Review - Reviewer's Assessment

1. Short summary / abstract
These guidelines were produced as a joint initiative between the BTS, the BIS and the HPA.
SARS is a potentially severe and highly infectious disease to which health care workers involved in the management of cases are particularly vulnerable. The guidelines summarise optimal and safe practice for healthcare staff involved in the emergency care of patients with probable or confirmed SARS.
The guidelines contain: -
·Case definitions to be used during an outbreak once the re-emergence of SARS has been verified by the World Health Organisation (WHO)
- Case definition for a probable case of SARS
- Case definition for a confirmed case of SARS
- Case definition for a discarded case
- Case definition for a person under investigation (PUI)
·Adult presenting to hospital with probable SARS
- Infection control issues
- General management
- Laboratory testing for SARS
- Specific management of a patient with probable or confirmed SARS
- Potential additional treatment for SARS
·Management of the close contacts of a probable or confirmed SARS case
·Discharge from hospital and follow up of a probable or confirmed SARS case
·Management of a person under investigation (PUI) who requires hospital admission but has a normal chest radiograph
As more information about SARS becomes available this guidance will be updated


2. What question is the document addressing?
The guidelines outline the hospital management of adults with probable or confirmed SARS

3. Type of study
review of expert opinion and case studies

4. Methods valid & appropriate?
Yes

Comments:
The guidelines do not cover management in the community of a person under investigation or management of paediatric cases.

5. Results / recommendations reliable?
As far as they can be given that SARS is a new and emerging infectious disease

6. Any major problems and biases?
This is a novel infection with limited research, especially in the UK, with which to inform this guidance. Because the situation can potentially change, the reader is advised to consult the latest guidance available on the BTS and HPA website (see 7. below)

7. Any other important / relevant studies which confirm or contradict?
1. British Thoracic Society website http://www.brit-thoracic.org.uk
a. Guidelines on the management of Community acquired pneumonia (CAP) in adults www.brit-thoracic.org.uk/guide/guidelines.html
2. Health Protection Agency information : -
a. http://www.hpa.org.uk/infections/topics_az/SARS/menu.htm
b. SARS reporting form http://www.hpa.org.uk/infections/topics_az/SARS/pdfs/repform.pdf
c. SARS Infection Control measures http://www.hpa.org.uk/infections/topics_az/SARS/hosp_infect_cont.htm http://www.escmid.org
Detailed guidance on masks and respirators http://www.hpa.org.uk/infections/topics_az/SARS/maskFAQs.htm
Details on laboratory testing http://www.hpa.org.uk/infections/topics_az/SARS/micro.htm
Guidance on voluntary home isolation http://www.hpa.org.uk/infections/topics_az/SARS/primarycare.htm
Guidance on discharge from hospital www.who.int/csr/sars/discharge/en/
3. Seto WH, Tsang D, Yung RW, et al. Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS) Lancet 2003; 361 (9368):1519-20.
4. Peiris JS,Chu CM, Cheng VC, et al Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study. Lancet 2003; 361 (9371):1767-72 5.
Li TS, Buckley TA, Yap FH, SungJJ, Joynt GM. Severe acute respiratory syndrome (SARS):infection control. Lancet 2003; 361(9366):1386


8. Keywords
Severe Acute Respiratory Syndrome (SARS) surveillance infection control measures infectious disease personal protective equipment (PPE)



Reviewer's Details:

Name:Sue Wiseman
Post:Nurse Consultant –Infection Control, DH
Affiliations
(Society / Organisation / Advisory Committee):
Member Advisory Committee on Dangerous Pathogens
Health Protection Adviser Royal College of Nursing P/T
Member Infection Control Nurses Association


*** Note: These are the views of a professional expert rather than an official statement from his or her society, organisation or advisory committee.






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