Malawi Integrated Guidelines and Standard Operating Procedures for Providing HIV Services. 3rd edition 2016
Guía para países de bajos ingresos. 2 edición
GHWA Task Force on Scaling Up Education and Training for Health Workers
Update, 23 de junio de 2022
Ce document d'orientation est destiné aux cliniciens qui s'occupent de patients atteints de COVID-19 à toutes les phases de leur maladie (c'est-à-dire du dépistage à la sortie de l'hôpital). Cette mise à jour a été étendue pour répondre aux besoins des cliniciens de première ligne et fa...vorise une approche multidisciplinaire des soins aux patients atteints de COVID-19, y compris ceux qui présentent une maladie légère, modérée, grave et critique. Les sections suivantes sont entièrement nouvelles : parcours de soins COVID-19, traitement des infections aiguës et chroniques, gestion des manifestations neurologiques et mentales, maladies non transmissibles, réadaptation, soins palliatifs, principes éthiques et déclaration du décès ; les chapitres précédents ont également été considérablement étoffés.
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For patients on HFNO with persistent hypoxaemia or respiratory distress:
• Check the equipment: inspect the exterior of the machine, the tubing (circuit), the prong for any sign of mechanical damage, confirm it fits and the filters are in place. Ensure the settings are appropriate and flow is max...imized.
• Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the device 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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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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15 July 2021. This report describes the demographics, clinical presentation, clinical outcomes, and risk factors among people living with HIV (PLHIV) who have been hospitalized for suspected or confirmed COVID-19.
The specific objectives of the analysis were to:
describe the clinical char...acteristics and outcomes of PLHIV hospitalized for COVID-19
assess whether PLHIV hospitalized with COVID-19 were at increased risk of presenting with severe or critical illness at admission and were at increased risk of in-hospital death compared to individuals not infected with HIV
assess risk factors associated with severe or critical illness at hospital admission and of in-hospital death among PLHIV hospitalized for COVID-19.
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Practical considerations
It provides more detailed and practical guidance for continuing services for each life stage across the life-course continuum. As such, both documents should be read and used together. The countries in South-East Asia and the Pacific regions would like to adapt the guidance... within the national and sub-national continuity plans, based on the local situation of COVID-19 transmission, containment response and health system capacity.
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Health Workers and Health Facilities under Attack 2015, and Early 2016