Procédures de gestion clinique standard.
La maladie à virus Ebola (MVE) est une maladie multisystémique potentiellement mortelle qui entraîne souvent une hypovolémie, une acidose métabolique, une hypoglycémie et une défaillance multi-viscérale. L'épidémie prolongée de MVE en Afrique de... l'Ouest en 2013-2016 a permis une évolution dans le domaine des soins telle qu'à la fin de l'épidémie, de nombreux patients ont pu recevoir des soins de support individualisés et optimisés, dont la réanimation hydro-électrolytique, le contrôle des symptômes, la surveillance biologique en laboratoire et au chevet de la glycémie et des électrolytes, la prise en charge des défaillances d’organe, ainsi que la détection et le traitement rapides des co-infections, contribuant ainsi à une réduction de la mortalité.
Toutefois, le niveau des soins varie considérablement d'un centre de traitement Ebola (CTE) à l'autre, au cours de la même épidémie, ainsi que d’une épidémie à l’autre
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Poor quality health services are holding back progress on improving health in countries at all income levels.
Today, inaccurate diagnosis, medication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training an...d expertise prevail in all countries.
The situation is worst in low and middle-income countries where 10 percent of hospitalized patients can expect to acquire an infection during their stay, as compared to seven percent in high income countries. This is despite hospital acquired infections being easily avoided through better hygiene, improved infection control practices and appropriate use of antimicrobials.. At the same time, one in ten patients is harmed during medical treatment in high income countries.
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"Explosions can produce unique patterns of injury seldom seen outside combat.
When they do occur, they have the potential to inflict multi-system life-threatening injuries
on many persons simultaneously. The injury patterns following such events are a product of
the composition and amount of the ...materials involved, the surrounding environment,
delivery method (if a bomb), the distance between the victim and the blast, and any
intervening protective barriers or environmental hazards. Because explosions are relatively
infrequent, blast-related injuries can present unique triage, diagnostic, and management
challenges to providers of emergency care. "
accessed 2018/03/29
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Overview on Covid-19 and emergency medicine
Lancet Respir Med 2020Published OnlineMarch 20, 2020https://doi.org/10.1016/S2213-2600(20)30121-1
4ª edição
Nos próximos meses, a COVID Reference apresentará atualizações regulares e narrará os dados científicos o mais coerente possível.
Updated 2022. This guide addresses the care pathway from presentation of the patient to a health facility to patient discharge. It considers different levels of disease severity, from asymptomatic individuals to critically ill patients. Accounting for variations in the benefits and harms of chest im...aging in different situations, remarks are provided to describe the circumstances under which each recommendation would benefit patients. The guide also includes implementation considerations for different settings, provides suggestions for impact monitoring and evaluation and identifies knowledge gaps meriting further research.
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While many of the countries hit by the COVID-19 in the first few months of the year are now beginning to relax lockdown measures as infection and death rates fall, in the regions most affected by HIV, TB and malaria, such as Africa, South Asia and Latin America, the pandemic continues to accelerate.... In lower resource settings, lockdowns are less effective and hard to sustain, and clinical care facilities are extremely limited. In such environments, the response to COVID-19 must focus on containing the pandemic’s spread as far as possible through testing, contact tracing and isolation, protecting the health workforce through training and the provision of personal protective equipment (PPE) and minimizing the knock-on impact on other diseases through shoring up fragile health systems, and adapting existing disease programs.
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Tại nhiều quốc gia, cú sốc của làn sóng kiểm dịch thứ nhất đã lắng xuống, số ca bệnh cũng đã giảm, việc gỡ bỏ các lệnh phong tỏa đang được xem xét hoặc đã được thực hiện ở nhiều nơi. Vũ Hán đã mở cửa trở lại. Nhưng ph...ải chăng ta đang bị đánh lừa bởi vẻ ngoài? Liệu làn sóng dịch bệnh thứ hai có xảy ra không, và nếu có thì khi nào chúng sẽ đến?
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This rapid advice guide examines the evidence and makes recommendations for the use of chest imaging in acute care of adult patients with suspected, probable or confirmed COVID-19. Imaging modalities considered are radiography, computed tomography and ultrasound. This guide addresses the care pathwa...y from presentation of the patient to a health facility to patient discharge. It considers different levels of disease severity, from asymptomatic individuals to critically ill patients. Accounting for variations in the benefits and harms of chest imaging in different situations, remarks are provided to describe the circumstances under which each recommendation would benefit patients. The guide also includes implementation considerations for different settings, provides suggestions for impact monitoring and evaluation and identifies knowledge gaps meriting further research.
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A partir de que el SARS-CoV-2 se detectó en China en diciembre de 2019, la COVID-19 se ha convertido rápidamente
en una pandemia. Los pacientes con COVID-19 presentan síntomas respiratorios inespecíficos de intensidad variable y
en ocasiones se les debe prestar ventilación asistida avanzada. ...Actualmente, el diagnóstico de COVID-19 se confirma
mediante la realización de pruebas analíticas, a saber, la determinación de ARN vírico a través de la reacción en
cadena de la polimerasa con retrotranscriptasa (RT PCR).
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This update of the Guidelines for poison control, entitled Guidelines for establishing a poison centre, reflects the development of the role of poison centres in public health and the sound management of chemicals, described in section 1, and the opportunities provided by new technology. Assessments... carried out under the IHR show
continuing gaps in capacity for managing chemicals (2). In particular, many countries still lack access to poison
centre services (3). There is therefore demand for updated guidance.
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Second edition. June 2022. This revised guidance recommends that access to COVID-19 testing is decentralized as far as possible and made available at health facilities, and through the use of self tests to enable access to care and the mitigation of transmission. Testing should be prioritized for hi...gh-risk and vulnerable individuals presenting with acute onset of respiratory illness so that those found to be infected can benefit from clinical care and access to COVID-19 therapeutics and vaccines
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The World Health Organization (WHO) recognizes the challenges countries face for maintaining their COVID-19 response while addressing competing public health challenges, conflicts, climate change and economic crises.
It remains critical for national programmes to continue to offer testing for COVI...D-19 in line with three main objectives: reduce morbidity and mortality through linkage to prompt care and treatment, reduce onward transmission and track the evolution of the epidemic and the virus
itself.
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MEDBOX Issue Brief no. 24 (Sept.2022)
On 20 September 2022, Uganda health authorities declared an outbreak of Ebola disease, caused by Sudan virus,
following laboratory confirmation of a patient from a village in Madudu sub-county, Mubende district, central
Uganda.
Therefore the MEDBOX Team cre...ated this issue brief to give a quick overview of the most important documents and training material.
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The annual celebration of International Chagas Day on the 14th of April highlights the impact of this disease on the global health scenario.
Heart failure (HF) is a global public health concern with disproportionate socioeconomic, morbidity and mortality burden on low- and middle-income countries (LMICs). This review summarises contemporary data on the demographic and clinical characteristics, aetiologies, treatment, economic burden and ...outcomes of HF in LMICs. Patients with HF in LMICs are younger than those from high-income countries (HICs) and present at advanced stages of the disease. Hypertension, ischaemic heart disease (IHD), cardiomyopathy (CMO), and rheumatic heart disease (RHD) are the leading causes of HF in LMICs. The contribution of infectious diseases to HF remains prominent in many LMICs. Most health facilities in LMICs lack adequate diagnostic tools for HF, and the use of evidence-based medical and device therapies is suboptimal. Further, HF in LMICs is associated with prolonged hospital stay and high in-hospital and one-year mortality. Finally, HF has profound economic impact on individual patients who, mostly, have no health insurance, and on societies where patients are young, comprising those who have the greatest potential to contribute to economic productivity.
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