COVID-19: A REMOTELY DELIVERED STRATEGY
- Harini
- May 8, 2020
- 2 min read
Taking Case history:
The infographics guidance is used flexibly to take account of the patient’s medical history and issues that emerge during the conversation. It is important to date-stamp the onset of disease. Asking the patients to record their own temperature using their home thermometer, also noting how long the temperature has lasted and the highest reading so far.
Most patients with covid-19 have a cough, which typically dry that persists for more than 5 days. Fewer than half the patients have difficulty in breathing, but these cases may deteriorate to more serious diseases, especially pneumoniae. Systemic symptoms include fatigue and muscle pain.
Asking about history of contact with a case of covid-19 (laboratory confirmed or clinically suspected) closer than 1 meter for 30 minutes or more, will help in tracing contact history.
Asking if anyone else in the family is unwell with Nasal congestion, conjunctival congestion and any other allergic symptoms like itchy eyes, revel a poor prognostic sign if present. Loss of appetite, and loss of a sense o smell (anosmia) are common early symptoms.
RED FLAGGING SYMPTOMS which indicate the patient needs urgent assessment.
Remote assessment of breathlessness:
By asking the patients to describe their problems with breathing in their own words, one can assess the ease and comfort of their speech.
The NHS 111 Symptom checker questions include (conversation pointers)
1. Are you breathless that you are unable to speak more than few words?
2. Are you breathing harder or faster than usual?
3. What makes you breathless now that didn’t make you breathless yesterday?
It is possible to measure the respiratory rate via a good video connection.
Interpreting the breathlessness in the context of the wider history and physical signs. Audible wheezes and a verbal report of blueness of the lips are concerning.
Managing mild or moderately severe illness:
Covid-19 is a frightening illness even if the patient only has mild symptoms. Explain that the condition is managed in a way like flu and often takes a similar course, though it can deteriorate.
Rest and take symptomatic remedies like paracetamol. If circumstances allow, the person with symptoms should self-isolate within the home and stay as far as possible from vulnerable family members.
A social safety net will be important in patients living alone:
Covid-19 can produce rapid deterioration in respiratory function, especially in the second week, so safety-netting advice is important for all patients, even if they are currently well.
Those living alone should identify someone to check on them regularly. They should maintain high fluid intake and seek medical help when necessary.
If they have difficulty in breathing, feel faint, stop passing urine, unable to keep down fluids, they should follow local protocol.
· But social distancing doesn’t have to be boring. You can always speak to family and friends.
· DOWN AIRTEL ‘’THANKS’’ APP.
· It is extremely important for you to abide by the instructions and advice given by the Central and State Governments and the medical fraternity.
· I request you not to take any medication without consulting doctors if you are showing any symptoms of this infection. Any sort of medical experiment can put your life to great risk.
· Every Indian will abide by the instructions of the Government and local authorities during this crucial hour.
Read more at:
· To recharge on the Airtel Thanks App.
· BMJ 2020; 368:m1182
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