Traffic Control Strategy inSARS Outbreak Control.ppt

Traffic Control Strategy in SARS Outbreak Control Muh-Yong Yen, Yu-sen E. Lin, Ih-Jen Su, Mei-Shang Ho, Kuang-Huan Tan, Chen-Hsen Lee Jen-Ai Municipal Hospital, Taipei City Veterans General Hospital, Kaohsiung STOP SARS at the bedside Life finds the way SARS is looking for the niche/leak to jump into next victims (HCW) Niche, leak Waves niche reasons/solution 1st wave 20-30 % mask glove 2nd wave 3-5 % PPE, NPIR 3rd wave 1 – 0.1 % intubation team Next wave ?? New concept ! HCW first, Patient next Traffic Control Myth of negative pressure Introduction The health officials shut down and quarantine the hospital to control nosocomial transmission. More than one thousand persons afected, chaos and panic rapidly ensued within the hospital. The president of Taiwan made an executive decision to evacuate the hospital within 36 hours. METHODS Renovation of hospitals A hospital: 67 beds B hospital: 18 beds Comparison Hospitals 746 NPIRs Hospital A, 松山 The first floor is an admission office that has a special pathway which leads the patient directly to the elevator The third floor is designated ward for suspect SARS cases, the fourth floor is for probable or confirmed cases. Hospital A, 松山 A residential apartment within 2 meters to the east. A “negative-pressure like” environment all windows due east were sealed air tight. A 16-inch exhaust fan was installed in patient’s rooms due west. All doors/bottom gap of patient’s rooms were sealed. Hospital A, 松山 The exits and staircase of each floor was sealed to prevent air interflow between floors. A separate central air conditioning system was used to circulate air within each floor with 50% of air-exchange rate. All of the exhaust air to the west was blow to a 60 by 30 meters restricted area, Hospital B, 松德 a 4-story healthcare facility for patients with tbc / chronic diseases. the first floor is the admission office with a