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Game Changers - CMAAO Coronavirus Facts and Myth Buster 73

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Dr KK Aggarwal    27 April 2020

Game Changers in COVID-19

(With regular inputs from Dr Monica Vasudev)

Early suspicion

  • 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

  1. Non touch temperature twice daily
  2. SPO2 monitoring: Keep it between 92-96%

Fall of > 4% on walking or talking is significant; report to your doctor

  1. Oxygen concentrator is worth investment in the extended family (5 litre per minute capacity or 10 litre per minute)
  2. Pool money and donate a HFNC (high flow nasal canula) to your hospital and ensure its availability if one of your members needs one.
  3. Pool money and donate a high-end ventilator to your hospital and ensure its availability if one of your members needs one.
  4. Start sleeping prone to have a practice in case you end up in prone oxygenation.
  5. While checking for SPO2 level, make sure no nail polish or artificial nails is there, making sure their hands are warm when checking oximetry.
  6. If you walk <200 meters in six minutes, you are a high-risk patient for COVID-19. Stay at home.
  7. Emotional personal protective equipment: Stay connected socially and emotionally
  8. 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

  1. Sub-clinical hypoxia: Subjective shortness of breath, oxygen saturation may be normal
  2. Silent hypoxia: You need O2, CPAP, Prone positioning
  3. 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

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