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PIERLUIGI DALLAPINA
Of course, the coronavirus no longer overwhelms hospitals with waves of dying people, but it is no less dangerous for this. In fact, it is now more subtle, because it must be eliminated by families, the last front, along with protected houses, in the fight against contagion. A few days ago, the hospital established a team of professionals, with ultrasound and swabs, at the service of general practitioners to treat the most problematic cases. This equipment is an evolution of the multidisciplinary mobile units (abbreviated with the abbreviation Umm) that were already used on a large scale for about a month in sheltered houses and have now also been hijacked within them. The goal is the usual one: find the virus quickly, isolate the infected and treat them in the best way. Where “best” means finding personalized attention for each individual patient, since this virus is a difficult monster and difficult to cage. So far, 29 people have been treated: only one has been hospitalized.
THE WINNING WEAPON
“Thanks to the multidisciplinary units, we want to discover positive cases at the beginning of the disease,” begins Tiziana Meschi, director of the geriatric rehabilitation department and director of the Covid hospital. “We have to be timely, this is the lesson we have learned in recent months. The sooner we intervene against the virus, the greater the effectiveness of the therapy, “says the director, before explaining how the multidisciplinary units operate during their interventions at home.” When they go to the houses of the sick, they make swabs for the entire The family and in four or five hours, the Hygiene laboratory can give the results of the tests. In this way, the therapy can be configured as soon as possible “.
PARMA IS THE SCHOOL
The idea of sending a team of specialists directly to patients’ homes is a national rarity that, from the pages of the Corriere della Sera, has garnered the appreciation of Giuseppe Remuzzi, director of the “Mario Negri” Institute for Pharmacological Research at Milan. For Remuzzi, the contagion will remain under control and, hopefully, it will also be gained by investing in the territory, that is, in general practitioners, defined as the first bulwark against the spread of the virus.
FAMILY DOCTORS
The role of primary care physicians is the pillar on which Umm interventions rest, as the units do not move independently. As the director explains, “everything revolves around the general practitioner, because it is he who activates his intervention based on the patient’s state of health.” This can be a positive patient or a case of positively suspected coronavirus. But if the patient does not present symptoms attributable to Covid or if he has a non-problematic clinical picture, the treatment route is administered directly by the doctor who, if he deems it necessary, can request the support of Usca, the special continuity units of the care they maintain The general condition of the patient is under control. In case things get worse, the doctor can call the hospital (a dedicated control panel will be active shortly) and request the intervention at home from the specialists.
ANTI-CONTAGION EQUIPMENT
The infectious diseases specialist, the geriatrician, the internist, the pulmonologist, the emergency and emergency specialist or the anesthesia and resuscitation specialist are the figures that, depending on the needs, may be presented at the patient’s home to guarantee more detailed advice. for each case To support Umm specialists, there is always a nurse who is tasked with swabbing patients to discover traces of Covid-19.
“The multidisciplinary mobile units do not have standard training, but they change according to the indications of the family doctor,” explains Antonio Nouvenne, director of internal medicine. “We want to put into practice the concept of personalized medicine. Therefore, the patient faces four specialists committed to understanding his clinical picture. In addition to the skills of various doctors, the strong point of these teams that hunt the virus inside our homes is the technological equipment. “We have ultrasound of different power available to carry out a first-rate evaluation or to make a more accurate diagnosis,” says Nouvenne. Just to give a concrete example, ultrasound of the abdomen may be a valid alternative to CT to trace the signs of interstitial pneumonia, typical of the presence of coronavirus. Finally, Tiziana Vallara, coordinator of the units, remembers that the last word about the presence or absence of the virus is the buffer. And for this it must be entrusted to expert hands. “Nasal and oropharyngeal swabs are effective only if done correctly.”
