1.Death management.pptx
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GUIDELINES ON DEAD BODY MANAGEMENT Scope of the document Key Facts Standard Precautions to be followed by health care workers while handling dead bodies of COVID. Training in infection and prevention control practices Removal of the body from the isolation room or area Environmental cleaning and disinfection Handling of dead body in Mortuary
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There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
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1.Death management.pptx
- 1. Module 4.3 Managing Death during Pandemics
- 2. Description During outbreaks of illnesses, many patients may expire, due to various causes. This is more common among persons of extreme ages (children and elderly) depending on the pathogen. It is also likely to be more common among persons with co-morbidities as well. These co-morbidities may also make them vulnerable to death as well.
- 3. The inevitable consequence of death during pandemics must be handled with extreme caution. The management may start from the time the person becomes sick or is brought in a moribund condition.
- 4. Learning points • The emotional issues for the relatives and HCWs related to death of a person during epidemics. • The principles of documentation and reporting and legal and ethical issues of death during epidemics. • The aspects related to infection control practices like prophylaxis (if any), disinfection etc.
- 5. Death may be unexpected or even expected at times. Many procedures discussed in the previous module may not help in preventing death.
- 6. Breaking the bad news regarding the condition of the patient well in time may ease the handling of death related issues.
- 7. Documentation of death in as much clear terms as possible is absolutely essential.
- 8. Handling of the dead body adhering to the infection control recommendations is also very important. Cooperation from relatives and administration has to be ensured, depending on the situation. The IMG is expected to be well aware of the medical and social consequences of death during a pandemic. Beyond the skills that are necessary to perform these procedures, the IMG should also have the knowledge, attitude and communication skills to manage such a situation.
- 9. Case study - • Mr. Abdul, 50 years old, has been admitted with a febrile illness, which he developed after staying with his son who recently came from a metropolitan city where an unknown disease had been declared. He was intubated and was on ventilator for two days. He was being managed in an isolation room with all airborne precautions. He was showing signs of improvement when he suddenly became unconscious and stopped breathing. Cardio-pulmonary resuscitation was attempted but failed. He died about 15 minutes after he developed the symptoms in the ICU. The doctor declared that he is no more.
- 10. Questions to answer Q 1.How is the event discussed with the relatives? Q 2· What documents are to be prepared regarding the event? Q 3. · What care has to be exercised to prevent the transmission of infection after death? Q4. · How will you discuss the issues with the relatives?