Surely you are very worried about the Carona flu pandemic with the scientific name (ncov) that in recent days the world has been warning people that special precautions must be taken with this virus, because it spread rapidly, from person to person through breathing
I: What is corona virus
Carona virus form has been discovered for a long time, it is itself just a common cold,. But recently it developed and transformed into a different strain with many other characteristics and currently there is no cure
Symptoms of an infected person (nCov)
- Tired people
- Sore throat
- Shortness of breath
- Fever from 37-40 degrees
- May lead to respiratory depression,
- A weakened immune system and can be fatal
II: Clinical diagnosis of New nCarona Virus infection
1- Manifestations of fever and pneumonia or interstitial pneumonia, or progressive progressive respiratory distress syndrome (ARDS), based on clinical findings either directly or via X-ray
2 – Persons who are exposed to the epidemic should be put into isolation and followed up within 14 days (because the incubation period is usually 14 days to develop the next symptoms).
Carona virus pneumonia should be diagnosed differently from the common types of flu
- Severe influenza (influenza A / H1N1 or avian influenza H5N1)
- SARS -CoV And MER- Cov
- Atypical pneumonia due to other causes, for example, syncytial virus (SRV) adenovirus, mycoplasma, …
Influenza identification technique nCov virus is a Real Time RT-PCR technique with samples of respiratory fluids, sputum and intubation collected by specialized devices, stored in suitable environment.
III:Treatment of nCov (Carona Virus)
- Treatment principle: when cases are detected, they should be isolated immediately, properly collected samples, and tested for verification.
- The virus is very contagious, when experimentally it needs to be protected and equipped to avoid infecting health workers,
- Treatment of respiratory failure
- For patients lying on their backs with an angle (30-40 degrees)
Oxygen supply: SP02 gas <92% or Pa02 <65mmHg or when breathing is difficult, (tachypnea, concave chest, shortness of breath)
- Breathing OXY through the nose: 1–5 liters / minute so that SPO2> 92%
- Breathing oxygen through a simple mask: oxygen 6-12 lt / minute when breathing through the nose rim without SPO2> 92%
-Opening oxygen through the mask mask bag: oxygen flow is high enough to not collapse the bag when breathing period
Conduct CPAP or high flow oxygen nasal passages indicated when SPO2 oxygen measures did not improve, SPO2 <92%. If possible, proceed as soon as failure to breathe oxygen through the rim of the nose + Target: SP02> 92% or less than 0.6
+ If you do not reach 92%, you can accept> 85%
- Artificial air does not penetrate BiPAP: Indicated when the patient is in good health, spitting, and cooperation
Respiratory support Intra-artificial ventilation:
+ Specify when the patient has severe respiratory failure and does not respond to pine when artificial does not invade.
+ Start with volume control breathing, with Vt as low as 6 – 8 ml / kg, frequency 12 – 16 times / minute, VE = 1/2, PEEP = 5 and adjust FiO) to achieve SpO2 > 92%.
- If progressing to ARDS, conduct mechanical ventilation according to the artificial ventilation regimen allowed.
- For children, can breathe under pressure control (PCV). Depending on the patient’s condition to adjust the breathing machine parameters accordingly. – Exchanging oxygen through ECMO (Extra – Corporeal Membrane Oxygenation):
- ECMO may be considered for use in patients with ARDS who do not respond to the above optimal treatments.
+ Since ECMO can only be implemented at a number of central level facilities, in case of consideration for ECMO appointment, lower levels should decide to transfer patients early and follow the procedures for transporting patients by the Ministry of Health. specified. Support the function of organs: Stable hemodynamic stability:
- Make sure the volume of circulation, heart medication, vasomotor if necessary Support kidney function:
– Ensure fluid balance, maintain stable hemodynamics, diuretics. Hemodialysis (intermittent or continuous) or peritoneal dialysis when indicated Support of other organ functions:
- Use medicine to reduce them if they have a lot: drop nose with regular nose drops
- Antipyretic: If the fever is above 38, 5 ° C, give antipyretic paracetamol at a dose of 10-15 mg / kg in children, for adults no more than 2 g / day.
- Adjustment of water, electrolyte disturbance and acid alkali balance
- Ensure nutrition, control blood sugar
- In case of multiple bronchopulmonary infections should use broad-spectrum antibiotics and work with bacteria that cause infections in hospitals.
- For severe cases, consider using intravenous gammaglobulin (IVIG)
- Treatment of underlying disease (if any). 4. Discharge standards: Patients are discharged when they fully meet the following criteria:
- Fever goes away for at least 3 days.
- Good condition: pulse, blood pressure, breathing, blood tests returning to normal; X
- Improved lung photon.
- Kidney function returns to normal 5. After discharge: Patients must monitor the temperature every 12 hours, if the temperature is higher than 38 ° C for two consecutive measurements or show other abnormalities, they must be re-examined at the treated place.
IV. PREVENTION OF NEW CORONA INFECTION
first . Prevention of infection outside the community:
- Wear a mask and seek medical attention immediately after breathing symptoms.
- Personal hygiene :
- Clean hands: Wash hands often with soap and water or with an alcohol-based hand sanitizer, especially after sneezing, coughing, or wiping the nose,
- Cover your nose and mouth when sneezing and coughing, and tissues wipe your nose and mouth into a separate trash can
Ensure adequate diet
- No smoking. –
Environmental sanitation :
- Maintain a well ventilated place of residence or workplace
- Avoid contact and gather in crowded places, not well-ventilated areas.
- Limit direct contact with domestic animals and wild animals
- Full vaccination 2. Prevention of infection in hospitals: Strictly implementing the flow of examination, isolation and treatment of patients, measures for infection control, infection prevention for health workers, caregivers and other other patients in patient treatment facilities under the guidance of the Ministry of Health
Organization of isolated areas
High-risk areas: Treatment and care for patients with suspected or confirmed new infection with corona virus. This area must be displayed in red with the words “Special isolation area” and detailed instructions hanging at the entrance, with guards.
- Risk areas: A place where people are more likely to have a coronary infection who have just come for first examination and treatment (such as respiratory medicine, emergency care, medical examination..). This area must have detailed instruction boards hanging at the entrance and have yellow symbols.
- Patients need to be isolated and treated at health facilities, minimizing complications and deaths. The time of isolation until the end of clinical symptoms.
- Patients who are not short of breath should use medical masks properly when interacting with others to limit the spread of disease. 2 . 2 . Prevention for patients and visitors:
- Immediately isolate people suspected of having disease, not to classify people who have been confirmed to wear corona with the suspect. All must wear masks. X-rays, tests, specialist exams. . . Should be carried out at the bed, if moving the patient, must have adequate protective equipment. The patient spits on a disposable soft tissue and immediately places in a medical trash.
- Practice good personal hygiene, wash hands often with soap; Use antiseptic nasopharyngeal drugs such as: gargle with antiseptic and other antiseptic solution of nose and throat. – Spread to crowded places to prevent spreading to others