[ad_1]
A new measure in hospitals for patients infected by the new coronavirus. In emergency reception units, triage will be carried out with rapid tests, for rapid decongestion. The measure is granted by order of the Minister of Health.
However, asymptomatic patients stay at home under the supervision of family doctors, and the latter will have a standardized questionnaire to know what to ask them.
Those with risk factors will be transferred to hospitals, With those with medium shapes or serious will be hospitalized, with your consent, in phase I or II hospitals.
Patients who experience post-COVID-19 sequelae after discharge (dyspnea, fatigue, neurological disorders and others) will need additional follow-up both by the family doctor and by specialized services with periodic reviews.
Rapid tests in emergency units
According to the document, the patient with a positive SARS VOC 2 no longer needs to be retested for RT-PCR for 90 days after healing, except in people with severe immunosuppression or who develop clearly suggestive symptoms. However, if the test is retested, a positive result within 90 days of healing cannot be considered a new infection, except for people who are severely immunosuppressed or who develop clearly suggestive symptoms.
For the triage of symptoms, according to the case definition, in UPU / CPU, given the need to decongest as quickly as possible, but also safely, these areas have created the legal framework for the use of antigen detection tests SARS CoV-2.
Simultaneously with the rapid test, the collection for RT-PCR will be performed.
Patients with a positive test result will be immediately isolated in the Covid areas.
Patients with negative test result they will remain in the buffer zone if they present symptoms that require hospitalization; If they do not require hospitalization, they will be left at home until the RT-PCR result is received.
For asymptomatic patients, the use of rapid tests is not recommended at this time.
What do testers have to do until they receive the result
Until infection with an infectious disease is confirmed, individuals with signs and symptoms suggestive of the case definition are isolated at home or at another location of their choice..
In this case, people in this situation have the obligation to contact and inform the family doctor about the hypothesis in which they are, including about the place where they decided to isolate themselves.
The family doctor is obliged to register and control the health of the affected persons and sends the isolate follow-up form based on the follow-up form to the public health department.
What the patient should test for the new coronavirus
Thus, all patients detected in the RT-PCR test with a positive result for SARS-CoV-2 have the obligation to contact and inform the family doctor about the hypothesis in which they are, including about the place where they decided to isolate themselves. The family doctor is obliged to register and monitor the health of the affected persons and sends the isolated follow-up form to the public health department.
Then telephone evaluation of the family doctor, based on the questionnaire provided in the Monitoring Sheet in the annex to this order, patients will be included in the following clinical categories:
- a) Asymptomatic or mildly symptomatic patients who do not require hospitalization: they can be isolated at home or in the declared place. if it declares that it has isolation conditions, or in an alternative place attached to a health facility, or in specially designated spaces if it does not have isolation conditions; In the case of isolation at home or in the place declared by the patient, the family doctors will carry out a daily health monitoring. These asymptomatic / symptomatic patients with mild forms who have completed the isolation period of 14 days from the date of the first positive test, declared cured without the second control test, can resume their current and professional activities by keeping their distance and using the mask at home and on site. for another 10 days, in compliance with current legal provisions.
- second) Symptomatic patients with risk factors, on the recommendation of the family doctor, at their request and with their consent, will be transferred through SAJ / SABIF to hospitals. provided for in the Order of the Minister of Health No. 555/2020, with subsequent modifications and completions, where they will be clinically evaluated, through laboratory tests and, if deemed necessary, pulmonary radiological examination or computed tomography examination. The evaluation can be carried out by means of hospitalization of the patient, by day hospitalization or without hospitalization of the patient (consultation and paraclinical examinations in the ward / UPU / CPU).
- C) Symptomatic patients with moderate or severe forms will be hospitalized with their consent in phase I or II hospitals. that have in their structure intensive care units or in support hospitals, in case phase I or II hospitals do not have intensive care units, the hospitalization period will be established by the treating physician.
What are the admission criteria
- a) Asymptomatic patients with risk factors can be isolated in phase I, phase II or support hospitals on the recommendation of the family doctor, upon request and with their consent.
Asymptomatic patients with positive risk factors in the control test you can register even before 10 days, after at least 72 hours of absence of any symptoms of COVID-19, if the treating physician considers it appropriate based on clinical and paraclinical criteria, provided that isolation at home or in the place declared by the patient until 14 days of the isolation period, which is calculated from the collection date of the first positive test, without requiring a second control test.
Monitoring of the patient’s health during isolation at home or in the place declared by the person is carried out by the family doctor, daily, by telephone, through a remote medical consultation. PAmong patients who are not on a family doctor’s list, the county or Bucharest public health department carries out a daily follow-up.
The family doctor will declare the patient cured based on the results of the daily monitoring, through remote medical consultation, considering as curative criterion the absence of clinical manifestations during the follow-up period. The healing condition will be communicated in writing by medical letter sent using remote electronic means of communication to the county / Bucharest public health directorate, which is obliged to enter the healing status on the Corona forms platform within 24 hours after receiving the letter.
Patients with kidney disease who require dialysis and who test positive can stay in the hospital for up to 14 days to ensure access to dialysis (a procedure that cannot be done in isolation at home).
- b) Symptomatic patients with moderate or severe forms will be hospitalized in phase I or II hospitals with intensive care units or in support hospitals, if phase I or II hospitals do not have intensive care units. Hospitalization should last until all of the following criteria are met: at least 14 days from the date of the first positive test and the absence of fever for at least 72 hours and improvement of symptoms. Control RT-PCR tests will be performed after meeting the above criteria.
Patients who test positive for SARS-CoV-2 RNA may be discharged if deemed appropriate by their physician. based on clinical and paraclinical criteria, with indications of isolation at home or in the place declared by the person for a period determined by the treating physician.
Patients with a negative SARS-CoV-2 RNA control test are declared cured at discharge by the health unit, and those who have been recommended for isolation are declared cured by their family doctor at the end of the recommended isolation period. If these patients do not have a family doctor, the cure will be declared at the end of the isolation period by the treating doctor who treated the case. The health unit where the patient was treated has the obligation to enter the healing status in the Corona-Formas platform within 24 hours after discharge.
Remote daily medical consultation by family doctors or DSP
Monitoring of the patient’s health during isolation at home or in the place declared by the person is carried out by the family doctor, daily, through remote medical consultation. For patients who are not registered on a family doctor’s list, the daily check is carried out by the county / Bucharest public health directorate.
Patients who experience post-COVID-19 sequelae after discharge (dyspnea, fatigue, neurological disorders and others) will need additional monitoring both by their family doctor and specialized services, with periodic check-ups of cardiac and pulmonary computed tomography , walk test, other investigations that the treating physician deems necessary.
After 14 days from the date of collection of the first positive test, for patients declared cured of COVID-19, upon re-entry to the community (workplace, educational unit, etc.) no epidemiological opinion or request for a test is required negative for RNA-SARS CoV-2.
Publisher: Georgiana Marina
