最新權威指導:世界衛生組織 WHO 發佈的口罩使用指南來了


導讀


2020 年 1 月 29 日,世界衛生組織的官網正式發了一份非常重要的書面材料,完整的全稱是《在新型冠狀病毒(2019-nCoV)爆發的背景下,對於社區、家庭護理和醫療環境中使用口罩的臨時指南》。

注:風雲之聲內容可以通過語音播放啦!讀者們可下載訊飛有聲APP,聽公眾號,查找“風雲之聲”,即可在線收聽~


2020 年 1 月 29 日,世界衛生組織的官網正式發了一份非常重要的書面材料,完整的全稱是《在新型冠狀病毒(2019-nCoV)爆發的背景下,對於社區、家庭護理和醫療環境中使用口罩的臨時指南》。


書面材料下載鏈接:

https://www.who.int/docs/default-source/documents/advice-on-the-use-of-masks-2019-ncov.pdf?sfvrsn=40619336_1&download=true

ps:請用電腦瀏覽器打開


最新權威指導:世界衛生組織 WHO 發佈的口罩使用指南來了


最新權威指導:世界衛生組織 WHO 發佈的口罩使用指南來了

最新權威指導:世界衛生組織 WHO 發佈的口罩使用指南來了

我看到以後,馬上讓牛牛小編全文翻譯了出來,因為我覺得這份文件出來的很及時,對我們每個人都有幫助。


在翻譯全文之前,我先把我所理解的這份指南中,對我們大多數普通人最具有價值的幾個關鍵點說一下:


  1. 口罩分為醫用防護口罩醫用外科口罩醫用護理口罩,以及日常家庭用的普通棉布口罩。根據我的仔細分析,在世衛組織的文件中提到的醫用口罩指的是醫用防護口罩和某些高標準的醫用外科口罩,最大的特徵是用繩帶打結綁在頭部,或者是一個杯子狀的外形,用繩帶綁或者兩根鬆緊帶套在頭上。也就是說,常見的那種用鬆緊帶掛在耳朵上的的那些薄薄的口罩都不是醫用防護口罩。對於預防這次新型肺炎來說,世衛組織指出,只有醫用口罩是有證據表明有效的。
  2. 假如你買不到醫用防護口罩或者醫用外科口罩,請不要恐慌。因為世衛組織指出,正常情況下,只要你的附近,小於 1 米直徑範圍內沒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。假如你因為戴了口罩而產生虛假的安全感,卻忘了最重要的洗手,那麼就是得不償失的。
  4. 假如你只是偶爾,很正常的咳嗽或者打個噴嚏,最好的處理方式是用手肘或者紙巾來捂住口鼻,而不是用手捂,或者戴著口罩打。
  5. 口罩如果戴著時間久了變溼潤了,就不能再戴,再戴下去,不但不能防住各種細菌病毒,還會增加患病的風險。
  6. 一次性口罩不要重複使用。
  7. 注意啦,在醫療場所,也就是那些高危場所,世衛組織明確指出,戴普通的布或者棉的口罩只會增加健康人的感染風險,要戴只能戴醫用防護口罩。這個道理其實細想一下就能理解,普通棉布口罩根本無法過濾細菌和病毒,反而更容易讓細菌和病毒在你的口罩上聚集,是弊大於利的。


最新權威指導:世界衛生組織 WHO 發佈的口罩使用指南來了

醫用防護口罩


最新權威指導:世界衛生組織 WHO 發佈的口罩使用指南來了

醫用護理口罩


你明白了嗎?如果想節約點口罩,把它用在刀刃上,在

空曠的室內外沒有戴口罩的必要。大家沒必要過度恐慌,病毒沒有電影中的那樣恐怖,吸一口空氣就中毒。請保持理性。


以上這些是世衛組織對我們這些大多數普通健康人的建議,而對於那些疑似並被隔離的人來說,世衛組織有一條非常非常重要的建議,假如現在有人正在看或者聽我這個節目的疑似患者,請你務必聽仔細,這條建議是:如果你正在醫院的單人病房中隔離獨處,請不要佩戴口罩。再說一遍,在單人病房隔離獨處時,不要佩戴任何口罩,包括醫用防護口罩。但是,咳嗽或打噴嚏時要用一次性紙巾捂住口鼻。妥善處理它們,並立即進行手部清潔。


這個道理不難理解,咳嗽和打噴嚏都是人體的免疫反應,對人體是有好處的。你戴了口罩,病菌都噴在了口罩上,容易形成二次感染。但要儘量避免汙染環境。


好,下面是世衛組織發佈的這份口罩使用指南的全文。


最新權威指導:世界衛生組織 WHO 發佈的口罩使用指南來了


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)爆發的背景下,對於社區、家庭護理和醫療環境中使用口罩的臨時指南


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.


世衛組織 2020 年 1 月 29 日在線發表

概述

本文件為已報告新型冠狀病毒(2019-nCoV)爆發地區的社區、家庭和醫療設施使用醫用防護口罩提供了快速建議。這份建議面向公共衛生、感染預防和控制(IPC)專業人員、醫療保健管理人員和工作者,以及社區衛生工作者。隨著更多數據的獲得,我們也將對其進行修訂。


譯者注:中英文的口罩名稱有差異,本文所指的醫用防護口罩(medical mask)也包括部分高標準的醫用外科口罩,但不包括本文中的“醫用護理口罩”。


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.


根據目前掌握的信息,新型冠狀病毒的人傳人途徑是通過呼吸道飛沫和接觸傳播。如果與有打噴嚏、咳嗽等呼吸道症狀的人密切接觸,一般為 1 米以內,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.


本建議所指的醫用防護口罩是那種扁平或摺疊的外科或手術口罩(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

佩戴醫用防護口罩是限制某些呼吸系統疾病(包括新型冠狀病毒)在受影響地區傳播的預防措施之一。然而,僅僅使用口罩不足以提供足夠的保護,應採取其他同等相關的措施。如果要使用口罩,這項措施必須與手部衛生和其他感染預防和控制(IPC)措施相結合,以防止新型冠狀病毒的人際傳播。世衛組織為家庭護理和醫療環境制定了關於感染預防和控制(IPC)戰略的指導,以便在懷疑感染新型冠狀病毒時使用。


在沒有症狀的情況下戴上醫用防護口罩可能會產生不必要的費用,造成採購負擔,併產生虛假的安全感,從而可能導致忽視其他必要措施,如重視手部衛生習慣。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.


社區環境

無呼吸道症狀的個人應:

  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症狀(如咳嗽、打噴嚏)的人保持至少 1 米的距離;
  3. 經常保持手部衛生,如果手沒有被明顯弄髒,用含有酒精的洗手液洗手;否則,請用肥皂和水洗手;
  4. 如果咳嗽或打噴嚏,用彎曲的手肘或紙巾捂住口鼻,使用後應立即處理掉紙巾,並做好手部清潔;
  5. 不要用手接觸口鼻;
  6. 不需要醫用防護口罩,因為沒有證據表明它能保護非病患人群。


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,根據當地風俗習慣,有些國家的人可能也會戴普通口罩。如果使用普通口罩,關於如何佩戴、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.


有呼吸道症狀的個人應:

1. 如果出現發燒、咳嗽和呼吸困難,應儘快或按照當地慣例戴上醫用防護口罩並就醫;

2. 請遵循以下有關口罩適當管理的建議:


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.


家庭護理指南

鑑於目前可獲得的有關新型冠狀病毒及其傳播的數據,世衛組織建議對其感染的疑似病例採用隔離預防措施進行護理,並在醫院環境中進行監測。這將確保醫療的安全性和有效性(以防病人症狀惡化),也能保證公共衛生安全。


但是,由於幾個可能的原因,包括住院床位不夠,或住院環境不安全的情況(即能力和資源有限,無法滿足醫療保健服務的需求),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境中提供醫療保健。此時應遵循如下指導意見:


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.


疑似患者並有輕度呼吸道症狀的個人應:

  1. 經常保持手部衛生,如果手沒有被明顯弄髒,用含有酒精的洗手液洗手;否則,請用肥皂和水洗手;
  2. 儘量與健康人保持距離(至少 1 米);
  3. 為了控制呼吸道分泌物,應為個人提供醫用防護口罩,只要可以忍受,就應儘量佩戴。對於無法忍受醫用防護口罩的患者,則應該嚴格採取呼吸衛生措施,即在咳嗽或打噴嚏時用一次性紙巾捂住口鼻。使用後丟棄材料。接觸呼吸道分泌物後應立即洗手;
  4. 儘可能多地打開窗戶來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.


疑似患者並有輕度呼吸道症狀個人的親屬或照料者應該:

  1. 經常保持手部衛生,如果手沒有被明顯弄髒,用含有酒精的洗手液洗手;否則,請用肥皂和水洗手;
  2. 儘量與病患保持距離(至少 1 米);
  3. 與病患在同一房間時,戴上醫用防護口罩;
  4. 病患使用後的物品應立即丟棄。接觸呼吸道分泌物後立即清潔雙手
  5. 儘可能多地打開窗戶來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.


醫療機構中

有呼吸道症狀的個人應:

  1. 在分流區或候診區等待,或在場所內活動期間,戴上醫用防護口罩;
  2. 在與疑似或確診病例同處的場所內,戴上醫用防護口罩;
  3. 在單人房間隔離獨處時不要佩戴醫用防護口罩,咳嗽或打噴嚏時用一次性紙巾捂住口鼻。妥善處理它們,並立即進行手部清潔。


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.


醫務工作者應:

  1. 進入收治疑似或確診患者的房間時,以及在為他們提供任何護理的情況下,佩戴醫用防護口罩;
  2. 在執行氣霧生成程序(如氣管插管、無創通氣、氣管切開、心肺復甦、插管前人工通氣、支氣管鏡檢查)時,使用微粒呼吸器,其防護能力至少應達到美國國家職業安全與健康研究所(NIOSH)認證的 N95、歐盟(EU)標準 FFP2 或同等標準。


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

如果戴上醫用防護口罩,必須適當使用和處理,以確保其有效,並避免因不正確使用和處理口罩而增加傳播風險。


以下關於正確使用醫用防護口罩的信息,來源於醫療場所的實踐:

  1. 仔細找對口罩的佩戴位置,蓋住口鼻,繫好綁帶保證安全,儘可能減少臉部與口罩之間的空隙;
  2. 使用過程中,避免觸摸口罩;
  3. 使用適當的方法取下口罩(即不要觸摸前面,而是從後面取下綁帶);
  4. 取下後或在無意中觸摸了用過的口罩,應用含酒精的洗手液清潔雙手;如明顯弄髒,用肥皂和水清潔雙手;
  5. 一旦口罩受潮/變溼潤,立即更換新的乾淨、乾燥的口罩;
  6. 不要重複使用一次性口罩;
  7. 一次性口罩,每次使用後應立即丟棄。在任何情況下都不建議使用棉或紗布口罩(譯者注:特指在醫療場所中)。


最新權威指導:世界衛生組織 WHO 發佈的口罩使用指南來了


以上是全文,限於時間有限,水平有限,有可能會有翻譯錯誤,我附上了英文全文,請有能力的讀者自行查閱原文。假如我的理解與原文有衝突的,請務必以原文為準。


尤其是我對各種口罩類型的理解是臨時抱佛腳的,不一定準確,僅供各位參考,希望有專業人士留言補充。但注意不要講的太專業,講的太專業對普通大眾而言不實用。


最後我想說,我國有 14 億人口,現在的情況是,去掉可能最偏遠地區的 1 億人口,我想至少有 13 億人都有戴口罩的需求,可是大家注意聽一下新聞就知道了,假如 13 億人每人每天需要一隻口罩,那麼全世界的口罩產能都不足以供應給我們。


這就說明一個很殘酷的現實是,大多數人其實都買不到口罩,更不要說是醫用口罩了,即使買到了,也根本不夠一天一個這樣消耗的。


在這種情況下,怎樣合理使用有限的資源,讓它們發揮最大的效用,是值得我們每個人都瞭解的。我們健康人每合理減少一個口罩的使用,就能為最需要它們的人增加一個口罩的使用,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。


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病毒來襲,科學家告訴你這樣選口罩 | 117三人行


背景簡介:本文作者為汪詰,文章於2020年1月30日發表於微信公眾號 科學有故事(最新權威指導 | 世界衛生組織 WHO 發佈的口罩使用指南來了!),風雲之聲獲權轉載。


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