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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Fact Sheet Global Atlas of medical devices
Acta Med Peru. 2017;34(3):203-7
En el Perú, la elaboración de guías de práctica clínica tiene exigencia normativa desde el año
2005; sin embargo, su desarrollo ha ténido poco énfasis en la calidad metodológica de las mismas, prefiriendo el tipo narrativo. Desde hace varios años se realiz...an esfuerzos dispersos para mejorar la calidad metodológica, principalmente que su elaboaración esté basada en evidencias científicas. Actualmente se cuenta con una nueva normativa que pone mayor enfasis en esta exigencia y algunas instituciones ya trabajan para adecuarse a estandares internacionales y poder generar impactos positivos en nuestro sistema de salud a través del adecuado desarrollo de guias de practica clínica en nuestro pais
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Peru celebrates 200 years of independence in 2021. Over this period of independent life, and despite the turbulent socio-political scenarios, from internal armed conflict to economic crisis to political instability over the last 40 years, Peru has experienced major changes on its epidemiological and... population health profile. Major advancements in maternal and child health as well as in communicable diseases have been achieved in recent decades, and today
Peru faces an increasing burden of non-communicable diseases including mental health conditions. In terms of the configuration of the public health system, Peru has also strived to secure country-wide optimal health care, struggling in particular to improve primary health care and intercultural services.
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Adapting community-led approaches . Three out of 10 people in urban areas do not use improved sanitation facilities, and one out of 10 people are forced to practise open defecation. Still higher proportions do not have access to safely managed sanitation facilities, where the fecal sludge
is contai...ned and either left in situ or safely emptied, transported, and delivered to a treatment plant.
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La Tripanosomiasis Americana o Enfermedad de Chagas es una antropozoonosis,
es decir una enfermedad que afecta tanto al hombre como a numerosos animales
mamíferos y que es producida por un protozoario flagelado de la sangre y de los
tejidos el Trypanosoma cruzi.
Manual de Normas para el Diagnóstico y Tratamiento de Chagas Congénito
Infectious disease outbreaks and epidemics are increasing in frequency, scale and impact. Health care facilities can amplify the transmission of emerging infectious diseases or multidrug-resistant organisms (MDRO) within their settings and communities. Therefore, evidence-based infection prevention ...and control (IPC) measures in health care facilities are critical for preventing and containing outbreaks, while still delivering safe, effective and quality health care. This toolkit is intended to support IPC improvements for outbreak management in all such facilities, both public and private throughout the health system. Specifically, this document systematically describes a framework of overarching principles to approach the preparedness, readiness and response outbreak management phases. The document also provides a toolkit of resource links to guide specific actions for each infectious disease and/or MDRO outbreak management phase at any health facility. This document is specifically tailored to an audience of stakeholders who establish and monitor health care facility-level IPC programs including: IPC focal points, epidemiologists, public health experts, outbreak response incident managers, facility-level IPC committee(s), safety and quality leads and managers, and other facility level IPC stakeholders.
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The Global guidance framework for the responsible use of the life sciences: mitigating biorisks and governing dual-use research (the framework) aims to provide values and principles, tools and mechanisms to support Member States and key stakeholders to mitigate and prevent biorisks and govern dual-u...se research.
The framework adopts the One health approach and focuses on the role that responsible life sciences research can play in preventing and mitigating risks caused by accidents, inadvertent or deliberate misuse with the intention to cause harm to humans, nonhuman animals, plants and agriculture, and the environment.
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Lancet Planet Health 2022;6: e760–68
The emergence of COVID-19 has drawn the attention of health researchers sharply back to the role that food systems can play in generating human disease burden. But emerging pandemic threats are just one dimension of the complex relationship between agriculture... and infectious disease, which is evolving rapidly, particularly in low-income and middle-income countries (LMICs) that are undergoing rapid food system transformation. This changing relationship is examined through four current disease issues.
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Implementation guide for national, district and facility levels.
This implementation guide contains practical guidance for policy-makers,
programme managers, health practitioners and other actors working to
establish and implement quality of care (QoC) programmes for maternal,
newborn and child ...health (MNCH) at national, district and facility levels.
It is intended to help anyone, throughout the health system, who wants
to take action to improve the QoC for MNCH.
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An overview of validation structures and responsibilities at national, regional and global levels.
This governance document supplements the global guidance document. Validation of elimination requires rigorous assessment at the national, regional and global levels of the impact and process indicato...rs and the fulfilment of the four foundational requirements for (1) data quality, (2) strong programmes, (3) laboratory quality and (4) human rights, gender equality and community engagement.
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The 2018 NDHS is a national sample survey that provides up-to-date information on demographic and health indicators. The sample was selected using a stratified, two-stage cluster design, with enumeration areas (EAs) as the sampling units for the first stage. The second stage was a complete listing o...f households carried out in each of the 1,400 selected EAs. The target groups were women age 15-49 and men age 15-59
in randomly selected households across Nigeria. A representative sample of approximately 42,000 households was selected for the survey. One-third of the households (14,000) were selected for malaria, anaemia, and genotype testing of children age 6-59 months. Also, in the subsample of households selected
for the men’s survey, one eligible woman in each household was randomly selected for additional questions regarding domestic violence. Specifically, information was collected on fertility levels, marriage, fertility preferences, awareness and use of family planning methods, child feeding practices, nutritional status of women and children, adult and childhood mortality, awareness and attitudes regarding
HIV/AIDS, and female genital mutilation. The survey also assessed the nutritional status (according to weight and height measurements) of women and children in these households. In addition to presenting national estimates, the report provides estimates of key indicators for both rural and urban areas, the country’s six geopolitical zones and 36 states, and the Federal Capital Territory (FCT).
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The 2019 SLDHS is a national sample survey that provides up-to-date information on demographic and health indicators. The sample was selected using a stratified, two-stage cluster design, with enumeration areas (EAs) as the sampling units for the first stage. The second stage was a complete listing ...of households carried out in each of the 578 selected EAs. The target groups were women age 15-49 and men age 15-59 in
randomly selected households across the country. A representative sample of approximately 13,872 households was selected for the survey. Half of the households (6,936) were selected for biomarker and men’s interview. The men’s survey was conducted in half (50%) of the sample households, and all men age 15-59 in these households were included. In this subsample, one eligible woman in each household was randomly selected to be asked additional questions about domestic violence.
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Climate change is already having severe impacts across our planet, bringing new and previously unimaginable challenges to the people least responsible for greenhouse gas emissions.
This report, the first we’ve released jointly in the history of our organizations, provides a sobering review of h...ow just one of those challenges – the increase in deadly heat-waves – threatens to drive new emergency needs in the not-so-distant future.
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In September 2021, the UN and its partners presented a response plan to mitigate the impact of the water crisis in northern and north-east Syria which requested US$200 million to assist up to 3.4 million of the over five million people estimated to be affected by the water crisis in northern Syria b...etween September 2021 and February 2022. Under the auspices of the 2022-2023 Syria Humanitarian Response Plan, this updated water response plan presents the most recent needs based on latest forecasts and is a continuation of the earlier plan presented in 2021. It covers the needs from all response modalities/areas1 for Syria, aims to assist 5 million people until December 2022 and requests $226.2 million.
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