Covid19 takeaway message
RT-PCR is only 70% sensitive. It increases when symptoms progress and that’s the reason we r not testing on asymptomatic patients.
40% patients are afebrile and so doesn’t rule out covid19. If someone develops cough advise to wear mask.
Lower respiratory signs like sob start only around day 8 or 9
Average 12 days ventilator time.
Bil ground glass opacities
Lymphopenia
Elevated CRP is a marker. If normal think of other diagnosis.procalcotonin normal.
D dimer is elevated- prognosis bad.
If stable send pt home with
Pulseox thermometer resp rate check. tele health nurse to check
Cardiomyopathy/myocarditis develops.
Acute renal failure is a strong predictor of mortality. If that is acute renal failure the mortality is 92%. It is more predictive of mortality than development of ARDS.
They said something about ‘viral shelter’?(couldn’t understand - sounded like a device attached to the intubation kit) during intubation to prevent viral dissemination.
Co-infection with flu and covid19 exists only 2%. So we don’t recommend testing both.
Swab- when swabbing use an N95 mask and appropriate PPE on the person who s collecting. Deep nasal swab recommended for collection of sample.
Herd immunity- currently under exploration.
Self quarantine - stay in a room have separate bathroom. If positive isolation - continue.
Treatment in the US -remdesivir and chloroquine. Not hydroxychloroquine. Tamiflu is not useful
Nebuliser not recommended. Aerosolized and so causes spread. MDI better
Steroid ok.
ACEI - according to Mass general don’t take away ACEI. Don’t add it. In investigation
Antiseptic- home made-
1 tbsp of bleach and 4 cups of water
Quarter cup of bleach and 1 gallon of water
Healthcare workers- don’t bring your steth, labcoat, workcloths home. If possible change and then come home. If not change as soon as your enter home, put it for washing and then enter. Wipe your steth and bags with disinfectant
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