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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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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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?