MOH Policy and Guidelines for Health Institutions
Guideline
SAJHIVMED DECEMBER 2013, Vol. 14, No. 4
Quality Assurance (QA) and Quality Improvement (QI). The guide provides general information on how to organize, implement and follow up on quality assurance/quality improvement clinical facility and service assessments. At the website you will find checklists intended to be used with the clinical fa...cility assessment guide
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A Guide For Multicentre Trials in High-Burden Countries
BMC Medicine (2015) 13:42 DOI 10.1186/s12916-014-0263-6
Standard Treatment Guideline
Standard Treatment Guideline
Standard Treatment Guideline
Document No. : FDA/SMC/CTD/GL-CCT/2013/01
Waste Management & Research 39(1) DOI: 10.1177/0734242X211029175
WHO recommends prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support.
Hypoxaemic respiratory failure in ARDS commonly re...sults from intrapulmonary ventilation-perfusion mismatch or shunt and usually requires mechanical ventilation.
At any time, if there are urgent or emergent indications for intubation, do not delay.
WHO suggests that hospitalized patients with severe or critical COVID-19 with acute hypoxaemic respiratory failure that do not require emergent intubation be treated with HFNO, or CPAP or NIV (BiPAP) rather than standard oxygen therapy.
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For patients on NIPPV or HFNO with persistent hypoxaemia or respiratory distress:
• Check the equipment: inspect the exterior of the machine, the tubing (circuit), the mask for any sign of mechanical damage, confirm it fits securely without leak (if CPAP/BiPAP) and the filters are in place. Ensur...e the settings are appropriate and flow is maximized.
• Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the ventilator must have a blender.
• Check there is no obstruction with secretions: patients with COVID-19 may have very thick secretions which may block small and large airways and cause sudden respiratory deterioration.
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The content of these guidelines goes beyond the technicalities of medical needs with additional insights into community empowerment, possible access to welfare and economic opportunities and similar issues. If these are adequately explored, the health and quality of life of people affected and their... families would be greatly restored.
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