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最新權(quán)威指導(dǎo) | 世界衛(wèi)生組織 WHO 發(fā)布的口罩使用指南來(lái)了!

【科友召集】


2020 年 1 月 29 日,世界衛(wèi)生組織的官網(wǎng)正式發(fā)了一份非常重要的書(shū)面材料,完整的全稱是《在新型冠狀病毒(2019-nCoV)爆發(fā)的背景下,對(duì)于社區(qū)、家庭護(hù)理和醫(yī)療環(huán)境中使用口罩的臨時(shí)指南》。

書(shū)面材料下載鏈接:
https://www.who.int/docs/default-source/documents/advice-on-the-use-of-masks-2019-ncov.pdf?sfvrsn=40619336_1&download=true
ps:請(qǐng)用電腦瀏覽器打開(kāi)



我看到以后,馬上讓牛牛小編全文翻譯了出來(lái),因?yàn)槲矣X(jué)得這份文件出來(lái)的很及時(shí),對(duì)我們每個(gè)人都有幫助。

在翻譯全文之前,我先把我所理解的這份指南中,對(duì)我們大多數(shù)普通人最具有價(jià)值的幾個(gè)關(guān)鍵點(diǎn)說(shuō)一下

  1. 口罩分為醫(yī)用防護(hù)口罩、醫(yī)用外科口罩醫(yī)用護(hù)理口罩,以及日常家庭用的普通棉布口罩。在世衛(wèi)組織的文件中提到的醫(yī)用口罩特指醫(yī)用防護(hù)口罩,最大的特征是用繩帶打結(jié)綁在頭部,或者是一個(gè)杯子狀的外形,用繩帶綁或者兩根松緊帶套在頭上。也就是說(shuō),常見(jiàn)的那種用松緊帶掛在耳朵上的的那些薄薄的口罩都不是醫(yī)用防護(hù)口罩。對(duì)于預(yù)防這次新型肺炎來(lái)說(shuō),世衛(wèi)組織指出,只有醫(yī)用防護(hù)口罩是有證據(jù)表明有效的。
  2. 假如你買不到醫(yī)用防護(hù)口罩,請(qǐng)不要恐慌。因?yàn)槭佬l(wèi)組織指出,正常情況下,只要你的附近,小于 1 米直徑范圍內(nèi)沒(méi)有咳嗽或者打噴嚏的疑似患者,你就是安全的。
  3. 洗手比戴口罩更重要。假如你因?yàn)榇髁丝谡侄a(chǎn)生虛假的安全感,卻忘了最重要的洗手,那么就是得不償失的。
  4. 假如你只是偶爾,很正常的咳嗽或者打個(gè)噴嚏,最好的處理方式是用手肘或者紙巾來(lái)捂住口鼻,而不是用手捂,或者戴著口罩打。
  5. 口罩如果戴著時(shí)間久了變濕潤(rùn)了,就不能再戴,再戴下去,不但不能防住各種細(xì)菌病毒,還會(huì)增加患病的風(fēng)險(xiǎn)。
  6. 一次性口罩不要重復(fù)使用。
  7. 注意啦,在醫(yī)療場(chǎng)所,也就是那些高危場(chǎng)所,世衛(wèi)組織明確指出,戴普通的布或者棉的口罩只會(huì)增加健康人的感染風(fēng)險(xiǎn),要戴只能戴醫(yī)用防護(hù)口罩。這個(gè)道理其實(shí)細(xì)想一下就能理解,普通口罩根本無(wú)法過(guò)濾細(xì)菌和病毒,反而更容易讓細(xì)菌和病毒在你的口罩上聚集,是有百害而無(wú)一利的。

醫(yī)用防護(hù)口罩

醫(yī)用護(hù)理口罩


你明白了嗎?如果想節(jié)約點(diǎn)口罩,把它用在刀刃上,在空曠的室內(nèi)外沒(méi)有戴口罩的必要。大家沒(méi)必要過(guò)度恐慌,病毒沒(méi)有電影中的那樣恐怖,吸一口空氣就中毒。請(qǐng)保持理性。

以上這些是世衛(wèi)組織對(duì)我們這些大多數(shù)普通健康人的建議,而對(duì)于那些疑似并被隔離的人來(lái)說(shuō),世衛(wèi)組織有一條非常非常重要的建議,假如現(xiàn)在有人正在看或者聽(tīng)我這個(gè)節(jié)目的疑似患者,請(qǐng)你務(wù)必聽(tīng)仔細(xì),這條建議是:如果你正在醫(yī)院的單人病房中隔離獨(dú)處,請(qǐng)不要佩戴口罩。再說(shuō)一遍,在單人病房隔離獨(dú)處時(shí),不要佩戴任何口罩,包括醫(yī)用防護(hù)口罩。但是,咳嗽或打噴嚏時(shí)要用一次性紙巾捂住口鼻。妥善處理它們,并立即進(jìn)行手部清潔。

這個(gè)道理不難理解,咳嗽和打噴嚏都是人體的免疫反應(yīng),對(duì)人體是有好處的。你戴了口罩,病菌都噴在了口罩上,容易形成二次感染。但要盡量避免污染環(huán)境。

好,下面是世衛(wèi)組織發(fā)布的這份口罩使用指南的全文。


Advice on the use of masks the community, during home care and in health care settings in the context of the novel coronavirus (2019-nCoV) outbreakInterim guidance

在新型冠狀病毒(2019-nCoV)爆發(fā)的背景下,對(duì)于社區(qū)、家庭護(hù)理和醫(yī)療環(huán)境中使用口罩的臨時(shí)指南

29January 2020WHO/nCov/IPC_Masks/2020.1

Introduction
This document provides rapid advice on the use of medical masks in communities, at home and at health care facilities in areas that have reported outbreaks caused by the 2019 novel coronavirus (2019-nCoV). It is intended for public health and infection prevention and control (IPC) professionals, health care managers, health care workers and community health workers. It will be revised as more data become available.

世衛(wèi)組織 2020 年 1 月 29 日在線發(fā)表

概述
本文件為已報(bào)告新型冠狀病毒(2019-nCoV)爆發(fā)地區(qū)的社區(qū)、家庭和醫(yī)療設(shè)施使用醫(yī)用防護(hù)口罩提供了快速建議。這份建議面向公共衛(wèi)生、感染預(yù)防和控制(IPC)專業(yè)人員、醫(yī)療保健管理人員和工作者,以及社區(qū)衛(wèi)生工作者。隨著更多數(shù)據(jù)的獲得,我們也將對(duì)其進(jìn)行修訂。

With the current information available, it is suggested that the route of human-to-human transmission of 2019-nCoV is either via respiratory droplets or contact. Any person who is in close contact (within 1 meter) with someone who has respiratory symptoms (e.g., sneezing, coughing, etc.) is at risk of being exposed to potentially infective respiratory droplets.

根據(jù)目前掌握的信息,新型冠狀病毒的人傳人途徑是通過(guò)呼吸道飛沫和接觸傳播。如果與有打噴嚏、咳嗽等呼吸道癥狀的人密切接觸,一般為 1 米以內(nèi),就有可能被傳染。

Medical masks are surgical or procedure masks that are flat or pleated (some are like cups); they are affixed to the head with strapsa.

本建議所指的醫(yī)用防護(hù)口罩是那種扁平或折疊的外科或手術(shù)口罩(有些像杯子);它們用繩帶固定在頭部。

General Advice
Wearing a medical mask is one of the prevention measures to limit spread of certain respiratory diseases, including 2019-nCoV, in affected areas. However, the use of a mask alone is insufficient to provide the adequate level of protection and other equally relevant measures should be adopted. If masks are to be used, this measure must be combined with hand hygiene and other IPC measures to prevent the human-to-human transmission of 2019-nCov. WHO has developed guidance for home care and health care settings on infection prevention and control (IPC) strategies for use when infection with 2019-nCoV is suspected.

Wearing medical masks when not indicated may cause unnecessary cost, procurement burden and create a false sense of security that can lead to neglecting other essential measures such as hand hygiene practices. Furthermore, using a mask incorrectly may hamper its effectiveness to reduce the risk of transmission.

總體建議
佩戴醫(yī)用防護(hù)口罩是限制某些呼吸系統(tǒng)疾?。òㄐ滦凸跔畈《荆┰谑苡绊懙貐^(qū)傳播的預(yù)防措施之一。然而,僅僅使用口罩不足以提供足夠的保護(hù),應(yīng)采取其他同等相關(guān)的措施。如果要使用口罩,這項(xiàng)措施必須與手部衛(wèi)生和其他感染預(yù)防和控制(IPC)措施相結(jié)合,以防止新型冠狀病毒的人際傳播。世衛(wèi)組織為家庭護(hù)理和醫(yī)療環(huán)境制定了關(guān)于感染預(yù)防和控制(IPC)戰(zhàn)略的指導(dǎo),以便在懷疑感染新型冠狀病毒時(shí)使用。

在沒(méi)有癥狀的情況下戴上醫(yī)用防護(hù)口罩可能會(huì)產(chǎn)生不必要的費(fèi)用,造成采購(gòu)負(fù)擔(dān),并產(chǎn)生虛假的安全感,從而可能導(dǎo)致忽視其他必要措施,如重視手部衛(wèi)生習(xí)慣。此外,戴口罩的目的是為了減少病毒傳播,但如果佩戴不正確,有效性可能會(huì)打折扣。

Community setting
Individuals without respiratory symptoms should:
  1. avoid agglomerations and frequency of closed crowded spaces;
  2. maintain distance of at least 1 meter from any individual with 2019-nCoV respiratory symptoms (e.g., coughing, sneezing);
  3. perform hand hygiene frequently, using alcohol-based hand rub if hands are not visibly soiled or soap and water when hands are visibly soiled;
  4. if coughing or sneezing cover nose and mouth with flexed elbow or paper tissue, dispose of tissue immediately after use and perform hand hygiene;
  5. refrain from touching mouth and nose;
  6. a medical mask is not required, as no evidence is available on its usefulness to protect non-sick persons.

社區(qū)環(huán)境
無(wú)呼吸道癥狀的個(gè)人應(yīng):
  1. 避免頻繁聚集在封閉、擁擠的空間;

  2. 與任何有新型冠狀病毒呼吸癥狀(如咳嗽、打噴嚏)的人保持至少 1 米的距離;

  3. 經(jīng)常保持手部衛(wèi)生,如果手沒(méi)有被明顯弄臟,用含有酒精的洗手液洗手;否則,請(qǐng)用肥皂和水洗手;

  4. 如果咳嗽或打噴嚏,用彎曲的手肘或紙巾捂住口鼻,使用后應(yīng)立即處理掉紙巾,并做好手部清潔;

  5. 不要用手接觸口鼻;

  6. 不需要醫(yī)用防護(hù)口罩,因?yàn)闆](méi)有證據(jù)表明它能保護(hù)非病患人群。


However, masks might be worn in some countries according to local cultural habits. If masks are used, best practices should be followed on how to wear, remove, and dispose of them and on hand hygiene action after removal (see below advice regarding appropriate mask management).

不過(guò),根據(jù)當(dāng)?shù)仫L(fēng)俗習(xí)慣,有些國(guó)家的人可能也會(huì)戴普通口罩。如果使用普通口罩,關(guān)于如何佩戴、取下和處置口罩,以及如何洗手的最佳做法,你需要遵循我們的如下建議:
 
Individuals with respiratory symptoms should:
  1. wear a medical mask and seek medical care if experiencing fever, cough and difficulty breathing, as soon as possible or in accordance with to local protocols;
  2. follow the below advice regarding appropriate mask management.

有呼吸道癥狀的個(gè)人應(yīng):
1. 如果出現(xiàn)發(fā)燒、咳嗽和呼吸困難,應(yīng)盡快或按照當(dāng)?shù)貞T例戴上醫(yī)用防護(hù)口罩并就醫(yī);
2. 請(qǐng)遵循以下有關(guān)口罩適當(dāng)管理的建議:

Home Care
In view of the currently available data on the disease and its transmission, WHO recommends that suspected cases of 2019-nCoV infection be cared for using isolation precautions and monitored in a hospital setting. This would ensure both safety and quality of health care (in case patients’ symptoms worsen) and public health security.

However, for several possible reasons, including situations when inpatient care is unavailable or unsafe (i.e. limited capacity and resources unable to meet demand for health care services), or in a case of informed refusal of hospitalization, home settings for health care provision may need to be considered. Specific IPC guidance for home care should be followedb.

家庭護(hù)理指南
鑒于目前可獲得的有關(guān)新型冠狀病毒及其傳播的數(shù)據(jù),世衛(wèi)組織建議對(duì)其感染的疑似病例采用隔離預(yù)防措施進(jìn)行護(hù)理,并在醫(yī)院環(huán)境中進(jìn)行監(jiān)測(cè)。這將確保醫(yī)療的安全性和有效性(以防病人癥狀惡化),也能保證公共衛(wèi)生安全。

但是,由于幾個(gè)可能的原因,包括住院床位不夠,或住院環(huán)境不安全的情況(即能力和資源有限,無(wú)法滿足醫(yī)療保健服務(wù)的需求),或者在病患獲知病情但拒絕住院的情況下,可能需要考慮在家庭環(huán)境中提供醫(yī)療保健。此時(shí)應(yīng)遵循如下指導(dǎo)意見(jiàn):

Individuals with suspected 2019-nCoV infection with mild respiratory symptoms should:
  1. perform hand hygiene frequently, using alcohol-based hand rub if hands are not visibly soiled or soap and water when hands are visibly soiled;
  2. keep distance from well individuals as much as possible (at least 1 meter);
  3. to contain respiratory secretions, a medical mask should be provided to the individual and worn as much as possible, if it can be tolerated. For individuals who cannot tolerate a medical mask, he/she should rigorously apply respiratory hygiene, i.e. cover mouth and nose when coughing or sneezing with disposable paper tissue. Dispose of the material after use. Clean hands immediately after contact with respiratory secretions;
  4. improve airflow in living space by opening windows and door as much as possible.

疑似患者并有輕度呼吸道癥狀的個(gè)人應(yīng):
  1. 經(jīng)常保持手部衛(wèi)生,如果手沒(méi)有被明顯弄臟,用含有酒精的洗手液洗手;否則,請(qǐng)用肥皂和水洗手;
  2. 盡量與健康人保持距離(至少 1 米);
  3. 為了控制呼吸道分泌物,應(yīng)為個(gè)人提供醫(yī)用防護(hù)口罩,只要可以忍受,就應(yīng)盡量佩戴。對(duì)于無(wú)法忍受醫(yī)用防護(hù)口罩的患者,則應(yīng)該嚴(yán)格采取呼吸衛(wèi)生措施,即在咳嗽或打噴嚏時(shí)用一次性紙巾捂住口鼻。使用后丟棄材料。接觸呼吸道分泌物后應(yīng)立即洗手;
  4. 盡可能多地打開(kāi)窗戶來(lái)改善居住空間的空氣流通。

Relatives or caregivers to individuals with suspected 2019-nCoV infection with mild respiratory symptoms should:

  1. perform hand hygiene frequently, using alcohol-based hand rub if hands are not visibly soiled or soap and water when hands are visibly soiled;

  2. keep distance from affected individual as much as possible (at least 1 meter);

  3. wear a medical mask when in the same room with the affected individual;

  4. dispose of the material immediately after use. Clean hands immediately after contact with respiratory secretions;

  5. improve airflow in living space by opening windows as much as possible.


疑似患者并有輕度呼吸道癥狀個(gè)人的親屬或照料者應(yīng)該:
  1. 經(jīng)常保持手部衛(wèi)生,如果手沒(méi)有被明顯弄臟,用含有酒精的洗手液洗手;否則,請(qǐng)用肥皂和水洗手;
  2. 盡量與病患保持距離(至少 1 米);
  3. 與病患在同一房間時(shí),戴上醫(yī)用防護(hù)口罩;
  4. 病患使用后的物品應(yīng)立即丟棄。接觸呼吸道分泌物后立即清潔雙手
  5. 盡可能多地打開(kāi)窗戶來(lái)改善居住空間的空氣流通。

Health Care Facilities
Individuals with respiratory symptoms should:
  1. wear a medical mask while waiting in triage or waiting areas or during transportation within the facility;
  2. wear a medical mask when staying in cohorting areas dedicated to suspected or confirmed cases;
  3. do not wear a medical mask when isolated in single rooms but cover mouth and nose when coughing or sneezing with disposable paper tissues. Dispose them appropriately and perform hand hygiene immediately afterwards.

醫(yī)療機(jī)構(gòu)中
有呼吸道癥狀的個(gè)人應(yīng):
  1. 在分流區(qū)或候診區(qū)等待,或在場(chǎng)所內(nèi)活動(dòng)期間,戴上醫(yī)用防護(hù)口罩;
  2. 在與疑似或確診病例同處的場(chǎng)所內(nèi),戴上醫(yī)用防護(hù)口罩;
  3. 在單人房間隔離獨(dú)處時(shí)不要佩戴醫(yī)用防護(hù)口罩,咳嗽或打噴嚏時(shí)用一次性紙巾捂住口鼻。妥善處理它們,并立即進(jìn)行手部清潔。

Health care workers should:
  1. wear a medical mask when entering a room where patients suspected or confirmed of being infected with 2019-nCoV are admitted and in any situation of care provided to a suspected or confirmed casec;
  2. use a particulate respirator at least as protective as a US National Institute for Occupational Safety and Health (NIOSH)-certified N95, European Union (EU) standard FFP2, or equivalent, when performing aerosolgenerating procedures such as tracheal intubation, noninvasive ventilation, tracheotomy, cardiopulmonary resuscitation, manual ventilation before intubation, and bronchoscopy.

醫(yī)務(wù)工作者應(yīng):
  1. 進(jìn)入收治疑似或確診患者的房間時(shí),以及在為他們提供任何護(hù)理的情況下,佩戴醫(yī)用防護(hù)口罩;

  2. 在執(zhí)行氣霧生成程序(如氣管插管、無(wú)創(chuàng)通氣、氣管切開(kāi)、心肺復(fù)蘇、插管前人工通氣、支氣管鏡檢查)時(shí),使用微粒呼吸器,其防護(hù)能力至少應(yīng)達(dá)到美國(guó)國(guó)家職業(yè)安全與健康研究所(NIOSH)認(rèn)證的 N95、歐盟(EU)標(biāo)準(zhǔn) FFP2 或同等標(biāo)準(zhǔn)。


Masks management
If medical masks are worn, appropriate use and disposal is essential to ensure they are effective and to avoid any increase in risk of transmission associated with the incorrect use and disposal of masks.

The following information on correct use of medical masks derives from the practices in health-care settingsd:

  1. place mask carefully to cover mouth and nose and tie securely to minimise any gaps between the face and the mask;

  2. while in use, avoid touching the mask;

  3. remove the mask by using appropriate technique (i.e. do not touch the front but remove the lace from behind);

  4. after removal or whenever you inadvertently touch a used mask, clean hands by using an alcohol-based hand rub or soap and water if visibly soiled

  5. replace masks with a new clean, dry mask as soon as they become damp/humid;

  6. do not re-use single-use masks;

  7. discard single-use masks after each use and dispose of them immediately upon removal.Cloth (e.g. cotton or gauze) masks are not recommended under any circumstance.


口罩管理
如果戴上醫(yī)用防護(hù)口罩,必須適當(dāng)使用和處理,以確保其有效,并避免因不正確使用和處理口罩而增加傳播風(fēng)險(xiǎn)。

以下關(guān)于正確使用醫(yī)用防護(hù)口罩的信息,來(lái)源于醫(yī)療場(chǎng)所的實(shí)踐:
  1. 仔細(xì)找對(duì)口罩的佩戴位置,蓋住口鼻,系好綁帶保證安全,盡可能減少臉部與口罩之間的空隙;

  2. 使用過(guò)程中,避免觸摸口罩;

  3. 使用適當(dāng)?shù)姆椒ㄈ∠驴谡郑床灰|摸前面,而是從后面取下綁帶);

  4. 取下后或在無(wú)意中觸摸了用過(guò)的口罩,應(yīng)用含酒精的洗手液清潔雙手;如明顯弄臟,用肥皂和水清潔雙手;

  5. 一旦口罩受潮/變濕潤(rùn),立即更換新的干凈、干燥的口罩;

  6. 不要重復(fù)使用一次性口罩;

  7. 一次性口罩,每次使用后應(yīng)立即丟棄。在任何情況下都不建議使用棉或紗布口罩(譯者注:特指在醫(yī)療場(chǎng)所中)。

以上是全文,限于時(shí)間有限,水平有限,有可能會(huì)有翻譯錯(cuò)誤,我附上了英文全文,請(qǐng)有能力的讀者自行查閱原文。假如我的理解與原文有沖突的,請(qǐng)務(wù)必以原文為準(zhǔn)。

尤其是我對(duì)各種口罩類型的理解是臨時(shí)抱佛腳的,不一定準(zhǔn)確,僅供各位參考,希望有專業(yè)人士留言補(bǔ)充。但注意不要講的太專業(yè),講的太專業(yè)對(duì)普通大眾而言不實(shí)用。

最后我想說(shuō),我國(guó)有 14 億人口,現(xiàn)在的情況是,去掉可能最偏遠(yuǎn)地區(qū)的 1 億人口,我想至少有 13 億人都有戴口罩的需求,可是大家注意聽(tīng)一下新聞就知道了,假如 13 億人每人每天需要一只口罩,那么全世界的口罩產(chǎn)能都不足以供應(yīng)給我們。

這就說(shuō)明一個(gè)很殘酷的現(xiàn)實(shí)是,大多數(shù)人其實(shí)都買不到口罩,更不要說(shuō)是醫(yī)用口罩了,即使買到了,也根本不夠一天一個(gè)這樣消耗的。

在這種情況下,怎樣合理使用有限的資源,讓它們發(fā)揮最大的效用,是值得我們每個(gè)人都了解的。我們健康人每合理減少一個(gè)口罩的使用,就能為最需要它們的人增加一個(gè)口罩的使用,所以,理性看待口罩,正確使用口罩,就是在為防控疫情做出自己的貢獻(xiàn)。



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