儿童疑似新型冠状病毒感染CT检查的镇静流程及应急方案

The sedation and emergency protocol of computer tomography examination for children suspected with infection of SARS-CoV-2

目的探讨疑似新型冠状病毒感染儿童CT检查的镇静流程及应急方案。方法根据国家针对新型冠状病毒肺炎的各种规范和指南,制定疑似新型冠状病毒肺炎儿童CT检查的镇静流程、镇静用药方案、镇静相关物品的准备,核查方案和制定应急方案,并且对相关人员进行培训。结果昆明市儿童医院镇静镇痛中心从2020年2月3日至2020年3月10日共完成疑似新型冠状病毒肺炎CT检查镇静76例,患儿年龄(17±5)个月,体重(11.4±1.7)kg,其中74例使用丙泊酚静脉注射镇静,诱导时间(2.8±1.2)min,检查时间(5.6±1.6)min,复苏时间(16.2±2.2)min。2例使用右美托咪定滴鼻镇静。所有患儿均完成CT检查。不良事件中2例(2.63%)记录为低氧血症、3例(3.95%)在回到病房2 h内发生呕吐,无喉痉挛、心搏骤停和死亡病例。结论在感染相关风险的特殊场地为儿童提供镇静,应该根据国家相关规定和指南,制定合理的流程,划定功能区域,对所需物品进行合理分类,对相关医务人员进行特殊环境下的应急方案的培训,才能为疑似新型冠状病毒肺炎CT检查的镇静患儿提供安全的舒适化医疗。

Objective To discuss the sedation and emergency protocol of computer tomography(CT)examination for pediatric patients suspected with infection of SARS-CoV-2.Methods According to national COVID-19 policies and guidelines,we established a sedation protocol,a medication protocol,and a protocol for preparing sedation related materials,a checking protocol,and an emergency protocol,and sedation related personals were trained.Results From February 3 to March 10,2020,the Sedation and Analgesia Center of Kunming Children´s Hospital completed sedation for CT examination of 76 pediatric patients with suspected COVID-19.The children were(17±5)months,weighing(11.4±1.7)kg.Among them,74 patients were sedated through intravenous injection of propofol.The induction time was(2.8±1.2)min,the examination time was(5.6±1.6)min and the recovery time was(16.2±2.2)min.Two patients were intranasal administered with dexmedetomidine.All children completed CT examination.Two cases(2.63%)of adverse events were recorded as hypoxemia,3 cases(3.95%)as vomiting within 2 h after returning to the ward.There were no laryngeal spasm,cardiac arrest and death cases.Conclusions In order to guarantee the safety of sedation for pediatric patients suspected with infection of SARS-CoV-2,we should establish proper protocols and lay out functional areas based on national regulations and guidelines,and rationally classify the necessities,and provide medical staff with emergency protocol training under special circumstances,so as to provide safe and comfort medical treatment for children with suspected COVID-19 during sedation for CT examination.