DOCSLIB.ORG

Terminal Sedation

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Terminal Sedation University of Tennessee, Knoxville TRACE: Tennessee Research and Creative Exchange Doctoral Dissertations Graduate School 7-2011 Terminal Sedation Karen L Smith [email protected] Follow this and additional works at: https://trace.tennessee.edu/utk_graddiss Part of the Bioethics and Medical Ethics Commons Recommended Citation Smith, Karen L, "Terminal Sedation. " PhD diss., University of Tennessee, 2011. https://trace.tennessee.edu/utk_graddiss/1127 This Dissertation is brought to you for free and open access by the Graduate School at TRACE: Tennessee Research and Creative Exchange. It has been accepted for inclusion in Doctoral Dissertations by an authorized administrator of TRACE: Tennessee Research and Creative Exchange. For more information, please contact [email protected]. To the Graduate Council: I am submitting herewith a dissertation written by Karen L Smith entitled "Terminal Sedation." I have examined the final electronic copy of this dissertation for form and content and recommend that it be accepted in partial fulfillment of the equirr ements for the degree of Doctor of Philosophy, with a major in Philosophy. John Hardwig, Major Professor We have read this dissertation and recommend its acceptance: David Reidy, Glenn Grabor, Nan Gaylord Accepted for the Council: Carolyn R. Hodges Vice Provost and Dean of the Graduate School (Original signatures are on file with official studentecor r ds.) TERMINAL SEDATION A Dissertation Presented for the Doctor of Philosophy Degree The University of Tennessee, Knoxville Karen L. Smith August 2011 Copyright © 2011 by Karen L. Smith All rights reserved. ii ACKNOWLEDGEMENTS There are many people whom I ought to thank for their invaluable assistance to me in completing this dissertation. My family, Channing and Bailey, did without in numerous ways to allow me the time and mental space to accomplish my work. Dr. John Hardwig, remained supportive of my intense desire to work as a clinical ethicist and provided practical assistance throughout my education at the University of Tennessee and guidance in the art of philosophy. His direction, prodding and insightful questioning has always been directed at my improvement. I am grateful to the members of my committee, Dr. Reidy, Dr. Graber, and Dr. Gaylord, who somehow didn‘t give up on me throughout my long hiatuses. I also would be most remiss if I did not acknowledge the efforts my good friend, Susan Williams provided in her constant encouragement and helping to keep my ducks in a row during this process. But, mostly this work is dedicated to my mother, a nurse, who died too soon to realize what an inspiration she provided. iii ABSTRACT This dissertation will support full ethical endorsement of terminal sedation for those most urgently in crisis and need of beneficence, those who are dying and in the final hours or days and suffering. To clarify the practice I first detail ethical differences between euthanasia, physician assisted suicide and terminal sedation. Moreover, I identify new areas where harms and benefits need to be evaluated as affecting not only patients, but also families and caregivers. I evaluate the current practice to allow the development of ethical guidelines and greater consensus on deciding the hard cases. This work may also serve to assist those looking to enlarge the practice in the future with ETS for those with debilitating diseases or disability, but they are not my primary goal. Below is the standard I propose for moral allowability for the use of terminal sedation. I will refer to it often in the pages that follow simply as my standard. Terminal sedation is the appropriate and intentional use of medications (benzodiazepines and/or narcotics) to produce ongoing, deep unconsciousness upon 1) a terminal patient’s (or surrogates) request due to 2) suffering intractable pain or other distressing clinical symptoms intolerable to the patient when 3) death is expected within hours or days (less than two weeks) due to the terminal illness, injury, or disease. I offer two versions of initial guidelines for development of hospital policy. The first version outlines minimal guidelines that ought to be utilized to allow TS for patients who fit my standard. The minimal guideline is based upon the recommendations of the American Medical Association with some modifications. The guideline is admittedly restrictive in hopes of gaining wider societal support for a currently controversial practice. Secondly, I offer more moderate guidelines for policy that could become a standard in the future. It maintains the restrictive focus of the minimal guidelines and offers additional education and support to others which has yet to be broadly provided. The moderate guidelines would mark an important step forward for allowing more choices in dying and offering additional supports to those involved with dying patients. iv TABLE OF CONTENTS Chapter Page Table of Contents CHAPTER 1 ....................................................................................................................... 1 WHAT IS TERMINAL SEDATION? ................................................................................ 1 Introduction ..................................................................................................................... 1 Background and History ................................................................................................. 5 The Problem of Definition ............................................................................................ 11 Drugs and Dosages ....................................................................................................... 20 An Evolving Consensus or More Conflict? .................................................................. 22 Is TS a type of Death? ................................................................................................... 25 Operational Definition .................................................................................................. 27 CHAPTER 2 ..................................................................................................................... 30 DISTINGUISHING TERMINAL SEDATION FROM ................................................... 30 PHYSICIAN-ASSISTED SUICIDE OR EUTHANASIA AND THE DOCTRINE OF DOUBLE EFFECT ........................................................................................................... 30 Euthanasia ..................................................................................................................... 31 Physician-Assisted Suicide (PAS) ................................................................................ 36 Terminal Sedation ......................................................................................................... 42 The Doctrine of Double Effect ..................................................................................... 48 Additional Criticism against Terminal Sedation........................................................... 53 Alternate Evaluations .................................................................................................... 57 CHAPTER 3 ..................................................................................................................... 62 BENEFITS AND HARMS FOR THE PATIENT ............................................................ 62 Introduction ................................................................................................................... 62 Relief from Suffering .................................................................................................... 64 Sedation like Sleep ........................................................................................................ 66 Slippery Slope Concerns ............................................................................................... 67 Autonomy and Control ................................................................................................. 71 Nutrition and Hydration ................................................................................................ 72 Consent ......................................................................................................................... 75 Surrogate Consent ......................................................................................................... 78 Unproven Effectiveness ................................................................................................ 83 Existential Concerns ................................................................................................. 87 Suffering & Religion................................................................................................. 91 Special Concern for the Demented ............................................................................... 93 Responsibility in Dying & Death Roles........................................................................ 97 Teaching Compassion for the Dying ........................................................................ 99 Unburdening Others ................................................................................................ 100 v Conclusion .................................................................................................................. 102 CHAPTER 4 ................................................................................................................... 104 ETHICAL BENEFITS AND HARMS FOR THE FAMILY ........................................
Load more

Recommended publications
  • A Novel Ebola Virus VP40 Matrix Protein-Based Screening for Identification of Novel Candidate Medical Countermeasures
    viruses Communication A Novel Ebola Virus VP40 Matrix Protein-Based Screening for Identification of Novel Candidate Medical Countermeasures Ryan P. Bennett 1,† , Courtney L. Finch 2,† , Elena N. Postnikova 2 , Ryan A. Stewart 1, Yingyun Cai 2 , Shuiqing Yu 2 , Janie Liang 2, Julie Dyall 2 , Jason D. Salter 1 , Harold C. Smith 1,* and Jens H. Kuhn 2,* 1 OyaGen, Inc., 77 Ridgeland Road, Rochester, NY 14623, USA; [email protected] (R.P.B.); [email protected] (R.A.S.); [email protected] (J.D.S.) 2 NIH/NIAID/DCR/Integrated Research Facility at Fort Detrick (IRF-Frederick), Frederick, MD 21702, USA; courtney.fi[email protected] (C.L.F.); [email protected] (E.N.P.); [email protected] (Y.C.); [email protected] (S.Y.); [email protected] (J.L.); [email protected] (J.D.) * Correspondence: [email protected] (H.C.S.); [email protected] (J.H.K.); Tel.: +1-585-697-4351 (H.C.S.); +1-301-631-7245 (J.H.K.) † These authors contributed equally to this work. Abstract: Filoviruses, such as Ebola virus and Marburg virus, are of significant human health concern. From 2013 to 2016, Ebola virus caused 11,323 fatalities in Western Africa. Since 2018, two Ebola virus disease outbreaks in the Democratic Republic of the Congo resulted in 2354 fatalities. Although there is progress in medical countermeasure (MCM) development (in particular, vaccines and antibody- based therapeutics), the need for efficacious small-molecule therapeutics remains unmet. Here we describe a novel high-throughput screening assay to identify inhibitors of Ebola virus VP40 matrix protein association with viral particle assembly sites on the interior of the host cell plasma membrane.
    [Show full text]
  • Robin Cook's Abduction
    Robin Cook’s Abduction: Sources of the Novel Alena Kolínská Bachelor Thesis 2013 ABSTRAKT Cílem této bakalářské práce je analýza románu Planeta Interterra (2000) spisovatele Robina Cooka z hlediska intertextuality. Uvede pojem intertextualita a stručně podá názory na vnímání intertextuality. Poté následuje rozbor dané knihy a hledání jejích možných zdrojů, které mohly spisovatele ovlivnit či inspirovat při psaní pro něj netypického románu. Z rozboru knihy vyplývá, že hlavními zdroji byly knihy Utopie (1516) Thomase Mora, Lidé jako bozi (1923) Herberta George Wellse, Konec civilizace: aneb Překrásný nový svět (1932) Aldouse Huxleyho a také řecká mytologie a historie všeobecně. Klíčová slova: Americká literatura; Robin Cook; intertextualita; Planeta Interterra; utopie; dystopie; fikce; dutozemě ABSTRACT The aim of this bachelor thesis is to analyze the novel Abduction (2000) by Robin Cook in the view of intertextuality. The term intertextuality is introduced, followed by a brief list of views on intertextuality. Subsequently the novel is analyzed, searching for the possible sources which might have influenced or inspired the author when writing a type of novel not typical for him. The analysis shows that the main sources for the novel were four: Utopia (1516) by Thomas More, Men like Gods (1923) by Herbert George Wells, Brave New World (1932) by Aldous Huxley, and Greek mythology as well as the history itself. Keywords: American literature; Robin Cook; intertextuality; Abduction; utopia; dystopia; fiction; hollow earth ACKNOWLEDGEMENTS I would like to express my deepest gratitude to my supervisor, Mgr. Roman Trušník, Ph.D., for his invaluable advice, patience, guidance and support. I also owe a great thanks to Mgr.
    [Show full text]
  • Summer Assignments – AP Biology Vincent J. Benitez [email protected]
    Summer Assignments – AP Biology Vincent J. Benitez [email protected] http://www.vbbiology.weebly.com 1. Reading Assignment o Choose a book by Robin Cook to read. A list of medical thriller novels is listed below. Dr. Robin Cook is considered to be the master of the medical thriller! He does an enormous amount of research, so all of his books contain good, exciting biology. After reading the book, write a 1-2 page paper containing the following: o Concise summary of the plot. o Highlight the biological aspect(s) of the novel. How does/do the biological aspect(s) play a role in the novel. What technologies/procedures/concepts were used in the novel? o Link the biological aspect(s) of the novel to chapters in the AP Biology textbook. For example, if the book were about a virus, where would you find that topic in the textbook? What other connections can be associated with viruses? Perhaps the immune system, or cells, or biotechnology, etc. List those chapters as well. o Your opinion of the novel. Did you like the book? Did the plot seem too farfetched, or perhaps very plausible? What did you think about how the author used biology to develop interest and carry the story line throughout the book? Book Review Coordinating Instructions o Before writing your book review, read: The Basics of Scientific Writing in APA Style, by Pam Marek. You can find this article at: http://www.macmillanlearning.com/catalog/uploadedfiles/content/worth/custom_solutions/psychology_forew ords/marek_ch04_apastyle_color.pdf. A link to this document is on my website under AP Biology – Articles.
    [Show full text]
  • Pandemic 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 S31 N32
    01 02 03 04 05 06 07 08 09 10 11 12 Pandemic 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 S31 N32 9780525535331_Pandemic_TX.indd i 8/8/18 2:28 PM 01 02 03 04 05 06 07 08 09 10 Titles by Robin Cook 11 12 Charlatans Contagion 13 Host Acceptable Risk 14 Cell Fatal Cure 15 Nano Terminal 16 Death Benefit Blindsight 17 Cure Vital Signs 18 Intervention Harmful Intent 19 Foreign Body Mutation 20 21 Critical Mortal Fear 22 Crisis Outbreak 23 Marker Mindbend 24 Seizure Godplayer 25 Shock Fever 26 Abduction Brain 27 Vector Sphinx 28 Toxin Coma 29 Invasion The Year of the 30 Intern S31 Chromosome 6 N32 9780525535331_Pandemic_TX.indd ii 8/8/18 2:28 PM 9780525535331_Pandemic_TX.indd iii 8/8/18 2:28 PM 01 02 03 04 05 06 07 08 09 10 11 12 13 Pandemic 14 15 16 17 Robin Cook 18 19 20 21 22 23 24 25 26 G. P. PUTNAM’S SONS 27 NEW YORK 28 29 30 S31 N32 9780525535331_Pandemic_TX.indd iv 8/8/18 2:28 PM 9780525535331_Pandemic_TX.indd v 8/8/18 2:28 PM 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 G. P. PUTNAM’S SONS Publishers Since 1838 18 An imprint of Penguin Random House LLC 375 Hudson Street 19 New York, New York 10014 20 21 22 Copyright © 2018 by Robin Cook Penguin supports copyright. Copyright fuels creativity, encourages diverse voices, 23 promotes free speech, and creates a vibrant culture.
    [Show full text]
  • Medical Thrillers
    Medical Thrillers Ablow, Keith Cell 20. The Bone Bed Frank Clevenger Charlatans 21. Dust 1. Denial Coma 22. Flesh & Blood 2. Projection Death Benefit 23. Depraved Heart 3. Compulsion Fatal Cure 24. Chaos 4. Psychopath Fever Cotterill, Colin 5. Murder Suicide Godplayer Thirty-Three Teeth 6. The Architect Harmful Intent Crichton, Michael Baden, Michael Host Andromeda Strain Manny Manfreda Invasion The Terminal Man 1. Remains Silent Mindbend Cuthbert, Margaret 2. Skeleton Justice Mortal Fear Silent Cradle Bass, Jefferson Mutation Darnton, John Body Farm Nano The Experiment 1. Carved in Bone Pandemic Mind Catcher 2. Flesh and Bone Seizure Delbanco, Nicholas 3. The Devil’s Bones Shock In The Name of Mercy 4. Bones of Betrayal Sphinx Dreyer, Eileen 5. The Bone Thief Terminal Brain Dead 6. The Bone Yard Toxin Sinners and Saints 7. The Inquisitor’s Key Jack Stapleton & Laurie With a Vengeance 8. Cut to the Bone Montgomery Follett, Ken 9. The Breaking Point 1. Blindsight The Third Twin 10. Without Mercy 2. Contagion Whiteout Becka, Elizabeth 3. Chromosome 6 Gerritsen, Tess Evelyn James 4. Vector Bloodstream 1. Trace Evidence 5. Marker The Bone Garden 2. Unknown Means 6. Crisis Gravity Benson, Ann 7. Critical Harvest Plague Tales 8. Foreign Body Life Support 1. The Plague Tales 9. Intervention The Bone Garden 2. The Burning Road 10. Cure Jane Rizzoli & Maura Isles Blanchard, Alice Marissa Blumenthal 1. The Surgeon Life Sentences 1. Outbreak 2. The Apprentice Bohjalian, Christopher 2. Vital Signs 3. The Sinner The Law of Similars Cordy, Michael 4. Body Double Midwives Crime Zero 5. Vanish Bova, Ben The Miracle Strain 6.
    [Show full text]
  • The Implicated and the Immune: Cultural Responses to AIDS
    The Implicated and the Immune: Cultural Responses to AIDS RICHARD GOLDSTEIN The Village Voice HEN AIDS FIRST PENETRATED AMERICAN consciousness back in 1981, few cultural critics were pre­ pared to predict that this epidemic would have a broad and W deep impact on the arts. But nine years later, it is possible to argue that virtually every form of art or entertainment in America has been touched by AIDS. Every month, it seems, more is added to the oeuvre of art, dance, music and fiction inspired by the current crisis. Not even tuberculosis, that most literary of epidemics, produced a comparable outpouring in so short a time. Though epidemics have played a major role in shaping American so­ ciety, artistic production in response to devastating periodic outbreaks of yellow fever, cholera, and influenza (not to mention consumption) has been few and far between. There is no great American novel about the “Spanish Lady” that killed millions in the years following World War I; no revered poem or play commemorating the evacuation of a major American city due to rampaging disease; no major motion pic­ ture about the polio epidemic that swept the nation in the 1950s. Nothing in American literature is comparable to the preoccupation with pestilence that had inspired great works of European realism by writers as diverse as Defoe, Ibsen, Mann, and Camus. Taken as a whole, American culture’s response to epidemics—from Edgar Allen Poe’s “Masque of the Red Death” to Sinclair Lewis’s Arrowsmith and The Milbank Quarterly, Vol. 68, Suppl. 2, 1990 © 1990 Milbank Memorial Fund 2-95 2.96 Richard Goldstein Hollywood melodramas like Jezebel—has been romantic and didactic.
    [Show full text]
  • YEAR 1 STUDENT HANDOUT 2015 Contents: 1. Vital Signs 2
    MEDICAL STUDIES IN ENGLISH CLINICAL SKILLS: YEAR 1 STUDENT HANDOUT 2015 Contents: 1. Vital signs 2. Symptoms and signs of vital organ failure 3. Basic life support in adults 4. Basic life support in infants and children 5. Newborn resuscitation 6. First aid for the injured 7. First aid for environmental injuries and bites 8. Poisoning and burns 9. Immobilisation and transport devices for trauma patients Department of Clinical Skills University of Split School of Medicine 1 1.VITAL SIGNS Irena Zakarija-Grković, MD, FRACGP, IBCLC, PhD Introduction Vital signs (from Latin signa vitae) are measurements of the body’s most basic functions. The four main vital signs routinely monitored are: 1. Body temperature 2. Pulse 3. Respiration 4. Blood pressure These measurements are taken to help assess the general physical health of a person, give clues to possible diseases and show progress toward recovery. Vital signs can be measured in a medical setting, at home, at the site of a medical emergency or elsewhere. Measurement of vital signs is a routine part of any physical examination. Body temperature The temperature should always be recorded as part of the initial clinical examination of the patient. The normal body temperature ranges from 36.6°C to 37.2°C. In very hot weather the temperature may rise up to 0.5°C higher. Fever is defined as a morning oral temperature of >37.2 °C (>98.9 °F) or an afternoon oral temperature of >37.7 °C (>99.9 °F). A temperature between 37.3°C and 38.5°C is classified as a ‘low-grade fever’, whereas a body temperature above 38.5°C is considered a ‘high- grade fever’.
    [Show full text]
  • Characteristics of SARS-Cov-2 and COVID-19
    REVIEWS Characteristics of SARS- CoV-2 and COVID-19 Ben Hu 1,3, Hua Guo 1,2,3, Peng Zhou 1 and Zheng- Li Shi 1 ✉ Abstract | Severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) is a highly transmissible and pathogenic coronavirus that emerged in late 2019 and has caused a pandemic of acute respiratory disease, named ‘coronavirus disease 2019’ (COVID-19), which threatens human health and public safety. In this Review, we describe the basic virology of SARS- CoV-2, including genomic characteristics and receptor use, highlighting its key difference from previously known coronaviruses. We summarize current knowledge of clinical, epidemiological and pathological features of COVID-19, as well as recent progress in animal models and antiviral treatment approaches for SARS- CoV-2 infection. We also discuss the potential wildlife hosts and zoonotic origin of this emerging virus in detail. Coronaviruses are a diverse group of viruses infecting and chest discomfort, and in severe cases dyspnea and many different animals, and they can cause mild to bilateral lung infiltration6,7. Among the first 27 docu- severe respiratory infections in humans. In 2002 and mented hospitalized patients, most cases were epidemi- 2012, respectively, two highly pathogenic coronaviruses ologically linked to Huanan Seafood Wholesale Market, with zoonotic origin, severe acute respiratory syndrome a wet market located in downtown Wuhan, which sells coronavirus (SARS- CoV) and Middle East respiratory not only seafood but also live animals, including poultry syndrome coronavirus (MERS- CoV), emerged in and wildlife4,8. According to a retrospective study, the humans and caused fatal respiratory illness, making onset of the first known case dates back to 8 December emerging coronaviruses a new public health concern 2019 (REF.9).
    [Show full text]
  • Fiction Books
    National Reference Center for Bioethics Literature & High School Bioethics Curriculum Project Joseph & Rose Kennedy Institute of Ethics Box 571212, Georgetown University Washington, DC 20057-1212 202-687-3885, 888-BIO-ETHX http://bioethics.georgetown.edu e-mail: [email protected] fax: 202-687-6770 Bioethics Resources for High School Teachers and Students BIOETHICS THEMES IN POPULAR LITERATURE FOR ADOLESCENTS & YOUNG ADULTS These bibliographies have been prepared by information specialists at The National Reference Center for Bioethics Literature, Kennedy Institute of Ethics (http://bioethics.georgetown.edu). The documents are “Works-in-Progress.” Please return to this website to view updates to these lists as new literature is identified by the High School Bioethics Project staff and/or added to the library collection. The books listed in these bibliographies might be used in high school classrooms to introduce or to generate discussion about bioethics themes and topics. No specific books are recommended. The individual teacher bears responsibility for reviewing each book or video to determine its appropriateness for his or her students, classroom, school setting, and community. Please refer to the classification scheme from The National Reference Center for Bioethics Literature (http://bioethics.georgetown.edu/databases/classcheme/) for information about the bioethics topics covered in these books. Numbers in parentheses correspond to numbers on the classification scheme and indicate that the bioethics themes indicated on the
    [Show full text]
  • In-Training Exam Prep Emergency Medicine Question Sets #1-5 Second Edition
    In-Training Exam Prep Emergency Medicine Question Sets #1-5 Second Edition Editors Michael Gottlieb, MD Rochelle Zarzar, MD Philippe Bierny, BA From the ALiEM Chief Resident 5 PracticeIncubator Tests ASSOCIATE EDITORS Foreword Dorothy Habrat, DO We would like to thank the many medical students, residents, Margaret Sheehy, MD, MSc and attending physicians for their contributions to this book. Samuel Zidovetzki, MD We would also like to thank the Academic Life in Emergency Medicine group with special thanks to Derek Sifford for their Adaira Chou, MD, MEd (c) support and assistance with the creation of this book. Finally, Nikita Joshi, MD we would like to thank Dorothy Habrat, Margaret Sheehy, Samuel Zidovetzki, and Adaira Chou for all of their efforts in Michelle Lin, MD editing the first edition of this book. Michael Gottlieb, MD Published by Academic Life in Emergency Medicine San Francisco, California, USA Rochelle Zarzar, MD Second edition, November 2016 Philippe Bierny, BA Available for usage under the Creative Commons Attribution- NonCommercial-NoDerivs 3.0 Unported License Book cover image: Creative Commons Attribution 2.0 by Alberto G on Flickr.com ISBN: 978-0-9907948-8-2 1 Contributing Authors Layla Abubshait, MD Joseph Bradley, DO Ryan Duhe, MD Eddie Garcia, MD Central Michigan University University of Arizona Sinai Grace Hospital Rutgers University Helen Adams, MD Holly Caretta-Weyer, MD Sean Dyer, MD Stephen Gau, MD Oregon Health & Science University of Wisconsin Cook County Hospital Central Michigan University Carmen Alcala,
    [Show full text]
  • 2020.01.22.914952V2.Full.Pdf
    bioRxiv preprint doi: https://doi.org/10.1101/2020.01.22.914952; this version posted January 23, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder. All rights reserved. No reuse allowed without permission. 1 2 Discovery of a novel coronavirus associated with the recent pneumonia outbreak in 3 humans and its potential bat origin 4 5 Peng Zhou1*, Xing-Lou Yang1*, Xian-Guang Wang2*, Ben Hu1, Lei Zhang1, Wei 6 Zhang1, Hao-Rui Si1,3, Yan Zhu1, Bei Li1, Chao-Lin Huang2, Hui-Dong Chen2, Jing 7 Chen1,3, Yun Luo1,3, Hua Guo1,3, Ren-Di Jiang1,3, Mei-Qin Liu1,3, Ying Chen1,3, Xu- 8 Rui Shen1,3, Xi Wang1,3, Xiao-Shuang Zheng1,3, Kai Zhao1,3, Quan-Jiao Chen1, Fei 9 Deng1, Lin-Lin Liu4, Bing Yan1, Fa-Xian Zhan4, Yan-Yi Wang1, Geng-Fu Xiao1, 10 Zheng-Li Shi1† 11 12 Affiliations: 13 1CAS Key Laboratory of Special Pathogens, Wuhan Institute of Virology, Center for 14 Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, People’s Republic 15 of China 16 2Wuhan Jinyintan hospital, Wuhan, China 17 3University of Chinese Academy of Sciences, Beijing, People’s Republic of China 18 4Hubei Provincial Center for Disease Control and Prevention, Wuhan, People’s 19 Republic of China 20 *These authors contributed equally. 21 †To whom correspondence should be addressed: [email protected] 22 bioRxiv preprint doi: https://doi.org/10.1101/2020.01.22.914952; this version posted January 23, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder.
    [Show full text]
  • Conducting Health Care-Associated Infection Outbreak Investigations
    Scan_2018_09_21_10_Conducting Health Care-Associated 55_24_378.pdf Infection Outbreak Investigations- A Guide for County Health Departments Health Care-Associated Infection Prevention Program Bureau of Epidemiology Division of Disease Control and Health Protection 1 Contents Executive Summary ............................................................................................................................ 4 Objectives ........................................................................................................................................... 4 Introduction ......................................................................................................................................... 5 Routine CHD Collaboration with Health Care Facilities ....................................................................... 6 What is a Health Care-Associated Infection (HAI)? ............................................................................. 6 What is an Outbreak? ......................................................................................................................... 6 Why Investigate HAI Outbreaks? ........................................................................................................ 6 Who May Be Involved in an HAI Outbreak? ........................................................................................ 7 Role of the CHD in Response to an HAI Outbreak .............................................................................. 8 Health Care-Associated Infection
    [Show full text]