Fwd:

[Anoop Chakrapani]

FYI

---------- Forwarded message ---------
From: rajalakshmi arjun <dr.a.raj...@gmail.com>
Date: Mon, Mar 9, 2020 at 4:44 PM
Subject:
To: Dr M I Sahadulla <m...@kimsglobal.com>, Dr Sahadulla (CMD) <c...@kimsglobal.com>, Dr. Rajan B Associate Dir Clinical Services. <drra...@kimsglobal.com>
Cc: muhammed niyas <niya...@gmail.com>, kalpana varghese <jekal...@gmail.com>, Jerry Philip <jerry....@kimsglobal.com>, Aisha Mubarak <ais...@kimsglobal.com>, Accamma Abraham <accamma...@kimsglobal.com>, Dr Deepak V <deep...@kimsglobal.com>, Dr Mani Varghese <drmani....@kimsglobal.com>, Dr. Zuhara P M <drzu...@kimsglobal.com>, Anoop Chakrapani <anoo...@gmail.com>

Sir,

Request the following circular be sent in the current context of increasing cases within India and abroad. Content as below, can modify.

In the current context of increasing cases of COVID19 within India and abroad, we are preparing ourselves to a situation where we need to admit patients with suspected or confirmed cases as KIMS is identified by Directorate of Health Services, Gov. of Kerala as one of the hospitals for admission. Hospital is preparing by surveillance questionnaire at various entry points, running fever clinic, identifying admission locations without risking other patients, identifying health care professionals to be part of the management team, training them in donning and doffing and isolation precautions, mock drills. Most importantly we need to reinforce our basic infection control practices to perform to our best of abilities and at the same time protecting ourselves. Huge amount of information is being circulated in social media and you would have come across many, but very few are actually put into practice. Kindly follow the instructions below to keep yourself safe.

1. Please find the flow chart attached to direct surveillance questionnaire to patients to identify a case, these may change time to time, and will be circulated. Point of contact would be- fever clinic ext. 2172/ 8644/ Dr. A. Rajalakshmi (ID and HIC)/ Dr. Muhammed Niyas (ID and HIC) / Dr. Kalpana John (HIC). Any further decision on admission or referral will be after this. 

2. Hand hygiene is proven beyond doubt as an important practice to prevent acquiring any infection, more so COVID19. Please make it a habit before and after touching any patient or high touch surfaces (immediate surrounding, door knobs, case files, computer key boards etc., - to protect yourself as well as your next patient. Avoid touching your face after examining patient without performing hand hygiene.

3. Surgical masks are worn if one is sick with respiratory illness or approaching a patient with suspected respiratory illness. In a patient with respiratory illness for asking a surveillance questionnaire and maintaining a distance of 1 metre,  does not need N95 mask. After the questionnaire, if you suspect COVID19 or if the patient needs aerosol producing procedure (like intubation, suctioning etc.,) then N95 mask and full PPE be used. It is important not to waste resources, especially those which we need for the front line staff, who take care of suspected patients. Also educate your patients about hand hygiene and not to misuse mask.

4. Those who are not trained or need further training on donning and doffing- please contact fever clinic for demo and practice.

5. It is a huge task to rule out COVID19 in a every single patient with respiratory illness, thus following surveillance questionnaire is important. In low risk cases evaluating for alternate etiology will help. In undiagnosed cases even if low risk, testing may be considered in consultation with ID consultant. 

6. All posted in the duty list in involved specialities should be available or alternate arrangements made with prior notice so the work force and patient care does not suffer.

7. In case of an emergency situation if a patient brought in critical condition to ER, they must be kept in the cubicle with exhaust on, and be given acute care till stabilisation with appropriate PPE and isolation practices.

Expecting your co-operation.

Dr. A. Rajalakshmi

Senior Consultant in Infectious diseases

Group co-ordinator - Hospital Infection Control

KIMS Hospital

Trivandrum