key: cord-283231-ju71zm7w
authors: Yu, Juan; Zhang, Han-wen; Lei, Yi
title: RE: Respiratory Infectious Disease in Resource Limited Setting: Radiology Management Advice
date: 2020-04-15
journal: Acad Radiol
DOI: 10.1016/j.acra.2020.03.020
sha: 
doc_id: 283231
cord_uid: ju71zm7w

nan

Dear Dr. Joob, Dr. Wiwanitkit, and Editors-In many countries and regions where access to health care is limited, it is important for medical institutions to develop appropriate programmes to prevent and control respiratory infections.

The characteristics of new respiratory infectious diseases in the early stages of an outbreak are not clear. The most effective way is to isolate them. It is suggested that radiology departments with limited resources take the following measures from the prevention of droplets, aerosols, and contact transmission:

(1) If the institute only has X-ray machines, chest radiographs are important in the diagnosis of pulmonary lesions. Special examination rooms and passageways should be reserved for suspected patients. The signs should be clear and special nurses can accompany the patients to avoid contact with other patients. Operators should make standard protection and try not to contact the patients directly. They can instruct the patients to pose themselves through the protective glass. After that, patients should leave quickly to shorten their stay in the radiology department. Then the examination room should be sterilized and the next patient should be checked at intervals of more than half an hour. If there is no special examination room for suspected patients, try to divide the time period for the ordinary patients and suspected patients. Suspected patients were concentrated in a certain period of time for examination, and the examination room should be thoroughly disinfected after completion. In addition, ordinary patients should be limited to reduce the chance of cross-infection. The use of mobile X-ray machines is also a good option in emergency departments, intensive care units, and isolation rooms.

(2) If CT equipment is available, HRCT scan is adopted, set at 210 mA and 120 kV, slice thickness not more than 3 mm, if possible. It is best to use a special examination room, if not, the method of inspection by time interval is adopted (1,2).

(3) Protection of first-line medical staffs: Disposable medical caps, protective glasses or face masks (anti-fog type), medical protective masks (N95), protective clothing or gowns, disposable latex gloves (double layers), disposable shoe covers are all required, and hand hygiene is strictly implemented (3).

(4) Examination room disinfection: Air disinfection with ultraviolet light, the surface of the object is wiped with a chlorine-containing disinfectant. Set a container for infectious disease medical waste.

(5) Layout of radiology department: The examination room and operation room that directly contact with patients are contaminated areas, and there should be a buffer zone between contaminated areas and cleaning areas.

Operators cannot enter the buffer zone and cleaning area without removing protective clothing and equipment. It should be emphasized that, for non-suspected patients, it is necessary to do a higher level of protection.

These are some of the lessons we have learned in the fight against COVID-19, and we hope to help our colleagues. Thank you! Yours sincerely, Juan Yu, MD, PhD, Han-Wen Zhang, MD, and Yi Lei, MD

CT imaging and differential diagnosis of COVID-19

CT imaging features of 2019 novel coronavirus (2019-nCoV)

Corona virus international public health emergencies: implications for radiology management