No fever, no cough
The 80-year-old father turned white after Yang.
Ms Xu's father is 80 years old this year. Pneumonia was diagnosed the afternoon before yesterday, and I was admitted to a 3A hospital in Hangzhou that day.
Ms. Xu said that since mid-February, the family has never stopped. First, the two children are Yang. A week later, her husband was Yang. A few days later, she will be Yang herself. During this period, the most worrying thing is that the two old people who live together are also infected, so in the past two months, the two old people have basically stayed in their rooms except going to the toilet. In order to do a good job of disinfection, I bought more than 20 bottles of alcohol disinfectant at home.
On Monday, she was finally cloudy and people were much more comfortable. In addition, the two old people are in good condition, thinking that life can finally be normal, and even discussing with their husbands whether to eat hot pot at home to celebrate "new life."
"My parents have never tested for antigens. After the test, I thought I would give them a test by the way. It turns out that the old man is actually positive and the two bars are obvious. "
Ms. Xu said that this result was somewhat unexpected to her family. Because the old man didn't have a fever or cough during this time, he himself said that he didn't feel anything uncomfortable except his heart beat faster. If it must be said that it is abnormal, it is that I had a bad appetite that morning and ate a bowl of rice porridge.
After testing the antigen, Ms. Xu took her father's temperature, 37.2℃, which was slightly higher.
On the same day, the online shopping oximeter finally arrived, and the blood oxygen was measured, 94, 95, which was slightly lower.
On that day, the temperature didn't go up again. The whole family didn't care too much.
The temperature was measured again the next morning, and it was normal, but the blood oxygen concentration dropped to 9 1 and 92 when it was the lowest.
"There are many reports on the Internet that the blood oxygen concentration has dropped below 93, so I have to go to the hospital, so I am a little worried and wonder if it will be pneumonia. But at that time, the old man didn't want to go to the hospital, saying that people didn't feel sick. Why not go to the hospital to queue up? "
Ms. Xu said that at first, she and her husband saw that their old father was in good spirits and had a loud voice, so they hesitated to go to the hospital. Indeed, at this time, there is a long queue to go to the hospital, whether it is emergency or outpatient, especially CT. I don't know when it will be my turn. But I still don't feel at ease after thinking about it. Finally, I decided not to go to a general hospital, but to find a private hospital without queuing and have a CT scan.
"My husband contacted a private hospital on Minhe Road in Xiaoshan District. This hospital usually does high-end physical examination. In the afternoon, I took my dad. Sure enough, you don't have to wait in line. You can do it whenever you want. After finishing, the doctor immediately stopped us and said that pneumonia was a bit serious, and the upper part of the lung was basically white. It is recommended that we go to the general hospital for emergency treatment immediately. "
Ms. Xu said that although this private hospital can't use medical insurance, the inspection fee of several hundred dollars is self-funded, but now I think about it, this money is too much.
Recalling her father's pneumonia experience, Ms. Xu said that he suffered from pneumonia twice a few years ago, but the symptoms were obvious, with high fever and cough. But I didn't expect that this time, COVID-19, whose lungs were all white, was still "asymptomatic".
Network picture
"If you want me to sum up, first, the oximeter is very important. I suggest that families with old people must prepare one. If we hadn't found that the blood oxygen concentration was only 9 1 and 92 this time, we wouldn't have made up our minds to take him for CT. If we put it off for another day or two, the situation may be different. Second, we should pay special attention to the appetite of the elderly after yang in this period. If our appetite suddenly deteriorates, we, as juniors, should be especially vigilant. The third is that if you don't want to line up in a general hospital, you can go to a private hospital for a CT. " Ms. Xu said.
8 1 year-old uncle has cough, fatigue and loss of appetite.
CT showed extensive ground-glass exudative inflammation in both lungs.
A few days ago, an 8 1 year-old patient was admitted to the respiratory department of Zhejiang Provincial People's Hospital. He entered the clinic with the help of his daughter.
Shao Fangchun, deputy chief physician of respiratory medicine, saw that the old man was walking slowly and breathing a little fast, so he quickly sat him down and leaned back in the chair.
The old man said that he has a bad appetite recently, and he always can't eat, and he is very weak. Without saying a few words, he coughed and then gasped.
The old man's daughter added that a few days ago, his family was infected with COVID-19 virus. It has been 65,438+00 days since his father's antigen test was positive. He has never had a fever, but he has a cough, no strength and no appetite. However, the elderly think that these are normal symptoms of the disease and have not attracted attention.
"I suggested that he come to the hospital. He said that it doesn't matter if you don't have a fever, so it will be delayed until now. " The daughter said that considering that her father had coronary heart disease and diabetes, she insisted on taking the elderly to the hospital for examination to be on the safe side.
As soon as the daughter's voice fell, the old man coughed again.
Cough for more than a week, shortness of breath, poor appetite, poor spirit Shao Fangchun judged from his own experience that the old man was likely to have a lung infection and immediately contacted the emergency department to take pictures of him.
During this period, the number of emergency chest CT examinations and reports in the radiology department of our hospital increased by 4-6 times, with 1 0,000-10,500 CT examinations per day. In addition to patients who have already made an appointment, emergency, severe and elderly people will be given priority.
On the way to the examination room, the old man took a break after taking two steps, but still thought that his illness was "not so serious".
Unexpectedly, the results of filming showed that there was a large area of ground-glass exudative inflammation in both lungs, which would soon develop into severe disease if it was not treated in time. Shao Fangchun immediately took him to the hospital, and the old man was still in hospital.
"The elderly over 60 years old, especially those over 65 years old who have not been vaccinated with COVID-19 vaccine, suffer from various chronic basic diseases, including chronic lung disease, heart disease, diabetes, obesity and cancer. People who use immunosuppressants and need regular dialysis treatment need to pay more attention to whether there is a lung infection. " Shao Fangchun said that about 10%-20% of the patients who came to the clinic recently suffered from pneumonia, especially some elderly people with basic diseases, who were often found to be seriously ill.
The 77-year-old uncle slept for half a day.
The affected area of both lungs accounts for more than 75%
Wang Haochu, deputy chief physician of the Department of Radiology, Zhejiang Provincial People's Hospital, said that a 77-year-old man came to the radiology department for emergency chest CT two days ago. Before the examination, he also said that he didn't have a fever or cough much, but he was not in good spirits. Results CT showed diffuse patchy ground glass shadow and consolidation shadow in his lungs, with blurred edges, and the affected area of both lungs exceeded 75%, showing typical "white lung" performance! In addition, there are bilateral pleural thickening, heart enlargement, calcified plaques of aorta and coronary artery, etc.
The old man's family said that he used to go to bed early and get up early. After COVID-19 was infected, other symptoms were not obvious, but he was particularly sleepy and slept in bed for almost half a day.
The attending doctor traced the medical history of the old man and found that he had a history of diabetes for 15 years and a history of hypertension for more than 10 years. He started hypoglycemic therapy only two years ago and is currently receiving insulin therapy. The elderly have a serious lung infection and the overall situation is worrying. He was admitted to hospital soon and is still undergoing further treatment.
According to Lin Yi, assistant director of radiology department and deputy director of diagnostic group,13 of the patients who came to radiology department for CT examination on October 3 were pneumonia caused by COVID-19, most of whom were elderly patients with basic diseases.
Shao Fangchun said that young people have strong immunity, and the immune system is stimulated after infection, which makes them more prone to high fever. The immunity of the elderly is relatively low, and they may not have a fever after infection, which also leads many people to ignore it and delay treatment.
"Generally speaking, the symptoms after infection will be relieved and disappear within one week. Older people should be more cautious and never delay for more than a week. Once it develops into severe pneumonia, it is not only troublesome to treat, but also has a worse prognosis. "
The old man stayed at home and basked in the sun.
The idea of not coming to the hospital is wrong.
Gong Jianhua, chief physician of general internal medicine of the First People's Hospital of Hangzhou, said that among the 180 patients admitted to the hospital one day, 20 were elderly people. They had no obvious symptoms-they didn't have a high fever or cough, but they had a bad appetite and didn't have the spirit to see a doctor. CT examination showed that severe pneumonia had occurred.
Gong Jianhua pointed out that there are many elderly outpatients, about 10%-20%. Because these old people themselves have basic diseases, and many of them are holding the concept of "tolerance" and holding the purpose of not coming to the hospital. For example, an 80-year-old diabetic admitted to the hospital a few days ago had low body temperature and no other obvious symptoms except poor appetite. However, as soon as CT examination was done, he found symptoms of pneumonia, hyponatremia and hypokalemia, and even heart failure.
"Many young people come to the hospital to see a doctor and think that they may be anxious about certain diseases, but the elderly who are really sick don't come to the hospital." When it comes to this situation, Gong Jianhua is very excited. "The response of the elderly is slow and somewhat slow, especially for many elderly people who live alone. They have no sense of seeking medical treatment."
For these elderly people, Gong Jianhua suggested that when they have poor appetite, poor mental state and short breath, they must seek medical advice in time so that doctors can judge the severity of the illness. "It is wrong for the old man to stay at home and take antipyretics. It is necessary to reverse this awareness of medical treatment. "
Gong Jianhua also pointed out that children are the people who know their parents best. "Children should pay attention to the elderly in their own homes in time, and observe whether their appetite is normal and whether their reaction is the same as usual. If there is any abnormality, you should send it to the doctor in time. "
Prone position treatment
It is helpful to improve blood oxygen saturation and promote sputum discharge.
"So far, patients have mild symptoms, but they have indeed encountered serious cases of pneumonia, but not many. I only have a few cases in my hand, mainly the elderly. "
Zhou Yong, deputy chief physician of the Department of Respiratory and Critical Care Medicine of Run Run Run Shaw Hospital, said that the situation of these elderly people is similar, and they all have some basic diseases more or less. After infection, the symptoms are not obvious, I feel no obvious chest tightness and asthma, and it doesn't look like panting. But in fact, their oxygen saturation is very poor, and they have severe pneumonia symptoms and need hospitalization. A similar situation is not necessarily unique to COVID-19. Before the emergence of COVID-19, pneumonia caused by common influenza may also show such manifestations.
"If patients with chronic heart and lung diseases have adapted to the hypoxic environment for many years, even if the oxygen saturation is poor, they may not seem to have obvious symptoms of shortness of breath."
"In any case, severe cases in COVID-19 often appear in the elderly and people with basic diseases. Once such people are infected with COVID-19 virus, they need to pay more attention and seek medical advice if necessary. " Zhou Yong warned.
In order to help COVID-19 patients with severe and high-risk factors better ventilate, Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run run
Run Run Run Shaw Hospital of Zhejiang University provided guidance and services for nearly 700 COVID-19 patients in the hospital.
Zhuang, deputy dean of nursing in Run Hospital of Zhejiang University, said that the novel coronavirus Diagnosis and Treatment Plan pointed out that ordinary, severe and critically ill patients with serious high-risk factors and rapid progress should be given standardized prone position treatment.
"When the prone position is adopted, it can not only promote the' resurrection' of the back alveoli, improve the exchange of qi and blood, but also improve the oxygen saturation and promote the discharge of sputum." Zhuang Yizhen said, "Lying down is the simplest, safe, economical and effective respiratory therapy, but it needs to be carried out under the guidance of medical staff to help patients improve their respiratory conditions and avoid developing into critical diseases."
Orange Persimmon Interactive Reporter Lin Lin Zhang Jing Zhang Huili
Trainee reporter Wu Shuang
Correspondent Yang Ma Hao Chu Wen Li