IAP Guideline on Practicing Safely During COVID-19 Era: Clinics and Small Establishments

Abstract

Justification The unprecedented COVID-19 pandemic has had a formidable impact on Indian health care. With no sight of its end as yet, various establishments including the smaller clinics and nursing homes are restarting full operations. Hence, there is the need for recommendations to allow safe practice ensuring the safety of both the heath care worker (HCW) and patients. Process Indian Academy of Pediatrics organized an online meeting of subject experts on 27 July, 2020. A committee was formed comprising of pediatricians, pediatric and neonatal intensivists, and hospital administrators. The committee held deliberations (online and via emails) and a final consensus was reached by November, 2020. Objectives To develop recommendations to provide a safe and practical healthcare facility at clinics and small establishments during COVID times. Recommendations The key recommendation to practise safely in this setting are enumerated. Firstly, organizing the out-patient department (OPD). Secondly, appropriate personal protective equipment (PPE) to provide protection to the individual. Thirdly, decontamination/disinfection of various common surfaces and equipment to prevent transmission of infection from fomites. Next, maintaining the heating ventilation and air conditioning (HVAC) to provide a stress-free, comfortable, and safe environment for patients and HCWs. Finally, steps to effectively manage COVID-19 exposures in a non-COVID-19 facility. All these measures will ensure safe practice during these unprecedent times in clinics and smaller establishments.

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“…All universal precautions should be followed while handling the contaminated equipment and interfaces. 30…”

“…We should use cuffed endotracheal tubes, head box and filters in older children while intubating. 5,29,30 Avoid bag and mask ventilation if possible, to limit aerosolization but if unavoidable then low tidal volumes should be used. Intubation should be done by experienced and trained person to decrease contact time and to limit spread of infection with minimum attempt.…”

“…Risk assessment and of close contacts for healthcare workers should be assessed once exposure has occurs. 30 All treating paediatrician should follow all practical advisory and recommendation of safety measures issued by IAP while practicing safely during covid era in their clinics and PICUs to cut down the risk of infections. Key recommendations has been recently issued by Indian Academy Of Paediatrics and printed in journal INDIAN PEDIATRICS.…”

“…Key recommendations has been recently issued by Indian Academy Of Paediatrics and printed in journal INDIAN PEDIATRICS. 30…”