestaffsFullsupplyofpreventionrequirementstoourstaffs SARSInfectionControlTeaminRadiology WorkdescriptionsTheinfectiouscontrolteamshouldreviewthepracticesintheradiologydepartment wherethereisdirectpatientcontact tohelpreinforceproperinfectioncontroltechniquesandcloseanyloopholes Onemember theleaderoftechnicians actsasa policeman toensuretheguidelinesareenforced Categorizationofpatients Outpatientswithoutsuspected confirmedSARSOutpatientswithsuspectedSARS Inpatientswithoutsuspected confirmedSARS Inpatientswithsuspected confirmedSARS Needhighestinfectioncontrolmeasures Categorizationofpatients SegregationofpatientsSegregationofpatientsbylocationandequipments threeportableX raysforperformingthosepatientsinfeverscreeningstation negative pressureroom andICU respectively Categorizationofpatients SegregationofpatientsSegregationofpatientsbytime Noon 2 00forin patientswithoutSARSinthemaindepartment lateeveningforin patientswithSARSforCTscanexaminations Congestionofwaitingareashouldbeminimizedoravoided Segregation SegregationofstaffsRadiologydepartmentcanbedividedintotwozones contamination and clean zonesbyclearnoticeplates Examinationrequests SARSpatients requestedorderby9 30PMonedaybeforePatientsatfeverscreeningstation scheduledbyphoneOtherpatients regulartime Examinationrequests ExaminationpoliciesChestfilmsarenotsuggestiveforscreeningpatientswithoutfever Attentionshouldbegivenonthefollowingpatientswithoutremarkablesymptomsoffever renaldisease DM long termsteroidtreatment cancer andimmobilepatients Examinationrequests ExaminationpoliciesRequestsforimagingstudiesonlyaremadewhentheexaminationresultwillhaveamajorimpactonpatienttreatment Allexaminationsshouldbeshortenedbutstillensuringtheclinicalquestionisanswered Reduceout patientsappointmentstoreduceoverload RadiographicfeaturessuggestiveforSARS Initialchestradiographscanbenormal 15 Commoninitialradiographicfeatures air spaceconsolidation ground glassattenuation nodules andmixedconsolidationandnodules Initialnormalradiographorunifocallunglesionhadabetterprognosisoutcome RadiographicfeaturesNOTsuggestiveforSARS MediastinalorhilarlymphadenopathyCavitationorabscessformationPleuraleffusions X Rays ChestPAviewonlyTakenbycomputerizeddigitalX raysAllocatepatientsinthesequenceoflowtohighriskforfeverscreening andmildtosevereforSARSpatientsinperformingX rays CTscan IsolatedventilationsystemforCTroomPatientandstaffsshouldfollowtheSARSinfectionguidelinesForpatientswhohavefeverandcontacthistory HRCTcanbeperformedwhenchestfilmsrevealnegativefindings ConsiderCTasanalternativeexaminationtosonogramforpatientsofwhomothercausesoffevershouldberuledout X raysmachines ThreeportableX raysinperformingSARSpatients feverscreening andICUpatients respectively Disinfectionafterperformingeachpatient by70 alcoholformetallicsurfaces Staffingandvisitors NoconferencesormeetingsisallowedNovisitorsisallowedenteringourdepartmentCleaningstaffsshouldbefollowedbyoneofournurseduringtheircleaningduty TwoteamsofradiologicaltechnicianstoperformexaminationsinfeverscreeningstationandSARSpatientsinnegative pressurerooms respectively Rotatingstaffstwiceamonthtoreduceworkoverloadandviralload ControlSupervision TwostaffsshouldbeworkedtogetherforportableX rays oneasacontrolsupervisiontoreviewallproceduresRegularpracticesforprotectiondressingbeforeperformingportableX raysproceduresAllofourstaffsshouldrecordtheirownbodytemperaturebefore10AM RoomCleaning Forgeneralareas thecleaningschedulearecleanedtwice AM PM daily Foralltelephones faxmachines computerkeyboards tablesurfacesarecleanedtwicedaily PersonalCare AlwayswearingmaskWashinghandsfrequentlyNottouchingthemaskandtheeyesPayattentiontoeverystepsindetailsinperformingproceduresorexaminationsAvoiddutyoverloadAvoid
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