There is a lack of protocols to treat Covid patients at home. The complaint of general practitioners
The Ministry of Health guidelines for family doctors for the care of Covid patients at home are not yet operational.
"For the home care of patients with Covid, we family doctors are firm on the indications that were provided to us between March and April". Thus the national secretary of the Federation of family doctors (Fimmg), Silvestro Scotti denounces the lack of shared protocols on anti Covid treatments to Ansa.
We are in mid-November, in the middle of the second Covid wave and insiders still complain about the absence of guidelines on treatments to treat patients with Covid.
SCOTTI: WE TREAT PATIENTS WITH PARACETAMOL AND VITAMINS
"For the care at home of patients with Covid, we family doctors are firm on the indications that were provided to us between March and April", said the national secretary of the Federation of family doctors (Fimmg), Silvestro Scotti, to Ansa . taking stock of the therapies used by general practitioners to treat patients at home.
“We treat the patients with paracetamol, ibuprofen, vitamins in the first place. If, on the other hand, the fever continues, also antibiotics and cortisone. If dyspnea occurs and the oximetry drops too much, we indicate the hospital, ”added Scotti.
VENESIA: A PROTOCOL IS NEEDED
We need an updated protocol, the doctors call.
"To treat Covid patients at home you need a protocol of homogeneous use, defined tasks, clear functions", Roberto Venesia, secretary of the Federation of General Practitioners (Fimmg) Piedmont, told Ansa .
“The guidelines should be written with the collaboration of virologists and pulmonologists.
It is also necessary to distinguish between therapies for people under 50 and for patients over 50 ”, added Venesia.
THE COMPLAINT OF BASSETTI
Matteo Bassetti, director of the Infectious Diseases clinic of the San Martino hospital in Genoa denounced the absence of shared protocols several times: "Since the Technical Scientific Committee has in fact centralized the relevant anti-pandemic rules to itself, I was expecting hospitalization criteria and treatment protocols from the CTS. There have not been and now there is chaos in the emergency rooms and in hospitals, where each doctor decides independently as there are no uniform hospitalization criteria and treatment protocols ", Bassetti told L'Aria che Tira, program by La7.
And always speaking to L'Aria che tira , a few days later, he says : “I believe that there has been a problem of organization. Many really need hospitalization, but there are just as many patients who, if they had support at home, if they knew that there were clear protocols, trained doctors who went to visit them and kept them connected to the hospital, they would have been treated at home ”.
READY LINES OF ADDRESS
The guidelines for family doctors for the care of Covid patients at home arrive. In the draft Protocol developed by the working group of the Ministry of Health, which also includes the President of the Higher Council of Health Franco Locatelli and other members of the CTS, among other things, the drugs to be used in home therapies are indicated. .
The document – explain sources of the Ministry to Ansa – aims to reduce the pressure on hospitals, through the monitoring and management of patients at home, with homogeneous methods throughout the national territory.
General practitioners , in collaboration with the Usca (Special Continuity Care Units) will be able to follow Covid-19 patients at home, indicate drug treatment and remotely monitor some parameters. Paracetamol is indicated for febrile symptoms, anti-inflammatories if the clinical picture of the Covid patient begins to worsen, cortisone only in emergency to avoid attacking the patient's immune system. No antirheumatic, no antibiotics. Heparin for people who have difficulty moving.
The text also contains the different classifications of the disease: the infection is considered mild if the patient has fever but the absence of dyspnea and radiological changes. It is moderate if the patient has pneumonia with radiological evidence and blood oxygenation is at the threshold values.
Severe when oxygenation is below the threshold, there is a high respiratory rate and pulmonary infiltrations are found. Finally, it is defined as a critical stage disease if respiratory failure, septic shock or multi-organ failure are present. The document also gives directions for establishing a therapeutic alliance with the patient and his caregiver. It will be the evaluation of the general practitioner , case by case, to indicate when the patient can no longer be treated at home but must be taken to the hospital.
This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/sanita/mancano-i-protocolli-per-curare-i-pazienti-covid-in-casa-la-denuncia-dei-medici-di-base/ on Sat, 14 Nov 2020 08:20:56 +0000.