Respiratory Distress: Analysis of SARS - Essay Example

?Running Head: RESPIRTAORY DISTRESS: ANALYSIS OF SARS Respiratory Distress: Analysis of SARS Respiratory Distress: Analysis of SARSIntroduction The case of SARS is both a testament to modern technology in dealing with disease outbreaks and a case study on how easy it is for a disease to spread throughout the world where modern travel carries it easily from one site to the next. SARS was initially contracted through interaction with an infected animal at a Chinese market, but through a healthcare worker, one of the most vulnerable groups to the illness, was spread into Hong Kong where it was then taken throughout a variety of other nations. Although the outbreak ended in 2003, the reoccurrence of the infection is possible because it is a cross species exposure that creates the introduction into the human population and there is little that can be done to fully protect against a new outbreak. Through protocols that provide for rapid information, reporting the illness and preventing its spread can now contribute to protecting the population. The following paper analyses the initial outbreak in 2002 and its spread throughout the world and then explores appropriate protocols for reporting a discovery of the illness within the community. In addition, information on addressing poor air quality environments for respiratory patients is explored to further the examination of influences on respiratory through poor air quality and the modification of treatment during these periods of time. Analysis The Outbreak The origin of the introduction of the illness into the human population was likely from a bat that interacted with an intermediary animal that was then sold in a Chinese food market. The virus is found in the Himalayan palm civet and the raccoon dog which are suspected to get the virus from bats, both having been present at the market that was the origin of the virus and might have either one been responsible for the outbreak into the human population (Shetty, Tang, & Andrews, 2009). The first documented case of the illness occurred in the Guangdong province of China. The illness was identified as coming from a unique Coronavirus that was identified as the etiological origin of the disease that could travel between humans through contact at an efficient rate. A doctor who had been treating patients in the province traveled to Hong Kong and began the outbreak from exposing to the virus those he encountered in the city and at a social gathering. Those he encountered spread the illness into other regions of Hong Kong, Vietnam, Canada and Singapore (see Figure 1). This spread of the illness brought it into the notice of the global community which provided for action that contained the illness within four months of the initial outbreak. (M’ikanatha, 2007). Figure 1 Spread of the SARS Virus from Hong Kong (M’ikanatha, 2007, p. 512) The Epidemiology SARS or Severe Acute Respiratory Syndrome developed in 2002 in Hong Kong with the disease spreading worldwide causing 916 deaths and over 8,000 known cases. The cause of the outbreak was the Coronavirus which is found in avian and mammal populations and is important for some species, but can cause respiratory tract infections in a variety of more domesticated species, including humans (M'ikanatha, 2007). The illness ran its course from the winter of 2002 until the last reported case in June of 2003. Overall fatality was averaged at about 10.9%, with only 1% occurring in those under 24 and 6% for over the age of 25. It was worse for those over the age of 44 with a 15% rate of fatality and a 50% rate of fatality for those over the age of 65 (World Health Organization (WHO), 2012). M’ikanatha (2007) describes the following factors as unique aspects of the SARS virus: the agent of the disease was novel, the transmission mode of the virus and how to prevent the spread was unknown, the World Health Organization issued a rare global alert, it created population fears that were unique to the time, healthcare workers were the most frequent victims and the use of integrated international surveillance was used to monitor and track the illness in order to address the outbreak. SARS was more of an issue in the healthcare industry because the exposure to the virus was concentrated during the care of patients. Because of the nature of the illness, protocols were often instituted after exposure where diagnosis was delayed or a lack of recognition of the infection occurred. The incubation of the virus was anywhere from 2 to 10 days, with symptoms developing most often around the fifth day after exposure. This meant that while unaware of the illness, healthcare workers could expose others to the infection and continue its spread. As a result, some healthcare facilities began to quarantine healthcare workers who had been exposed. The development of protocols to relieve the workers of the spread of infection was put into place in order to support containment (Lautenbach, Woeltie, & Malani, 2010). The most important part of the overall process was to develop a way to contain the disease so that a worldwide epidemic could not destroy a significant portion of the population. Community Health Nurse Response Reporting and Reaction Protocols Reporting starts with going up the chain of command, contacting the superior who has access to the proper channels towards getting the information out of the healthcare clinic. A nurse might go to the nursing supervisor who would then go to the administrating physician in the hospital. He would then contact the local health department and the CDC (Center for Disease Control). The CDC would then take the information to the World Health Organization which could implement tracking protocols in order to find the origin and spread of the illness so that containment could be achieved. In addition to reporting externally, internal awareness is vital in preventing the disease from spreading from contact through healthcare workers as the contract the virus then spread it pre-symptomatic response. The supervisors in the exposed departments would put into place the protocols that have been determined in relationship to response to exposure and quarantine any healthcare workers who are known to be directly at risk. Hospital administration would then put into force protocols that are intended to contain the spread of the virus. Poor Air Quality One of the problems that presents for patients with respiratory illnesses or conditions is that the air quality will vary, meaning that activities and actions in care need to be modified on a daily basis, depending on the affect of the air quality index. When the index is poor, the first recommendation that a health care worker should give to a patient is to limit exposure to outside air by closing up the living space and limiting the amount of time spent outside. In addition to limiting exposure to the air outside, it is vital to limit activities so that exertion does not put more pressure on the lungs. Creating a scale of activities that is relevant to the lifestyle of the patient would provide a system through which to identify which activities should be limited during periods of poor air quality. The scale of activities would vary from patient to patient, with different limitations and allowances being explored depending on the overall condition of the patient, the location of relevant activities, and the specifics of the condition that creates additional stress on the lungs. Another important step to combating the problem of poor air quality is making sure that medication, especially rescue mediations, are easily accessible at all times. If in a clinical care situation, keeping rescue medication near the bed of a patient is necessary at all times, but when a patient is living outside of clinical, it is essential that they have the habit of having their medications on them no matter where they go. This includes having them nearby even when in the home. During poor air quality periods of time, diligence is increased. Within a clinical setting, all healthcare workers who are in contact with patients should have knowledge of the location of rescue medications. In addition to rescue medication, teaching patients breathing techniques is crucial to rescue support so that air is filtered through the nose, lowering the probability of a reaction. Training and rescue support are essential at all times, but even more so during poor air quality periods. Hydration is essential during poor air quality periods of time, therefore increasing water intake or monitoring hydration, depending on the needs of the patient if hydration is a problem with combined conditions, should be increased. In order for the respiratory system to work it must have the proper hydration so that the balance that is required is maintained. During poor air quality periods, it is essential for this to be more acutely monitored, awareness being a preventative to a reaction to the environment. One of the hardest problems for dealing with poor air quality is that certain aspects of the home may be pumping elements into the air which will create a crisis situation. The growth of mold is one problem that can fill a home with irritants that will increase the number of breathing attacks that a patient experiences. As well, air ducts that are not kept clean will circulate dust and debris through the air, creating interior poor air quality and increasing the stress on lungs that are already under stress from the condition that plagues them. As a community health care worker, it is important to discuss the need for living in a clean air environment and utilizing whatever tools are available to make the home or living space as clean as possible. Summary The need for clean air is vital for those with respiratory conditions that put pressure on overall breathing capacities. When the exterior is plagued with poor air quality, preventative measures and limiting exposure should be done to prevent an attack. Interior spaces should be kept as clean as possible in relationship to good air quality, relieving the patient from the effects of poor air quality. When a patient has SARS, they are suffering from a virus that can react to poor air quality. Implementing good protocols for healthcare workers to follow when there are air quality issues so that they modify their behavior towards higher diligence can be details that help to prevent dire consequences from the illness. References Lautenbach, E., Woeltje, K. F., & Malani, P. N. (2010). Practical Healthcare Epidemiology. Chicago: The University of Chicago Press. M'ikanatha, N. M. (2007). Infectious disease surveillance. Malden, Mass: Blackwell Pub. Shetty, N., Tang, J. W., & Andrews, J. (2009). Infectious disease: Pathogenesis, prevention, and case studies. Chichester, UK: Wiley-Blackwell. World Health Organization (WHO). (2012). Retrieved from http://www.who.in t/csr/sars/country/2003_07_11/en/index.html Read More