Nucleic acid sampling is not necessary, but it is easy to cause “formalism”.
Writing | Tian Dongliang, Ling Jun
Source | “Medical Community” Public Account
In the summer of 2022, the temperature will be higher than in previous years, and there will be many cases of heat stroke and even death. “It’s hot to death” is not only used to describe the hot weather, but also to state objective facts.
Among the high-risk groups of heatstroke, the medical staff and volunteers participating in outdoor nucleic acid collection, because they are wearing airtight “big white”, are even more at high risk, and nucleic acid collection personnel faint from heatstroke The news of the downfall kept coming.
Today (16th), the team of Zhang Wenhong, director of the Department of Infectious Diseases of Huashan Hospital Affiliated to Fudan University, issued a document saying that they only need N95 masks + face screen protection when they are engaged in sampling work for the general population. , do not have to wear “big white”.
Anti-epidemic personnel “fallen” in a heatwave
On July 14, the temperature in Nanchang County, Jiangxi reached as high as 38°C. A nurse at the nucleic acid sampling site suddenly fainted and was rescued for half an hour before she was out of danger.
Big V doctor “Lynx in white” judged based on the video “released by Nanchang County” that the nurse had seizure symptoms, indicating that her brain had been thermally damaged. “We need to know that the brain damage of heat stroke patients is irreversible even if they can be rescued.”
“White Lynx” asked: Why not let them take off those white or blue clothes that are meaningless to protect against the new crown virus when working outdoors? How many more people will need to die from heat stroke for this pointless dress policy to change?
The isolation suit, affectionately known as “Dabai”, was originally designed to protect the epidemic prevention personnel from being infected by the new coronavirus, but in the hot summer, it became the life and health safety of the epidemic prevention personnel. direct threat.
Professor Miao Xiaohui, an infectious disease expert, told the “medical community” that wearing “big white” in “full armor” makes it inconvenient for medical staff to go to the toilet, which will reduce water intake. Excessive sweating and lack of water intake can easily lead to heat stroke and circulatory exhaustion.
“The second is heat stroke. The surrounding air is too hot, may exceed 40 degrees Celsius, and the package is tightly wrapped, and the regulation of the body temperature regulation center fails, and the body temperature may reach or be close to the ambient temperature, which will cause injury. Central nervous system. If you are still exposed to heat, it may lead to heat stroke, which will be life-threatening.” Professor Miao Xiaohui said.
Tan Swee Ching, an assistant professor in the Department of Materials Science and Engineering at the National University of Singapore, has shown in a study that at room temperature of about 35 °C, wearing protective clothing for one hour, health care workers usually Will experience a somatosensory temperature of approximately 64 °C. This can lead to discomfort, heat stroke and even death.
And in June 2022, “Thermal Engineering Case Study” magazine also published a study by scholars from the Second Affiliated Hospital of Guangzhou Medical University, which conducted “heat discomfort” on 3,658 medical staff investigation.
The results show that during the epidemic prevention period in June 2021, after wearing protective equipment, 80% of people reported sweating a lot, 55.2% of people had difficulty breathing, and dizziness (45.3%), Palpitations (29.3%), visual disturbances (49.3%) and excessive dehydration (46.8%).
In order to cool down, the “big whites” have also resorted to various tricks, sitting on ice to work, tying popsicles on their bodies, wearing ice vests over protective clothing… But after all, the symptoms are not cured. To cool Dabai, a company in Guangdong developed “air-conditioning protective clothing”, which is actually a mobile air conditioner attached to the protective clothing, which is very expensive and brings a lot of inconvenience to the action.
Is it necessary to wear “big white”?
Maybe the easiest and most effective way is to take off the “big white”.
The nucleic acid collectors in the outdoor sampling booths wear N95 masks, gloves and a protective face screen. Can this also play a protective role? In the opinion of Professor Miao Xiaohui, from the perspective of virus protection, it is worth discussing their wearing “big white”.
“Wrap up tightly from head to toe, the purpose is unexplainable. For them, the main parts that should be protected are the head and face, mainly the respiratory tract.” Professor Miao Xiaohui said, “It doesn’t make any sense to wrap the lower half of the body, let alone the wrapping of the feet. It’s time to correct the excessive protection that has been going on for so long.”
Professor Miao Xiaohui said that when outdoor nucleic acid sampling personnel are sampling, the sampled person will take off their masks and open their mouths to get up. For the sake of safety, it is necessary to wear N95 masks and protective face screens. .
“But for the registered code scanners, volunteers who maintain order, etc., because they and the sampled people both wear masks, there is not much communication, and the outdoor air is flowing, even if there is” Leaked aerosols containing viruses will also drift with the wind and will not constitute an infection. Therefore, not only do you not need to wear ‘big white’, but you don’t even need to wear N95 masks, ordinary surgical masks, plus protective face shields and gloves, etc. That’s it.” Professor Miao Xiaohui said.
Zhang Zhenhua, chief physician of the Department of Infectious Diseases of the Second Affiliated Hospital of Anhui Medical University, also holds the same view as Professor Miao Xiaohui.
He told the “medical community” that although there is no authoritative study comparing the infection risks of over-sampling sites, medical and nursing wearing protective clothing and not wearing protective clothing, but from the principle analysis, it is not necessary, but easy cause “formalism”.
“Protective clothing is nothing more than to prevent virus particles or aerosols from sticking to clothing when the mask is removed for sampling.” Zhang Zhenhua said, “But for the new coronavirus, as long as you don’t touch your mouth, nose and The risk of exposure to the eyes and object surfaces has been proven to be very low, coupled with outdoor air flow, it is sufficient to wear a thin disposable overalls for shielding during large-scale screening.”
Zhang Zhenhua believes that the “big white” isolation gown is suitable for the screening of hospital isolation wards and high-risk groups, where a large number of infected people gather, and the environmental virus concentration is high. At this time, it can fully play its role. Protective effects.
On the other hand, Zhang Zhenhua is worried that the per capita “brightness” will reduce the protection to “form”.
“Experienced medical care is fine. Some volunteers have not undergone strict professional training. The discomfort caused by protective clothing will cause some people to ‘loose’ their masks from time to time and touch them with their hands. Wiping sweat on their faces, etc.” Zhang Zhenhua said, “Instead of doing this, let them wear masks, gloves, and face shields as comfortably as possible, and impose strict requirements on some behavioral operations, which can better prevent cross-infection. .”
Ming Weijie, assistant professor of the Department of Infectious Diseases and Public Health at City University of Hong Kong, believes that relevant sampling protection guidelines should be improved, and graded protection measures can be implemented in different risk areas.
“The currently popular Austrian strain is highly contagious. Nucleic acid testing is carried out in areas with a high density of infected persons. It is recommended to wear protective clothing. If nucleic acid testing is carried out in low-risk areas, N95 masks are required. , goggles and disposable gowns are sufficient to protect medical staff.”
In this regard, Nanchang City, Jiangxi Province took the lead in making changes.
Today, Nanchang City held the 23rd press conference for the prevention and control of the new crown pneumonia epidemic. Zhu Shiming, director of the Nanchang Municipal Health Commission, introduced that in order to prevent heatstroke among medical staff and implement heatstroke prevention and cooling measures, outdoor sampling personnel No longer wearing protective clothing for sampling, but wearing disposable isolation gowns.
The source of the header of this article is “Nanchang News Network”
Source: Medicine
Editor in charge: Wang Hang
Proofreading: Zang Hengjia