{"id":10587,"date":"2020-07-07T12:02:07","date_gmt":"2020-07-07T12:02:07","guid":{"rendered":"https:\/\/jurmed.ro\/medici\/?p=10587"},"modified":"2020-07-07T12:02:07","modified_gmt":"2020-07-07T12:02:07","slug":"spre-deosebire-de-unitatile-sanitare-dedicate-covid-pentru-noi-ceilalti-provocarile-au-fost-si-raman-mai-mari","status":"publish","type":"post","link":"https:\/\/jurmed.ro\/medici\/spre-deosebire-de-unitatile-sanitare-dedicate-covid-pentru-noi-ceilalti-provocarile-au-fost-si-raman-mai-mari\/","title":{"rendered":"\u201cSpre deosebire de unit\u0103\u0163ile sanitare dedicate Covid, pentru noi ceilal\u0163i provoc\u0103rile au fost \u0219i r\u0103m\u00e2n mai mari\u201d"},"content":{"rendered":"
\"\"<\/a>
Prof. Dr. Simona Vl\u0103d\u0103reanu, Pre\u0219edintele Societ\u0103\u0163ii Rom\u00e2ne de Medicin\u0103 Fetal\u0103 \u0219i Neonatal\u0103<\/em><\/figcaption><\/figure>\n

Personalul medico-sanitar din maternit\u0103\u0163ile din Rom\u00e2nia este la fel de expus infect\u0103rii cu SARS-CoV-2 ca oricare altul din alte spitale. Au fost luate la timp m\u0103surile de prevenire a contamin\u0103rii astfel \u00eenc\u00e2t at\u00e2t cadrele sanitare c\u00e2t \u0219i nou-n\u0103scu\u0163ii s\u0103 nu fie \u00een pericol de a se \u00eemboln\u0103vi de Covid-19?<\/strong><\/p>\n

Da, at\u00e2t MS c\u00e2t \u0219i DSP-urile \u0219i INSP au intervenit prompt cu inform\u0103ri pertinente, actualizate func\u0163ie de dinamica r\u0103sp\u00e2ndirii infec\u0163iei virale \u00een popula\u0163ia \u0163\u0103rii. Absolut toate recomand\u0103rile elaborate \u0219i publicate au avut drept scop asigurarea prevenirii r\u0103sp\u00e2ndirii infec\u0163iei at\u00e2t la pacien\u0163i c\u00e2t \u0219i la personalul medical. M\u0103surile luate au fost \u00een cele mai multe spitale corect implementate, s-au asigurat materialele necesare (m\u0103\u0219ti, viziere, halate, boto\u0219i, combinezoane, m\u0103nu\u0219i, dezinfectan\u0163i etc. ). Iar noi, ca \u0219efi de clinici, am fost prezen\u0163i zilnic la spital, am organizat responsabil cicuitele, am exersat cu personalul medical echiparea \u0219i dezechiparea corect\u0103, i-am \u00eencurajat s\u0103 continue s\u0103 desf\u0103\u0219oare activitatea medical\u0103 la nivel optim \u0219i \u00een siguran\u0163\u0103 at\u00e2t pentru pacien\u0163i c\u00e2t \u0219i pentru personal.<\/em><\/p>\n

Spre deosebire de unit\u0103\u0163ile sanitare dedicate Covid, pentru noi ceilal\u0163i provoc\u0103rile au fost \u0219i r\u0103m\u00e2n mai mari \u00een sensul c\u0103 trebuie s\u0103 consider\u0103m orice pacient poten\u0163ial infectat \u0219i astfel e necesar\u0103 vigilen\u0163a \u0219i con\u0219tientizarea riscului de contaminare \u00een orice moment. Am asigurat triajul epidemiologic zilnic, am utilizat defini\u0163iile de caz a\u0219a cum au fost elaborate de c\u0103tre CNSCBT \u0219i am respectat toate criteriile de testare. P\u00e2n\u0103 acum nu am avut situa\u0163ii care s\u0103 ne scape de sub control. Mai dificil a fost s\u0103 convigem personalul medical c\u0103 prin respectarea m\u0103surilor de preven\u0163ie ne putem ap\u0103ra \u00een fa\u0163a acestei epidemii; au fost cazuri, pu\u0163ine, de solicitare de demisie, de teama unei poten\u0163iale contamin\u0103ri totu\u0219i prin prezen\u0163a noastr\u0103 constant\u0103, zilnic\u0103, prin \u00eencurajare \u0219i sus\u0163inere psihologic\u0103 a personalului medical am reu\u0219it s\u0103 rezolv\u0103m cu succes \u0219i aceste situa\u0163ii. Teama \u00een r\u00e2ndul cadrelor medicale r\u0103m\u00e2ne at\u00e2ta timp c\u00e2t m\u0103surile de prevenire nu sunt respectate.<\/em><\/p>\n

Care sunt recomand\u0103rile Societ\u0103\u0163ii de Obstetric\u0103 \u0219i Ginecologie din Rom\u00e2nia \u00een cazul nou-n\u0103scutului cu mama infectat\u0103 cu noul coronavirus?<\/strong><\/p>\n

Recomand\u0103rile privind protec\u0163ia mamei \u0219i nou-n\u0103scutului au fost cuprinse \u00een Metodologia elaborat\u0103 de c\u0103tre cele 2 comisii de specialitate din MS, \u00eenc\u0103 de la primele cazuri raportate \u00een Rom\u00e2nia aceste documente au fost imediat preluate \u0219i diseminate de c\u0103tre SOGR \u0219i Asocia\u0163ia Rom\u00e2n\u0103 de Neonatologie, ceea ce a adus un beneficiu major pentru speciali\u0219tii no\u0219tri \u00een rezolvarea cazurilor. E adev\u0103rat c\u0103 au st\u00e2rnit multe comentarii \u00een spa\u0163iul public, al unor blogguri preocupate nu de s\u0103n\u0103tatea \u0219i siguran\u0163a pacien\u0163ilor \u0219i a personalului medical ci de nevoia de a ie\u0219i din anonimat. Ceea ce trebuie s\u0103 \u00een\u0163eleag\u0103 p\u0103reri\u0219tii versus speciali\u0219tii\/exper\u0163ii este c\u0103 opinia celor din urm\u0103 este \u00eentodeauna responsabil\u0103, verificat\u0103 \u0219i \u00eentotdeauna \u00een folosul pacientului. Pe de alt\u0103 parte fiecare \u0163ar\u0103, fiecare sistem de s\u0103n\u0103tate are anumite particularit\u0103\u0163i dictate \u00een primul r\u00e2nd de caracteristicile popula\u0163iei \u0219i ale resurselor umane \u0219i materiale disponibile. Aceast\u0103 metodologie se adapteaz\u0103 \u00een func\u0163ie de dinamica epidemiologic\u0103 a virusului SARS COV2. Nu putem copia aidoma sau urma recomand\u0103ri ale altor \u0163\u0103ri sau organiza\u0163ii, fie ele OMS sau altele f\u0103r\u0103 a le adapta situa\u0163iei noastre specifice, mioritice \u0219i cred c\u0103 am spus destul.<\/em><\/p>\n

Dac\u0103 mama e pozitiv\u0103 cu noul tip de coronavirus, automat se na\u0219te \u0219i bebelu\u0219ul cu acest virus?<\/strong><\/p>\n

O serie de articole au fost publicate, pe baza unor studii observa\u0163ionale, prospective sau retrospective sau doar pe baza unor serii de cazuri, subiectul este \u00eenc\u0103 \u00een dezbatere la nivelul exper\u0163ilor interna\u0163ionali. Nu sunt r\u0103spunsuri clare, concludente. Majoritatea sus\u0163in c\u0103 nu s-au \u00eenregistrat cazuri de transmitere vertical\u0103. Totu\u0219i unii cercet\u0103tori au publicat documente care dovedesc prezen\u0163a virusului la nivelul placentei. Cele mai multe cazuri de Covid 19 la nou-n\u0103scu\u0163i \u0219i sugari au ap\u0103rut prin transmiterea orizontal\u0103, de la mama infectat\u0103 sau de la al\u0163i membrii din familie, iar altele de la personalul medical infectat.<\/em><\/p>\n

A\u0163i avut cazuri de mame \u0219i nou n\u0103scu\u0163i infecta\u0163i cu Covid19? <\/strong><\/p>\n

La noi \u00een Maternitate nu am avut cazuri. Am avut c\u00e2teva suspiciuni, gravide cu febr\u0103, neevaluate pe parcursul sarcinii, altele cu tuse dar am g\u0103sit alt\u0103 etiologie pentru simptomatologia prezentat\u0103. S\u0103 nu uit\u0103m c\u0103 exist\u0103 multe alte boli infec\u0163ioase sau de alte etiologii care se pot prezenta cu semne \u0219i simptome similare febr\u0103, tuse, dificultate respiratorie, disconfort digestiv etc.<\/em><\/p>\n

Care sunt din punctul dvs de vedere provoc\u0103rile pentru mam\u0103 \u0219i noun\u0103scut \u00een vreme de pandemie?<\/strong><\/p>\n

Este o situa\u0163ie delicat\u0103, pentru c\u0103 ini\u0163ial adresabilitatea c\u0103tre spital \u0219i cabinete medicale s-a restr\u00e2ns la urgen\u0163e, gravida, na\u0219terea \u0219i noun\u0103scutul reprezint\u0103 urgen\u0163e medicale mai ales atunci c\u00e2nd nu exist\u0103 posibilitatea monitoriz\u0103rii \u0219i accesul facil la consulta\u0163ii. Totu\u0219i s-au g\u0103sit solu\u0163ii rapid, \u00een sensul c\u0103 aceste categorii au fost introduse \u00een lista pacien\u0163ilor care s-au putut adresa institu\u0163iilor sanitare. Desigur, r\u0103m\u00e2ne teama pacientului de situa\u0163ia din spital de aceea au fost deosebit de importante m\u0103surile luate, distan\u0163area fizic\u0103, purtarea m\u0103\u0219tii respiratorii, triajul epidemiologic, igiena \u0219i dezinfec\u0163ia riguroase, asigurarea circuitelor \u00een spitale. S-au implicat \u0219i Asocia\u0163ii non-profesionale dar care \u0219i-au oferit sprijinul prin dezvoltarea unor linii telefonice permanente\u00a0 (NeoNat call) la care gravidele sau mamele care au n\u0103scut s\u0103 poate suna \u0219i primi informa\u0163ii specializate de la speciali\u0219tii din domeniu sau de la psihologi. Este salutar\u0103 interven\u0163ia \u0219i aportul acestor asocia\u0163ii<\/em>.<\/p>\n

Cum arat\u0103 situa\u0163ia \u00een spital, dup\u0103 aceste dou\u0103 luni de pandemie? <\/strong><\/p>\n

A\u0219 zice c\u0103 arat\u0103 bine. \u00cenc\u0103 sunt impuse anumite restric\u0163ii, de exemplu num\u0103rul vizitatorilor e minim dar a\u0219a spitalele sunt mai curate, cazurile de infec\u0163ii asociate actului medical au sc\u0103zut, se respect\u0103 m\u0103surile de preven\u0163ie, purtarea m\u0103\u0219tii respiratorii, dezinfec\u0163ia frecvent\u0103 a saloanelor \u0219i a spa\u0163iilor unde sunt consulta\u0163i pacien\u0163ii, se organizeaz\u0103 mai bine activitatea medical\u0103. La Elias se finalizeaz\u0103 construc\u0163ia unui spital modular ultramodern \/ o zon\u0103 tampon cu un num\u0103r de aproximativ 30-40 de paturi, dotat cu gaze medicale \u0219i spa\u0163ii adecvate pentru \u00eengrijirea pacien\u0163ilor suspec\u0163i sau confirma\u0163i Covid 19 p\u00e2n\u0103 la transferul lor \u00een spitalele dedicate COVID, \u0219i pentru care se vor putea asigura \u0219i servicii de terapie intensiv\u0103 astfel toate sec\u0163iile spitalului vor func\u0163iona la capacitatea lor maxim\u0103 deservind toate tipurile de patologii \u0219i \u00een siguran\u0163\u0103 pentru pacient \u0219i personalul medical aferent pentru urm\u0103toarea perioad\u0103, valul al doilea al pandemiei (pe perioada st\u0103rii de urgen\u0163\u0103 \u00een 3 sec\u0163ii importante activitatea medical\u0103 specific\u0103 s-a \u00eentrerupt pentru a facilita triajul \u0219i izolarea pacien\u0163ilor poten\u0163iali infecta\u0163i, deoarece fiind spital de urgen\u0163\u0103 \u0219i multidisciplinar, pacien\u0163ii \/cazurile grave nu au contenit s\u0103 fie prezente). Dar r\u0103m\u00e2ne un sentiment de team\u0103 pentru personalul medical.<\/em><\/p>\n

Ce ar trebui corectat ast\u0103zi, pentru ca un eventual val doi s\u0103 poat\u0103 fi controlat, din punct de vedere medical?<\/strong><\/p>\n

La nivelul spitalelor trebuie s\u0103 se men\u0163in\u0103 acelea\u0219i precau\u0163ii \u0219i aceea\u0219i atitudine corect\u0103, responsabil\u0103 a personalului medical. Din partea popula\u0163iei \u00eens\u0103 e nevoie de disciplin\u0103, de \u00eencredere \u00een sistemul sanitar, \u00een medici \u0219i asistente, de respect, apreciere \u0219i recunoa\u0219tere a eforturilor deosebite pe care ace\u0219tia le fac pentru \u00eengrijirea pacien\u0163ilor. To\u0163i suntem vulnerabili \u0219i la un moment dat poten\u0163iali pacien\u0163i, s\u0103 nu privim cu superficialitate aceste aspecte, s\u0103 fim inteligen\u0163i simptomatici \u0219i nu asimptomatici \u2013 dup\u0103 cum bine spunea un controversat jurnalist rom\u00e2n.<\/em><\/p>\n

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Personalul medico-sanitar din maternit\u0103\u0163ile din Rom\u00e2nia este la fel de expus infect\u0103rii cu SARS-CoV-2 ca oricare altul din alte spitale. 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