Theo quy\u1ebft 125\/Q\u0110-BYT ban h\u00e0nh ng\u00e0y 16\/01\/2020<\/p>\n\n\n\n
Vi r\u00fat corona (CoV) l\u00e0 m\u1ed9t h\u1ecd vi r\u00fat l\u1edbn g\u00e2y b\u1ec7nh t\u1eeb c\u1ea3m l\u1ea1nh th\u00f4ng th\u01b0\u1eddng \u0111\u1ebfn b\u1ec7nh n\u1eb7ng, \u0111e d\u1ecda t\u00ednh m\u1ea1ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh nh\u01b0 H\u1ed9i ch\u1ee9ng h\u00f4 h\u1ea5p c\u1ea5p t\u00ednh n\u1eb7ng (SARS-CoV) n\u0103m 2002 v\u00e0 H\u1ed9i ch\u1ee9ng h\u00f4 h\u1ea5p Trung \u0110\u00f4ng (MERS-CoV) n\u0103m 2012. Tuy nhi\u00ean, t\u1eeb th\u00e1ng 12 n\u0103m 2019, m\u1ed9t ch\u1ee7ng vi r\u00fat corona m\u1edbi (nCoV) g\u00e2y vi\u00eam ph\u1ed5i t\u1ea1i t\u1ec9nh V\u0169 H\u00e1n (Trung Qu\u1ed1c) \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh v\u00e0 c\u00f3 nguy c\u01a1 lan r\u1ed9ng.<\/p>\n\n\n\n
Ng\u01b0\u1eddi nhi\u1ec5m nCoV c\u00f3\nc\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ea5p t\u00ednh: ho, s\u1ed1t, kh\u00f3 th\u1edf, c\u00f3 th\u1ec3 di\u1ec5n bi\u1ebfn \u0111\u1ebfn vi\u00eam ph\u1ed5i n\u1eb7ng,\nsuy h\u00f4 h\u1ea5p c\u1ea5p ti\u1ebfn tri\u1ec3n v\u00e0 t\u1eed vong, \u0111\u1eb7c bi\u1ec7t \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 b\u1ec7nh m\u1ea1n t\u00ednh,\nsuy gi\u1ea3m mi\u1ec5n d\u1ecbch.<\/p>\n\n\n\n
Hi\u1ec7n ch\u01b0a c\u00f3 thu\u1ed1c \u0111i\u1ec1u\ntr\u1ecb \u0111\u1eb7c hi\u1ec7u v\u00e0 ch\u01b0a c\u00f3 v\u1eafc xin ph\u00f2ng b\u1ec7nh.<\/p>\n\n\n\n
I. CH\u1ea8N \u0110O\u00c1N B\u1ec6NH DO NHI\u1ec4M VI R\u00daT CORONA M\u1edaI<\/strong><\/p>\n\n\n\n 1. Ca b\u1ec7nh nghi ng\u1edd (Suspected case):<\/strong><\/p>\n\n\n\n Bao g\u1ed3m c\u00e1c tr\u01b0\u1eddng h\u1ee3p sau:<\/strong><\/p>\n\n\n\n 1.1. S\u1ed1t v\u00e0 vi\u00eam ph\u1ed5i,\nho\u1eb7c vi\u00eam ph\u1ed5i k\u1ebd, ho\u1eb7c h\u1ed9i ch\u1ee9ng suy h\u00f4 h\u1ea5p c\u1ea5p ti\u1ebfn tri\u1ec3n (ARDS) d\u1ef1a tr\u00ean l\u00e2m\ns\u00e0ng ho\u1eb7c h\u00ecnh \u1ea3nh X-quang t\u1ed5n th\u01b0\u01a1ng c\u00e1c m\u1ee9c \u0111\u1ed9 kh\u00e1c nhau m\u00e0 kh\u00f4ng l\u00fd gi\u1ea3i \u0111\u01b0\u1ee3c\nb\u1eb1ng c\u00e1c nhi\u1ec5m tr\u00f9ng ho\u1eb7c c\u0103n nguy\u00ean kh\u00e1c, bao g\u1ed3m t\u1ea5t c\u1ea3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u00f3 ch\u1ec9\n\u0111\u1ecbnh l\u00e2m s\u00e0ng x\u00e9t nghi\u1ec7m vi\u00eam ph\u1ed5i c\u1ed9ng \u0111\u1ed3ng<\/p>\n\n\n\n V\u00e0:<\/strong> S\u1ed1ng ho\u1eb7c \u0111i du l\u1ecbch t\u1edbi v\u00f9ng d\u1ecbch t\u1ec5\nc\u00f3 b\u1ec7nh do vi r\u00fat Corona m\u1edbi trong v\u00f2ng 14 ng\u00e0y tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u c\u00f3 tri\u1ec7u ch\u1ee9ng<\/p>\n\n\n\n – Ti\u1ebfp x\u00fac (trong\nth\u1eddi gian \u1ee7 b\u1ec7nh 14 ng\u00e0y) v\u1edbi tr\u01b0\u1eddng h\u1ee3p s\u1ed1t v\u00e0 nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p c\u1ea5p t\u00ednh\nch\u01b0a r\u00f5 nguy\u00ean nh\u00e2n xu\u1ea5t hi\u1ec7n trong v\u00f2ng 14 ng\u00e0y sau khi du l\u1ecbch t\u1edbi v\u00f9ng d\u1ecbch\nt\u1ec5 c\u00f3 b\u1ec7nh do vi r\u00fat Corona m\u1edbi.<\/p>\n\n\n\n 1.2. S\u1ed1t v\u00e0 c\u00f3 c\u00e1c\ntri\u1ec7u ch\u1ee9ng b\u1ec7nh l\u00fd h\u00f4 h\u1ea5p (ho, kh\u00f3 th\u1edf..)<\/p>\n\n\n\n V\u00e0:<\/strong><\/p>\n\n\n\n C\u00f3 m\u1eb7t t\u1ea1i c\u00e1c c\u01a1 s\u1edf\ny t\u1ebf \u1edf c\u00e1c v\u00f9ng d\u1ecbch t\u1ec5 \u0111\u00e3 x\u00e1c \u0111\u1ecbnh c\u00f3 c\u00e1c ca m\u1eafc b\u1ec7nh do vi r\u00fat Corona m\u1edbi\nli\u00ean quan t\u1edbi ch\u0103m s\u00f3c y t\u1ebf.<\/p>\n\n\n\n Ho\u1eb7c<\/p>\n\n\n\n – Ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp\nv\u1edbi v\u1eadt nu\u00f4i b\u1ecb b\u1ec7nh, \u0111\u1ed9ng v\u1eadt hoang d\u00e3 \u1edf c\u00e1c v\u00f9ng d\u1ecbch t\u1ec5 trong v\u00f2ng 14 ng\u00e0y.<\/p>\n\n\n\n 1.3. S\u1ed1t ho\u1eb7c c\u00f3\nc\u00e1c tri\u1ec7u ch\u1ee9ng h\u00f4 h\u1ea5p v\u00e0 kh\u1edfi ph\u00e1t trong v\u00f2ng 14 ng\u00e0y sau khi ti\u1ebfp x\u00fac v\u1edbi tr\u01b0\u1eddng h\u1ee3p c\u00f3 th\u1ec3 ho\u1eb7c kh\u1eb3ng \u0111\u1ecbnh m\u1eafc b\u1ec7nh do nCoV.<\/p>\n\n\n\n 2. Ca b<\/strong>\u1ec7<\/strong>nh\nc\u00f3 th\u1ec3 (Probable case):<\/strong><\/p>\n\n\n\n Khi c\u00f3 c\u00e1c b\u1eb1ng ch\u1ee9ng\nv\u1ec1 l\u00e2m s\u00e0ng v\u00e0 d\u1ecbch t\u1ec5:<\/p>\n\n\n\n B\u1eb1ng\nch\u1ee9ng d\u1ecbch t\u1ec5:<\/em><\/p>\n\n\n\n Ng\u01b0\u1eddi ti\u1ebfp x\u00fac tr\u1ef1c\nti\u1ebfp v\u1edbi ca b\u1ec7nh \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh b\u1eb1ng x\u00e9t nghi\u1ec7m, bao g\u1ed3m nh\u1eefng ng\u01b0\u1eddi\nch\u0103m s\u00f3c b\u1ec7nh nh\u00e2n: nh\u00e2n vi\u00ean y t\u1ebf ho\u1eb7c c\u00e1c th\u00e0nh vi\u00ean trong gia \u0111\u00ecnh; nh\u1eefng\nng\u01b0\u1eddi s\u1ed1ng chung v\u1edbi ng\u01b0\u1eddi b\u1ec7nh ho\u1eb7c\n\u0111\u1ebfn th\u0103m ng\u01b0\u1eddi b\u1ec7nh trong\nth\u1eddi gian c\u00f3 bi\u1ec3u hi\u1ec7n b\u1ec7nh.<\/p>\n\n\n\n B\u1eb1ng\nch\u1ee9ng l\u00e2m s\u00e0ng:<\/em><\/p>\n\n\n\n Ng\u01b0\u1eddi b\u1ec7nh c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng, X-quang ho\u1eb7c\nx\u00e9t nghi\u1ec7m gi\u1ea3i ph\u1eabu b\u1ec7nh c\u1ee7a b\u1ec7nh l\u00fd nhu m\u00f4 ph\u1ed5i (v\u00ed d\u1ee5 nh\u01b0 vi\u00eam ph\u1ed5i ho\u1eb7c\nARDS) ph\u00f9 h\u1ee3p\nv\u1edbi \u0111\u1ecbnh ngh\u0129a v\u1ec1 ca b\u1ec7nh \u1edf tr\u00ean,<\/p>\n\n\n\n V\u00e0<\/strong><\/p>\n\n\n\n – Kh\u00f4ng \u0111\u01b0\u1ee3c kh\u1eb3ng\n\u0111\u1ecbnh b\u1eb1ng x\u00e9t nghi\u1ec7m b\u1edfi v\u00ec kh\u00f4ng l\u1ea5y \u0111\u01b0\u1ee3c m\u1eabu b\u1ec7nh ph\u1ea9m ho\u1eb7c kh\u00f4ng l\u00e0m \u0111\u01b0\u1ee3c x\u00e9t nghi\u1ec7m \u0111\u1ec3 ch\u1ea9n\n\u0111o\u00e1n c\u0103n nguy\u00ean nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p<\/p>\n\n\n\n – Kh\u00f4ng l\u00fd gi\u1ea3i \u0111\u01b0\u1ee3c\nb\u1eb1ng c\u00e1c nhi\u1ec5m tr\u00f9ng ho\u1eb7c c\u0103n nguy\u00ean kh\u00e1c.<\/p>\n\n\n\n 3. Ca b\u1ec7nh x\u00e1c \u0111\u1ecbnh (Confirmed case)<\/strong><\/p>\n\n\n\n L\u00e0 ca b\u1ec7nh c\u00f3 bi\u1ec3u\nhi\u1ec7n l\u00e2m s\u00e0ng nh\u01b0 \u0111\u00e3 n\u00eau tr\u00ean v\u00e0 \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh b\u1eb1ng x\u00e9t nghi\u1ec7m Real time RT –\nPCR d\u01b0\u01a1ng t\u00ednh v\u1edbi nCoV.<\/p>\n\n\n\n 4. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t:<\/strong><\/p>\n\n\n\n Vi\u00eam ph\u1ed5i do nCoV\ng\u00e2y ra c\u1ea7n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi:<\/p>\n\n\n\n – C\u00fam n\u1eb7ng (c\u00fam\nA\/H1N1 ho\u1eb7c c\u00fam gia c\u1ea7m A\/H5N1…)<\/p>\n\n\n\n – SARS-CoV v\u00e0\nMER-CoV<\/p>\n\n\n\n – Vi\u00eam ph\u1ed5i kh\u00f4ng\n\u0111i\u1ec3n h\u00ecnh do c\u00e1c c\u0103n nguy\u00ean kh\u00e1c: Vi r\u00fat h\u1ee3p b\u00e0o h\u00f4 h\u1ea5p (SRV), adenovirus,\nmycoplasma,…<\/p>\n\n\n\n 5. X\u00e9t nghi\u1ec7m c\u1eadn l\u00e2m s\u00e0ng:<\/strong><\/strong><\/p>\n\n\n\n – K\u1ef9 thu\u1eadt x\u00e1c \u0111\u1ecbnh\nnCoV l\u00e0 k\u1ef9 thu\u1eadt Real time RT – PCR v\u1edbi b\u1ec7nh ph\u1ea9m l\u00e0 d\u1ecbch \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p, \u0111\u1eddm, d\u1ecbch\nn\u1ed9i kh\u00ed qu\u1ea3n \u0111\u01b0\u1ee3c thu th\u1eadp b\u1eb1ng t\u0103m b\u00f4ng v\u00e0 b\u1ea3o qu\u1ea3n trong m\u00f4i tr\u01b0\u1eddng ph\u00f9 h\u1ee3p. L\u01b0u \u00fd: \u0110\u1ed1i v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111\u1ea7u ti\u00ean nghi nhi\u1ec5m vi r\u00fat corona m\u1edbi,\nc\u00e1c \u0111\u01a1n v\u1ecb c\u1ea7n l\u01b0u m\u1eabu v\u00e0 chuy\u1ec3n m\u1eabu \u0111\u1ebfn c\u00e1c c\u01a1 s\u1edf x\u00e9t nghi\u1ec7m \u0111\u01b0\u1ee3c B\u1ed9 Y t\u1ebf cho\nph\u00e9p kh\u1eb3ng \u0111\u1ecbnh.<\/p>\n\n\n\n – Vi\u1ec7c thu th\u1eadp, b\u1ea3o\nqu\u1ea3n v\u00e0 v\u1eadn chuy\u1ec3n b\u1ec7nh ph\u1ea9m ph\u1ea3i th\u1ef1c hi\u1ec7n theo Ph\u1ee5 l\u1ee5c 1.<\/p>\n\n\n\n – Th\u1ef1c hi\u1ec7n \u0111\u1ea7y \u0111\u1ee7\nc\u00e1c x\u00e9t nghi\u1ec7m c\u1eadn l\u00e2m s\u00e0ng th\u01b0\u1eddng quy ph\u1ee5c v\u1ee5 ch\u1ea9n \u0111o\u00e1n, ti\u00ean l\u01b0\u1ee3ng, theo d\u00f5i b\u1ec7nh\nnh\u00e2n.<\/p>\n\n\n\n 6. B\u00e1o c\u00e1o:<\/strong><\/p>\n\n\n\n C\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u00f3 th\u1ec3 ho\u1eb7c kh\u1eb3ng \u0111\u1ecbnh m\u1eafc vi r\u00fat Corona m\u1edbi\nc\u1ea7n ph\u1ea3i b\u00e1o c\u00e1o l\u00ean C\u1ee5c Y t\u1ebf d\u1ef1 ph\u00f2ng (B\u1ed9 Y t\u1ebf) ho\u1eb7c Trung t\u00e2m ki\u1ec3m so\u00e1t d\u1ecbch\nb\u1ec7nh t\u1ea1i c\u00e1c \u0111\u1ecba ph\u01b0\u01a1ng.<\/p>\n\n\n\n II. \u0110I\u1ec0U TR\u1eca<\/strong><\/p>\n\n\n\n 1. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb:<\/strong><\/p>\n\n\n\n – C\u00e1c ca b\u1ec7nh nghi\nng\u1edd ho\u1eb7c c\u00f3 th\u1ec3 \u0111\u1ec1u ph\u1ea3i \u0111\u01b0\u1ee3c kh\u00e1m \u1edf khu ri\u00eang t\u1ea1i b\u1ec7nh vi\u1ec7n, \u0111\u01b0\u1ee3c l\u00e2y b\u1ec7nh ph\u1ea9m \u0111\u00fang c\u00e1ch \u0111\u1ec3 l\u00e0m x\u00e9t nghi\u1ec7m \u0111\u1eb7c hi\u1ec7u \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh b\u1ec7nh.<\/p>\n\n\n\n – Ca b\u1ec7nh x\u00e1c \u0111\u1ecbnh\nc\u1ea7n nh\u1eadp vi\u1ec7n theo d\u00f5i v\u00e0 c\u00e1ch ly ho\u00e0n to\u00e0n.<\/p>\n\n\n\n – Hi\u1ec7n nay ch\u01b0a c\u00f3\nthu\u1ed1c \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u, v\u00ec v\u1eady ch\u1ee7 y\u1ebfu ch\u1ec9 \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng, ph\u00e1t hi\u1ec7n v\u00e0\nx\u1eed tr\u00ed k\u1ecbp th\u1eddi t\u00ecnh tr\u1ea1ng suy h\u00f4 h\u1ea5p, suy th\u1eadn v\u00e0 c\u00e1c t\u1ea1ng kh\u00e1c (n\u1ebfu c\u00f3)<\/p>\n\n\n\n 2. \u0110i\u1ec1u tr\u1ecb suy h\u00f4 h\u1ea5p:<\/strong><\/p>\n\n\n\n 2.1. M\u1ee9c \u0111<\/strong>\u1ed9<\/strong>\nnh<\/strong>\u1eb9<\/strong>:<\/strong><\/p>\n\n\n\n – N\u1eb1m \u0111\u1ea7u cao 30\u00b0 – 45\u00b0<\/p>\n\n\n\n – Cung c\u1ea5p \u00f4xy: Khi\nSpO2<\/sub>\n\u2264 92% hay PaO2<\/sub>\n\u2264 65mmHg ho\u1eb7c khi c\u00f3 kh\u00f3 th\u1edf (th\u1edf g\u1eafng s\u1ee9c, th\u1edf nhanh, r\u00fat l\u00f5m ng\u1ef1c).<\/p>\n\n\n\n + Th\u1edf oxy qua g\u1ecdng\nm\u0169i: 1 – 5 l\u00edt\/ph\u00fat sao cho SpO2<\/sub> > 92%.<\/p>\n\n\n\n + Th\u1edf oxy qua m\u1eb7t n\u1ea1\n\u0111\u01a1n gi\u1ea3n: oxy 6 – 12 l\u00edt\/ph\u00fat khi th\u1edf oxy qua g\u1ecdng m\u0169i kh\u00f4ng gi\u1eef\n\u0111\u01b0\u1ee3c SpO2<\/sub>\n> 92%.<\/p>\n\n\n\n + Th\u1edf oxy qua m\u1eb7t n\u1ea1\nc\u00f3 t\u00fai d\u1ef1 tr\u1eef: l\u01b0u l\u01b0\u1ee3ng oxy \u0111\u1ee7 cao \u0111\u1ec3 kh\u00f4ng x\u1eb9p t\u00fai kh\u00ed \u1edf th\u00ec th\u1edf v\u00e0o, khi m\u1eb7t\nn\u1ea1 \u0111\u01a1n gi\u1ea3n kh\u00f4ng hi\u1ec7u qu\u1ea3.<\/p>\n\n\n\n 2.2. M\u1ee9c \u0111\u1ed9 trung b\u00ecnh<\/strong><\/p>\n\n\n\n – Th\u1edf CPAP ho\u1eb7c th\u1edf\n\u00f4 xy d\u00f2ng cao qua g\u1ecdng m\u0169i (High Flow Nasal Canula) n\u1ebfu c\u00f3: \u0110\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh khi t\u00ecnh tr\u1ea1ng gi\u1ea3m\noxy m\u00e1u kh\u00f4ng \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n b\u1eb1ng c\u00e1c bi\u1ec7n ph\u00e1p th\u1edf oxy, SpO2<\/sub> < 92%. N\u1ebfu\nc\u00f3 \u0111i\u1ec1u ki\u1ec7n, \u1edf tr\u1ebb em n\u00ean ch\u1ec9 \u0111\u1ecbnh th\u1edf CPAP ngay khi th\u1ea5t b\u1ea1i v\u1edbi th\u1edf oxy qua\ng\u1ecdng m\u0169i.<\/p>\n\n\n\n + M\u1ee5c ti\u00eau: SpO2<\/sub> > 92% v\u1edbi\nFiO2<\/sub>\nb\u1eb1ng ho\u1eb7c d\u01b0\u1edbi 0,6<\/p>\n\n\n\n + N\u1ebfu kh\u00f4ng \u0111\u1ea1t \u0111\u01b0\u1ee3c\nm\u1ee5c ti\u00eau tr\u00ean c\u00f3 th\u1ec3 ch\u1ea5p nh\u1eadn m\u1ee9c SpO2<\/sub> > 85%.<\/p>\n\n\n\n – Th\u00f4ng kh\u00ed nh\u00e2n t\u1ea1o\nkh\u00f4ng x\u00e2m nh\u1eadp BiPAP: Ch\u1ec9 \u0111\u1ecbnh khi ng\u01b0\u1eddi b\u1ec7nh c\u00f3 suy h\u00f4 h\u1ea5p c\u00f2n t\u1ec9nh, h\u1ee3p t\u00e1c t\u1ed1t,\nkh\u1ea3 n\u0103ng ho kh\u1ea1c t\u1ed1t.<\/p>\n\n\n\n 2.3. M\u1ee9c \u0111\u1ed9 n\u1eb7ng<\/strong><\/strong><\/p>\n\n\n\n H\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p<\/em><\/strong><\/p>\n\n\n\n Th\u00f4ng kh\u00ed nh\u00e2n t\u1ea1o\nx\u00e2m nh\u1eadp:<\/p>\n\n\n\n + Ch\u1ec9 \u0111\u1ecbnh khi ng\u01b0\u1eddi\nb\u1ec7nh c\u00f3 suy h\u00f4 h\u1ea5p n\u1eb7ng v\u00e0 kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi th\u00f4ng kh\u00ed nh\u00e2n t\u1ea1o kh\u00f4ng x\u00e2m nh\u1eadp.<\/p>\n\n\n\n + B\u1eaft \u0111\u1ea7u b\u1eb1ng ph\u01b0\u01a1ng\nth\u1ee9c th\u1edf ki\u1ec3m so\u00e1t th\u1ec3 t\u00edch, v\u1edbi Vt th\u1ea5p t\u1eeb 6 – 8 ml\/kg, t\u1ea7n s\u1ed1 12-16 l\u1ea7n\/ph\u00fat,\nI\/E = 1\/2, PEEP = 5 v\u00e0 \u0111i\u1ec1u ch\u1ec9nh FiO2<\/sub> \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c SpO2<\/sub> > 92%.<\/p>\n\n\n\n + N\u1ebfu ti\u1ebfn tri\u1ec3n\nth\u00e0nh ARDS, ti\u1ebfn h\u00e0nh th\u1edf m\u00e1y theo ph\u00e1c \u0111\u1ed3 th\u00f4ng kh\u00ed nh\u00e2n t\u1ea1o t\u0103ng th\u00e1n cho\nph\u00e9p.<\/p>\n\n\n\n + V\u1edbi tr\u1ebb em, c\u00f3 th\u1ec3\nth\u1edf theo ph\u01b0\u01a1ng th\u1ee9c ki\u1ec3m so\u00e1t \u00e1p l\u1ef1c (PCV). T\u00f9y t\u00ecnh tr\u1ea1ng ng\u01b0\u1eddi b\u1ec7nh \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh c\u00e1c th\u00f4ng s\u1ed1 m\u00e1y th\u1edf ph\u00f9\nh\u1ee3p.<\/p>\n\n\n\n – Trao \u0111\u1ed5i oxy qua m\u00e0ng ngo\u00e0i c\u01a1 th\u1ec3 ECMO\n(Extra-Corporeal Membrane Oxygenation):<\/p>\n\n\n\n + ECMO c\u00f3 th\u1ec3 c\u00e2n\nnh\u1eafc s\u1eed d\u1ee5ng cho ng\u01b0\u1eddi b\u1ec7nh ARDS\nkh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi c\u00e1c \u0111i\u1ec1u tr\u1ecb t\u1ed1i \u01b0u \u1edf tr\u00ean.<\/p>\n\n\n\n + Do ECMO ch\u1ec9 c\u00f3 th\u1ec3\n\u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1ea1i m\u1ed9t s\u1ed1 c\u01a1 s\u1edf tuy\u1ebfn trung \u01b0\u01a1ng, n\u00ean trong tr\u01b0\u1eddng h\u1ee3p c\u00e2n nh\u1eafc ch\u1ec9 \u0111\u1ecbnh ECMO, c\u00e1c tuy\u1ebfn d\u01b0\u1edbi\nn\u00ean quy\u1ebft \u0111\u1ecbnh chuy\u1ec3n ng\u01b0\u1eddi b\u1ec7nh s\u1edbm v\u00e0 tu\u00e2n th\u1ee7 quy tr\u00ecnh v\u1eadn chuy\u1ec3n ng\u01b0\u1eddi b\u1ec7nh do b\u1ed9 Y t\u1ebf quy \u0111\u1ecbnh.<\/p>\n\n\n\n H\u1ed7 tr\u1ee3 ch\u1ee9c n\u0103ng c\u00e1c c\u01a1 quan:<\/strong><\/p>\n\n\n\n \u1ed4<\/em><\/strong>n \u0111\u1ecbnh huy\u1ebft \u0111\u1ed9ng:<\/em><\/strong>–\n\u0110\u1ea3m b\u1ea3o kh\u1ed1i l\u01b0\u1ee3ng tu\u1ea7n ho\u00e0n, thu\u1ed1c tr\u1ee3 tim, v\u1eadn m\u1ea1ch n\u1ebfu c\u1ea7n<\/p>\n\n\n\n H\u1ed7 tr\u1ee3 ch\u1ee9c n<\/em><\/strong>\u0103<\/em><\/strong>ng th<\/em><\/strong>\u1ead<\/em><\/strong>n<\/em><\/strong>:<\/em><\/strong><\/p>\n\n\n\n – \u0110\u1ea3m b\u1ea3o c\u00e2n b\u1eb1ng\nd\u1ecbch, duy tr\u00ec huy\u1ebft \u0111\u1ed9ng \u1ed5n \u0111\u1ecbnh, thu\u1ed1c l\u1ee3i ti\u1ec3u l\u1ee3i ti\u1ec3u.<\/p>\n\n\n\n – L\u1ecdc m\u00e1u (ng\u1eaft\nqu\u00e3ng ho\u1eb7c li\u00ean t\u1ee5c) hay l\u1ecdc m\u00e0ng b\u1ee5ng khi c\u00f3 ch\u1ec9 \u0111\u1ecbnh<\/p>\n\n\n\n H\u1ed7 tr\u1ee3 ch\u1ee9c n\u0103ng\nc\u00e1c c\u01a1 quan kh\u00e1c:<\/em><\/strong> t\u00f9y\nt\u1eebng tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3<\/em><\/p>\n\n\n\n 3. \u0110i\u1ec1u tr<\/strong>\u1ecb<\/strong>\nh\u1ed7 tr<\/strong>\u1ee3<\/strong>:<\/strong><\/p>\n\n\n\n – D\u00f9ng thu\u1ed1c gi\u1ea3m\nho n\u1ebfu c\u00f3 ho nhi\u1ec1u: nh\u1ecf m\u0169i b\u1eb1ng c\u00e1c thu\u1ed1c nh\u1ecf m\u0169i th\u00f4ng th\u01b0\u1eddng.<\/p>\n\n\n\n – H\u1ea1 s\u1ed1t: N\u1ebfu s\u1ed1t\ntr\u00ean 38,5\u00b0 C\nth\u00ec cho d\u00f9ng thu\u1ed1c h\u1ea1 s\u1ed1t paracetamol v\u1edbi li\u1ec1u: 10 – 15 mg\/kg \u1edf tr\u1ebb em, v\u1edbi ng\u01b0\u1eddi l\u1edbn kh\u00f4ng qu\u00e1 2\ng\/ng\u00e0y.<\/p>\n\n\n\n – \u0110i\u1ec1u ch\u1ec9nh r\u1ed1i lo\u1ea1i\nn\u01b0\u1edbc, \u0111i\u1ec7n gi\u1ea3i v\u00e0 th\u0103ng b\u1eb1ng ki\u1ec1m toan<\/p>\n\n\n\n – \u0110\u1ea3m b\u1ea3o dinh d\u01b0\u1ee1ng,\nki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft<\/p>\n\n\n\n – Tr\u01b0\u1eddng h\u1ee3p b\u1ed9i\nnhi\u1ec5m ph\u1ebf qu\u1ea3n ph\u1ed5i n\u00ean d\u00f9ng kh\u00e1ng sinh ph\u1ed5 r\u1ed9ng v\u00e0 c\u00f3 t\u00e1c d\u1ee5ng v\u1edbi vi khu\u1ea9n\ng\u00e2y nhi\u1ec5m tr\u00f9ng \u1edf b\u1ec7nh vi\u1ec7n.<\/p>\n\n\n\n – \u0110\u1ed1i v\u1edbi tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng, c\u00e2n nh\u1eafc d\u00f9ng gammaglobulin\ntruy\u1ec1n t\u0129nh m\u1ea1ch (IVIG)<\/p>\n\n\n\n – \u0110i\u1ec1u tr\u1ecb b\u1ec7nh n\u1ec1n\n(n\u1ebfu c\u00f3).<\/p>\n\n\n\n 4. Ti\u00eau chu\u1ea9n xu\u1ea5t vi\u1ec7n:<\/strong><\/p>\n\n\n\n Ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c xu\u1ea5t\nvi\u1ec7n khi c\u00f3 \u0111\u1ee7 c\u00e1c ti\u00eau chu\u1ea9n sau:<\/p>\n\n\n\n – H\u1ebft s\u1ed1t \u00edt nh\u1ea5t 3\nng\u00e0y.<\/p>\n\n\n\n – To\u00e0n tr\u1ea1ng t\u1ed1t: M\u1ea1ch,\nhuy\u1ebft \u00e1p, nh\u1ecbp th\u1edf, c\u00e1c x\u00e9t nghi\u1ec7m m\u00e1u tr\u1edf v\u1ec1 b\u00ecnh th\u01b0\u1eddng; X-quang ph\u1ed5i c\u1ea3i thi\u1ec7n.<\/p>\n\n\n\n – Ch\u1ee9c n\u0103ng th\u1eadn tr\u1edf\nv\u1ec1 b\u00ecnh th\u01b0\u1eddng<\/p>\n\n\n\n 5. Sau khi xu\u1ea5t vi\u1ec7n:<\/strong><\/p>\n\n\n\n Ng\u01b0\u1eddi b\u1ec7nh ph\u1ea3i t\u1ef1\ntheo d\u00f5i nhi\u1ec7t \u0111\u1ed9 12 gi\u1edd\/l\u1ea7n, n\u1ebfu nhi\u1ec7t \u0111\u1ed9 cao h\u01a1n 38\u00b0 C \u1edf\nhai l\u1ea7n \u0111o li\u00ean ti\u1ebfp ho\u1eb7c c\u00f3 d\u1ea5u hi\u1ec7u b\u1ea5t th\u01b0\u1eddng kh\u00e1c, ph\u1ea3i \u0111\u1ebfn kh\u00e1m l\u1ea1i ngay t\u1ea1i n\u01a1i\n\u0111\u00e3 \u0111i\u1ec1u tr\u1ecb.<\/p>\n\n\n\n III. PH\u00d2NG L\u00c2Y NHI\u1ec4M VI R\u00daT CORONA M\u1edaI<\/strong><\/p>\n\n\n\n 1. Ph\u00f2ng l\u00e2y nhi\u1ec5m \u1edf ngo\u00e0i c\u1ed9ng \u0111\u1ed3ng:<\/strong><\/p>\n\n\n\n – \u0110eo kh\u1ea9u trang v\u00e0\n\u0111\u1ebfn c\u00e1c c\u01a1 s\u1edf y t\u1ebf kh\u00e1m b\u1ec7nh ngay khi c\u00f3 tri\u1ec7u ch\u1ee9ng h\u00f4 h\u1ea5p.<\/p>\n\n\n\n – V\u1ec7 sinh c\u00e1 nh\u00e2n:<\/p>\n\n\n\n + R\u1eeda tay s\u1ea1ch: R\u1eeda\ntay th\u01b0\u1eddng xuy\u00ean b\u1eb1ng x\u00e0 ph\u00f2ng v\u00e0 n\u01b0\u1edbc ho\u1eb7c b\u1eb1ng dung d\u1ecbch r\u1eeda tay c\u00f3 ch\u1ee9a c\u00f4n,\n\u0111\u1eb7c bi\u1ec7t sau khi h\u1eaft\nh\u01a1i, ho ho\u1eb7c ch\u00f9i m\u0169i.<\/p>\n\n\n\n + Che m\u0169i, mi\u1ec7ng\nkhi c\u00f3 h\u1eaft h\u01a1i v\u00e0 ho, v\u1ee9t c\u00e1c kh\u0103n gi\u1ea5y lau m\u0169i mi\u1ec7ng v\u00e0o th\u00f9ng r\u00e1c ri\u00eang c\u00f3 n\u1eafp\n\u0111\u1eady<\/p>\n\n\n\n + \u0110\u1ea3m b\u1ea3o ch\u1ebf \u0111\u1ed9 \u0103n\n\u0111\u1ea7y \u0111\u1ee7<\/p>\n\n\n\n + Kh\u00f4ng h\u00fat thu\u1ed1c\nl\u00e1.<\/p>\n\n\n\n – V\u1ec7 sinh m\u00f4i tr\u01b0\u1eddng:<\/p>\n\n\n\n + Duy tr\u00ec th\u00f4ng kh\u00ed\nn\u01a1i \u1edf ho\u1eb7c n\u01a1i l\u00e0m vi\u1ec7c t\u1ed1t<\/p>\n\n\n\n + Tr\u00e1nh ti\u1ebfp x\u00fac v\u00e0\nt\u1ee5 t\u1eadp \u1edf n\u01a1i \u0111\u00f4ng ng\u01b0\u1eddi, n\u01a1i kh\u00f4ng tho\u00e1ng kh\u00ed.<\/p>\n\n\n\n + H\u1ea1n ch\u1ebf ti\u1ebfp x\u00fac\ntr\u1ef1c ti\u1ebfp c\u00e1c v\u1eadt nu\u00f4i, \u0111\u1ed9ng v\u1eadt hoang d\u00e3<\/p>\n\n\n\n + Ti\u00eam ph\u00f2ng v\u1eafc\nxin \u0111\u1ea7y \u0111\u1ee7<\/p>\n\n\n\n 2. Ph\u00f2ng l\u00e2y nhi\u1ec5m trong b\u1ec7nh vi\u1ec7n:<\/strong><\/p>\n\n\n\n Th\u1ef1c hi\u1ec7n nghi\u00eam ng\u1eb7t\nvi\u1ec7c ph\u00e2n lu\u1ed3ng kh\u00e1m, c\u00e1ch ly v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n, c\u00e1c bi\u1ec7n ph\u00e1p ki\u1ec3m so\u00e1t\nnhi\u1ec5m khu\u1ea9n, ph\u00f2ng ch\u1ed1ng l\u00e2y nhi\u1ec5m \u0111\u1ed1i v\u1edbi c\u00e1n b\u1ed9 y t\u1ebf, ng\u01b0\u1eddi ch\u0103m s\u00f3c ng\u01b0\u1eddi b\u1ec7nh v\u00e0 c\u00e1c ng\u01b0\u1eddi b\u1ec7nh kh\u00e1c t\u1ea1i c\u00e1c c\u01a1 s\u1edf \u0111i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh theo h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u1ed9 Y t\u1ebf.<\/p>\n\n\n\n 2.1. T\u1ed5 ch\u1ee9c khu v\u1ef1c c\u00e1ch ly:<\/strong><\/p>\n\n\n\n – Khu v\u1ef1c nguy c\u01a1\ncao: N\u01a1i \u0111i\u1ec1u tr\u1ecb v\u00e0 ch\u0103m s\u00f3c ng\u01b0\u1eddi b\u1ec7nh nghi ng\u1edd ho\u1eb7c ch\u1eafc ch\u1eafn nhi\u1ec5m vi r\u00fat\ncorona m\u1edbi. Khu v\u1ef1c n\u00e0y ph\u1ea3i c\u00f3 b\u1ea3ng m\u00e0u \u0111\u1ecf ghi \u201cKhu v\u1ef1c c\u00e1ch ly \u0111\u1eb7c bi\u1ec7t\u201d v\u00e0\nh\u01b0\u1edbng d\u1eabn chi ti\u1ebft treo \u1edf l\u1ed1i v\u00e0o, c\u00f3 ng\u01b0\u1eddi tr\u1ef1c g\u00e1c.<\/p>\n\n\n\n – Khu v\u1ef1c c\u00f3 nguy\nc\u01a1: N\u01a1i c\u00f3 nhi\u1ec1u kh\u1ea3 n\u0103ng c\u00f3 ng\u01b0\u1eddi b\u1ec7nh nhi\u1ec5m vi r\u00fat corona m\u1edbi \u0111\u1ebfn kh\u00e1m v\u00e0 \u0111i\u1ec1u\ntr\u1ecb ban \u0111\u1ea7u (nh\u01b0 khoa h\u00f4 h\u1ea5p, c\u1ea5p c\u1ee9u, kh\u00e1m b\u1ec7nh…). Khu v\u1ef1c n\u00e0y ph\u1ea3i c\u00f3 b\u1ea3ng\nh\u01b0\u1edbng d\u1eabn chi ti\u1ebft treo \u1edf l\u1ed1i ra v\u00e0o v\u00e0 c\u00f3 k\u00fd hi\u1ec7u m\u00e0u v\u00e0ng.<\/p>\n\n\n\n – Ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n \u0111\u01b0\u1ee3c\nc\u00e1ch ly, \u0111i\u1ec1u tr\u1ecb t\u1ea1i c\u01a1 s\u1edf y t\u1ebf, h\u1ea1n ch\u1ebf t\u1ed1i \u0111a bi\u1ebfn ch\u1ee9ng, t\u1eed vong. Th\u1eddi gian\nc\u00e1ch ly \u0111\u1ebfn khi h\u1ebft c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng.<\/p>\n\n\n\n – Ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng\nkh\u00f3 th\u1edf c\u1ea7n s\u1eed d\u1ee5ng kh\u1ea9u trang y t\u1ebf \u0111\u00fang c\u00e1ch khi ti\u1ebfp x\u00fac v\u1edbi ng\u01b0\u1eddi kh\u00e1c \u0111\u1ec3 h\u1ea1n\nch\u1ebf l\u00e2y truy\u1ec1n b\u1ec7nh.<\/p>\n\n\n\n 2.2. Ph\u00f2ng ng\u1eeba cho ng\u01b0\u1eddi b\u1ec7nh v\u00e0 kh\u00e1ch \u0111\u1ebfn th\u0103m:<\/strong><\/p>\n\n\n\n – C\u00e1ch ly ngay nh\u1eefng\nng\u01b0\u1eddi nghi ng\u1edd m\u1eafc b\u1ec7nh, kh\u00f4ng x\u1ebfp chung ng\u01b0\u1eddi \u0111\u00e3 \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh m\u1eafc vi r\u00fat corona v\u1edbi ng\u01b0\u1eddi\nthu\u1ed9c di\u1ec7n nghi ng\u1edd. T\u1ea5t c\u1ea3 \u0111\u1ec1u ph\u1ea3i \u0111eo kh\u1ea9u trang. Vi\u1ec7c ch\u1ee5p X-quang, l\u00e0m c\u00e1c\nx\u00e9t nghi\u1ec7m, kh\u00e1m chuy\u00ean khoa… n\u00ean \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh t\u1ea1i gi\u01b0\u1eddng, n\u1ebfu di chuy\u1ec3n b\u1ec7nh\nnh\u00e2n, ph\u1ea3i c\u00f3 \u0111\u1ea7y \u0111\u1ee7 c\u00e1c ph\u01b0\u01a1ng ti\u1ec7n ph\u00f2ng h\u1ed9. Ng\u01b0\u1eddi b\u1ec7nh kh\u1ea1c nh\u1ed5 v\u00e0o kh\u0103n gi\u1ea5y m\u1ec1m d\u00f9ng m\u1ed9t l\u1ea7n v\u00e0 cho\nngay v\u00e0o th\u00f9ng r\u00e1c y t\u1ebf.<\/p>\n\n\n\n – Th\u1ef1c hi\u1ec7n t\u1ed1t v\u1ec7\nsinh c\u00e1 nh\u00e2n, th\u01b0\u1eddng xuy\u00ean r\u1eeda tay b\u1eb1ng x\u00e0 ph\u00f2ng; s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c s\u00e1t khu\u1ea9n\n\u0111\u01b0\u1eddng m\u0169i h\u1ecdng nh\u01b0: s\u00fac mi\u1ec7ng b\u1eb1ng n\u01b0\u1edbc s\u00e1t khu\u1ea9n v\u00e0 c\u00e1c dung d\u1ecbch s\u00e1t khu\u1ea9n\nm\u0169i h\u1ecdng kh\u00e1c.<\/p>\n\n\n\n – H\u1ea1n ch\u1ebf \u0111\u1ebfn n\u01a1i t\u1ee5\nh\u1ecdp \u0111\u00f4ng ng\u01b0\u1eddi \u0111\u1ec1 ph\u00f2ng l\u00e2y b\u1ec7nh cho ng\u01b0\u1eddi kh\u00e1c.<\/p>\n\n\n\n – Trong th\u1eddi gian\nc\u00f3 d\u1ecbch, h\u1ea1n ch\u1ebf t\u1ed1i \u0111a vi\u1ec7c ti\u1ebfp x\u00fac v\u1edbi ng\u01b0\u1eddi b\u1ec7nh v\u00e0 nh\u1eefng ng\u01b0\u1eddi kh\u00e1c, c\u1ea5m ng\u01b0\u1eddi nh\u00e0 v\u00e0\nkh\u00e1ch \u0111\u1ebfn th\u0103m khu c\u00e1ch ly.<\/p>\n\n\n\n – L\u1eadp danh s\u00e1ch nh\u1eefng\nng\u01b0\u1eddi ti\u1ebfp x\u00fac g\u1ea7n v\u00e0 theo d\u00f5i t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe trong v\u00f2ng 14 ng\u00e0y k\u1ec3 t\u1eeb khi\nti\u1ebfp x\u00fac l\u1ea7n cu\u1ed1i. T\u01b0 v\u1ea5n cho ng\u01b0\u1eddi ti\u1ebfp x\u00fac v\u1ec1 c\u00e1c d\u1ea5u hi\u1ec7u b\u1ec7nh v\u00e0 c\u00e1c bi\u1ec7n\nph\u00e1p ph\u00f2ng, ch\u1ed1ng \u0111\u1ec3 t\u1ef1 ph\u00f2ng b\u1ec7nh, t\u1ef1 theo d\u00f5i, ph\u00e1t hi\u1ec7n s\u1edbm c\u00e1c tri\u1ec7u ch\u1ee9ng\nc\u1ee7a b\u1ec7nh vi\u00eam \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p c\u1ea5p t\u00ednh. N\u1ebfu c\u00f3 xu\u1ea5t hi\u1ec7n c\u00e1c tri\u1ec7u ch\u1ee9ng s\u1ed1t, ho, \u0111au h\u1ecdng, kh\u00f3 th\u1edf … c\u1ea7n th\u00f4ng b\u00e1o ngay cho c\u01a1 s\u1edf y t\u1ebf g\u1ea7n nh\u1ea5t \u0111\u1ec3 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi.<\/p>\n\n\n\n – B\u1ea3o \u0111\u1ea3m th\u00f4ng kh\u00ed\nt\u1ed1t cho c\u00e1c bu\u1ed3ng b\u1ec7nh.<\/p>\n\n\n\n 2.3. Ph\u00f2ng ng\u1eeba cho nh\u00e2n vi\u00ean y t\u1ebf:<\/strong><\/p>\n\n\n\n – D\u00f9ng kh\u1ea9u trang\nngo\u1ea1i khoa, k\u00ednh b\u1ea3o h\u1ed9, m\u1eb7t n\u1ea1 che m\u1eb7t, \u00e1o cho\u00e0ng gi\u1ea5y d\u00f9ng m\u1ed9t l\u1ea7n, g\u0103ng tay, m\u0169, bao gi\u1ea5y ho\u1eb7c \u1ee7ng. Khi l\u00e0m th\u1ee7 thu\u1eadt ho\u1eb7c\nch\u0103m s\u00f3c tr\u1ef1c ti\u1ebfp ng\u01b0\u1eddi b\u1ec7nh n\u00ean s\u1eed d\u1ee5ng kh\u1ea9u trang N95. B\u1ec7nh ph\u1ea9m x\u00e9t nghi\u1ec7m\nph\u1ea3i \u0111\u01b0\u1ee3c \u0111\u1eb7t trong t\u00fai nylon ho\u1eb7c h\u1ed9p v\u1eadn chuy\u1ec3n. R\u1eeda tay b\u1eb1ng x\u00e0 ph\u00f2ng ho\u1eb7c\ndung d\u1ecbch s\u00e1t khu\u1ea9n sau khi ti\u1ebfp x\u00fac v\u1edbi d\u1ecbch ti\u1ebft \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p, d\u1ee5ng c\u1ee5 b\u1ea9n,\nch\u0103m s\u00f3c ng\u01b0\u1eddi b\u1ec7nh, sau khi th\u00e1o g\u0103ng tay, kh\u1ea9u trang v\u00e0 tr\u01b0\u1edbc khi r\u1eddi bu\u1ed3ng b\u1ec7nh,\nkhu v\u1ef1c c\u00e1ch ly. Nh\u1eefng ng\u01b0\u1eddi ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi ng\u01b0\u1eddi b\u1ec7nh \u1edf khu v\u1ef1c c\u00e1ch ly \u0111\u1eb7c bi\u1ec7t ph\u1ea3i t\u1eafm,\nthay qu\u1ea7n \u00e1o tr\u01b0\u1edbc khi ra kh\u1ecfi b\u1ec7nh vi\u1ec7n.<\/p>\n\n\n\n – B\u1ec7nh vi\u1ec7n c\u1ea7n l\u1eadp\ndanh s\u00e1ch nh\u00e2n vi\u00ean y t\u1ebf l\u00e0m vi\u1ec7c t\u1ea1i khoa c\u00f3 ng\u01b0\u1eddi b\u1ec7nh nhi\u1ec5m vi r\u00fat corona m\u1edbi.\nH\u1ecd s\u1ebd t\u1ef1 theo d\u00f5i\nnhi\u1ec7t \u0111\u1ed9 h\u1eb1ng ng\u00e0y, n\u1ebfu c\u00f3 d\u1ea5u hi\u1ec7u nghi m\u1eafc vi r\u00fat corona m\u1edbi s\u1ebd \u0111\u01b0\u1ee3c kh\u00e1m,\nl\u00e0m c\u00e1c x\u00e9t nghi\u1ec7m v\u00e0 theo d\u00f5i.<\/p>\n\n\n\n 2.4. X\u1eed l\u00fd d\u1ee5ng c\u1ee5, \u0111\u1ed3 v\u1ea3i v\u00e0 \u0111\u1ed3 d\u00f9ng sinh ho\u1ea1t cho b\u1ec7nh\nnh\u00e2n:<\/strong><\/p>\n\n\n\n Th\u1ef1c hi\u1ec7n theo quy\ntr\u00ecnh ki\u1ec3m so\u00e1t nhi\u1ec5m khu\u1ea9n c\u1ee7a B\u1ed9 Y t\u1ebf.<\/p>\n\n\n\n 2.5. X\u1eed l\u00fd m\u00f4i tr\u01b0\u1eddng v\u00e0 ch\u1ea5t th\u1ea3i b\u1ec7nh vi\u1ec7n:<\/strong><\/p>\n\n\n\n C\u00e1c m\u1eb7t b\u1eb1ng, b\u00e0n\ngh\u1ebf \u1edf khu v\u1ef1c bu\u1ed3ng b\u1ec7nh v\u00e0 khu v\u1ef1c c\u00e1ch ly ph\u1ea3i \u0111\u01b0\u1ee3c lau t\u1ed1i thi\u1ec3u 2 l\u1ea7n\/ng\u00e0y\nb\u1eb1ng c\u00e1c h\u00f3a ch\u1ea5t s\u00e1t khu\u1ea9n. Nh\u00e2n vi\u00ean l\u00e0m v\u1ec7 sinh ph\u1ea3i s\u1eed d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ti\u1ec7n\nph\u00f2ng h\u1ed9 nh\u01b0 nh\u00e2n vi\u00ean y t\u1ebf. M\u1ecdi ch\u1ea5t th\u1ea3i r\u1eafn t\u1ea1i khu v\u1ef1c c\u00e1ch ly \u0111\u1eb7c bi\u1ec7t ph\u1ea3i\n\u0111\u01b0\u1ee3c thu gom \u0111\u1ec3 \u0111em \u0111i ti\u00eau h\u1ee7y theo quy \u0111\u1ecbnh c\u1ee7a B\u1ed9 Y t\u1ebf.<\/p>\n\n\n\n 2.6. V\u1eadn chuy\u1ec3n ng\u01b0\u1eddi b\u1ec7nh:<\/strong><\/p>\n\n\n\n H\u1ea1n ch\u1ebf v\u1eadn chuy\u1ec3n\nng\u01b0\u1eddi b\u1ec7nh, tr\u1eeb nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng, v\u01b0\u1ee3t qu\u00e1 kh\u1ea3 n\u0103ng \u0111i\u1ec1u tr\u1ecb c\u1ee7a c\u01a1 s\u1edf.\nNh\u00e2n vi\u00ean v\u1eadn chuy\u1ec3n ph\u1ea3i mang \u0111\u1ea7y \u0111\u1ee7 ph\u01b0\u01a1ng ti\u1ec7n ph\u00f2ng h\u1ed9. L\u00e0m s\u1ea1ch v\u00e0 kh\u1eed khu\u1ea9n\nxe c\u1ee9u th\u01b0\u01a1ng sau m\u1ed7i l\u1ea7n v\u1eadn chuy\u1ec3n.<\/p>\n\n\n\n 2.7. X\u1eed l\u00fd ng\u01b0<\/strong>\u1edd<\/strong>i b\u1ec7nh t\u1eed vong:<\/strong><\/p>\n\n\n\n Ng\u01b0\u1eddi b\u1ec7nh t\u1eed vong\nph\u1ea3i \u0111\u01b0\u1ee3c kh\u00e2m li\u1ec7m t\u1ea1i ch\u1ed7, ph\u1ea3i kh\u1eed khu\u1ea9n b\u1eb1ng c\u00e1c h\u00f3a ch\u1ea5t Chloramin B,\nPormalin. Chuy\u1ec3n t\u1eed thi \u0111\u1ebfn n\u01a1i ch\u00f4n c\u1ea5t hay h\u1ecfa t\u00e1ng b\u1eb1ng xe chuy\u00ean d\u1ee5ng. T\u1eed thi ph\u1ea3i \u0111\u01b0\u1ee3c h\u1ecfa\nt\u00e1ng ho\u1eb7c ch\u00f4n c\u1ea5t trong v\u00f2ng 24 gi\u1edd t\u1ed1t nh\u1ea5t l\u00e0 h\u1ecfa t\u00e1ng.\/.<\/p>\n","protected":false},"excerpt":{"rendered":" Theo quy\u1ebft 125\/Q\u0110-BYT ban h\u00e0nh ng\u00e0y 16\/01\/2020 Vi r\u00fat corona (CoV) l\u00e0 m\u1ed9t h\u1ecd vi r\u00fat l\u1edbn g\u00e2y b\u1ec7nh t\u1eeb c\u1ea3m l\u1ea1nh th\u00f4ng th\u01b0\u1eddng \u0111\u1ebfn […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6,9,5],"tags":[],"class_list":["post-864","post","type-post","status-publish","format-standard","hentry","category-ban-tin-y-te","category-dao-tao","category-phac-do-dieu-tri"],"_links":{"self":[{"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=\/wp\/v2\/posts\/864","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=864"}],"version-history":[{"count":1,"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=\/wp\/v2\/posts\/864\/revisions"}],"predecessor-version":[{"id":865,"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=\/wp\/v2\/posts\/864\/revisions\/865"}],"wp:attachment":[{"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=864"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=864"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/phongkhamdaihocypnt.edu.vn\/bantin\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=864"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}