Vietnam: Instructions on caring for children infected or suspected of being infected with SARS-CoV-2

On February 8, 2021, the Ministry of Health of Vietnam issued Decision 1125/QD-BYT on guidelines for the care of COVID-19 patients in healthcare establishments, including instructions on caring for children infected or suspected of being infected with SARS-CoV-2

Vietnam: Instrutions on caring for children infected or suspected of being infected with SARS-CoV-2 (Illustration)

According to the Guidelines of the Ministry of Health of Vietnam, the rules for infection prevention is that nurses must perform standard precautions in combination with contact, droplet, and airborne precautions during the treatment.

For those without respiratory failure: Place the child in a comfortable position suitable for their age and not obstructing their airway. Monitor their general condition, vital signs, fever, cough and respiratory tract infection 2 - 4 times a day and where necessary. To minimize unnecessary contact, healthcare workers may monitor the child via camera or communicate with the child’s caregiver via the bedside speaker or phone. Instruct them on how to clean the mouth and throat with NaCl 9‰ solution or mouthwash.

For children receiving oxygen support: Elevate the child’s head to 30 degrees, let the child lie in a comfortable position and suction sputum where necessary. Provide oxygen with suitable flow rate to reach SpO2 ≥ 94% via mask or nasal cannula. When the child’s condition has stabilized, adjust rate to reach SpO2 ≥ 90%. Monitor general condition, vital signs and SpO2 every 3 hours and where necessary depending on the child’s condition. Inform the doctor of any anomaly. Evaluate the airway, respiratory pattern, oxygen support efficiency and development of the illness. Clean the nose and mouth using NaCl 9‰ solution.

For mechanically ventilated children: Elevate the child’s head to 30º- 45º, use closed sputum suctioning system. Evaluate vital signs, SpO2, chest movements, skin color, mucous membranes and consciousness (AVPU scale) and fluid input - output balance every 30 minutes - 1 hour depending on the child’s condition and inform the doctor of any abnormally. Change the child’s position every 4 - 6 hours, provide dental care daily. Use closed sputum suctioning system (to prevent airborne transmission) and observe sputum quantity, color and properties.

In addition to implementing the above contents, caregivers for children infected or suspected of being infected with SARS-CoV-2 also need to control the child's temperature; warm compresses for children in the following positions: forehead, armpits, groin; Give your child plenty of water to drink. At the same time, it is necessary to pay attention to the prevention of superinfection and ensure nutrition for children with a suitable diet. Assess the child's and caregiver's psychological progress during hospital stay and provide appropriate reassurance. Explain the disease, guide to find out information about the disease on the media about the situation of SARS-CoV-2.

Healthcare workers need to guide caregivers to prevent infection by taking the following measures:

+ Instruct the child on how to wear face masks and replace face masks daily or immediately when the mask gets wet.

+ When the child coughs or sneezes, cover their nose and mouth with a disposable tissue paper and then discard it in the garbage bin according to regulations.

+ Practice hand hygiene regularly using soap or hand sanitizer, avoid letting the child touch their own eyes, nose and mouth.

+ The child’s caregiver shall wear sufficient PPE, including a face mask, headwear, protective clothing and safety goggles or face shield.

+ Avoid hugging or holding the child where unnecessary.

+ Discard waste properly.

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