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Game Changers in COVID-19
(With regular inputs from Dr Monica Vasudev)
- Not feeling well
- Dry Cough
- Feverish like feeling
- Loss of taste or smell
- Diarrhea despite all hand wash precautions
- Breathlessness on walking or talking
Home monitoring equipment
- Non touch temperature twice daily
- SPO2 monitoring: Keep it between 92-96%
Fall of > 4% on walking or talking is significant; report to your doctor
- Oxygen concentrator is worth investment in the extended family (5 litre per minute capacity or 10 litre per minute)
- Pool money and donate a HFNC (high flow nasal canula) to your hospital and ensure its availability if one of your members needs one.
- Pool money and donate a high-end ventilator to your hospital and ensure its availability if one of your members needs one.
- Start sleeping prone to have a practice in case you end up in prone oxygenation.
- While checking for SPO2 level, make sure no nail polish or artificial nails is there, making sure their hands are warm when checking oximetry.
- If you walk <200 meters in six minutes, you are a high-risk patient for COVID-19. Stay at home.
- Emotional personal protective equipment: Stay connected socially and emotionally
- Physical personal protective equipment: Cloth masks, gloves and shoe covers; Bleaching powder and hand sanitizers.
Remember high risk situations
Walking dead: You look all right, but your oxygen levels are 40-50 (Red Zone)
What is walking dead phenomenon
The walking dead phenomenon is what doctors in the ER are currently reporting with many COVID-19 patients. These patients do not have any sensation of breathing problems, even though their chest X-rays shows diffuse pneumonia and their oxygen is below normal.
Green and Red zones
- Sub-clinical hypoxia: Subjective shortness of breath, oxygen saturation may be normal
- Silent hypoxia: You need O2, CPAP, Prone positioning
- Red Zone: Intubation and high mortality
763: Heart Rate
Exertional increased heart rate may be the first sign of silent hypoxia.
Dr KK Aggarwal
President CMAAO, HCFI and Past National President IMA