新冠疫情期间入境航班及相关区域的医疗保障

Discussion on the medical security for inbound flights and related areas during the COVID-19 epidemic period

高风险的入境航班及相关区域是我国当前新冠病毒肺炎病例输入的主要关口,入境航班及相关场所的医疗保障存在缺乏大医疗环境支撑、感染不确定性、现场救治决策难、潜在暴露感染风险、器材设施设备消杀困难、关联单位多、协调难度大等特点和风险点。原则上宜建立区域医疗保障机制,专人、专车、专用设施设备,医护人员要集中居住、做好自身防护措施,在让患者得到高效医疗救治的同时,又要规避医疗事件可能造成的疫情播散。入境航班及相关工作区域的病例,宜充分利用区域负压隔离舱等设施设备,原则上应通过视频远程初步了解病情,如患者病情平缓,应尽量规避暴露感染风险,在不对国内区域造成污染的前提下,迅速脱离高风险环境、规范脱卸防护装备再开展救治;病情紧急,需立即抢救的急症,遵循救命第一的原则,解除致命病因,建立生命支持,在不对国内区域造成污染的前提下,选择最快捷径脱离环境,尽量减少疫情播散风险。入境航班机组及保障人员集中隔离居住区域,对发病患者加大核酸检测频次,升级隔离、防护和消毒措施,尽早排除新冠感染可能;日常普通疾病采取优先线上诊疗等措施减少疫情播撒风险;在保障室内空气洁净的前提下,在居住地开展部分常规治疗活动解决患者病痛;病情危重则及时后送以拯救生命;必要时实施紧急消杀,规范处置医疗垃圾,强化信息追访,共促疫情防控。

Being the main entry points for the current COVID-19 importations in China,high-risk inbound flights and related areas are facing many challenges,such as lack of support for the general medical environment,infection uncertainty,difficulty in on-site rescue decision-making,risks of potential exposure to infection,difficulties in equipment and equipment disinfection,many associated units and departments,and difficulty in coordination.In principle,a regional medical security mechanism should be established,with dedicated personnel,special vehicles,special facilities and equipment.Medical staff should live in a centralized manner and take self-protection measures so that patients can receive efficient medical treatment while the spread of the epidemic caused by medical events could be avoided.For the cases of inbound flights and relevant work areas,it is advisable to make full use of facilities and equipment,such as a regional negative pressure isolation cabin.In principle,the patient's condition should be preliminarily investigated through video calls.If the patient's condition is mild,then the risk of exposure and infection should be avoided as much as possible.On the premise of not causing contamination domestically,it is advisable to quickly leave the high-risk environment and unload the protective equipment in a standardized manner before treatment;For emergencies that are in urgent condition and require immediate rescue,the principle of life-saving should be followed as the top priority.Fatal cause shall be removed and life support shall be established,choosing the fastest shortcut to leave the environment without contaminating the domestic areas so as to minimize the risk of spreading.Besides,the cabin crew and support personnel of inbound flights shall be isolated in their living areas,while the patients shall go through high-frequency nucleic acid detection,isolation upgrading,and preventive and disinfection measures to eliminate the possibility of infection as soon as possible;Daily common diseases shall be encouraged to online diagnosis to reduce the risk of spreading;On the premise of ensuring clean indoor air,part of the routine treatment activities shall be carried out at the place of residence to solve the patients'illnesses;In case of critical illness,timely evacuation is a must to save lives;Emergency disinfection shall be implemented when necessary,accompanied by standardizing the disposal of medical waste,strengthening information follow-up,and jointly promoting epidemic prevention and control.