How to arrange the best job for critically ill patients in COVID-19?

(1) Find out the base

Quickly find out the number of key groups such as chronic patients, hemodialysis patients and mental patients in the jurisdiction and register them, implement classified management, and require accurate home visits so as to determine the demand for medical services at the first time.

(2) Health education and publicity

Improve the vaccination rate, strictly prevent patients from going home and during treatment, rationally regulate the use of protective equipment, strictly abide by the "two points and one line", avoid unnecessary going out and gathering, and stay away from closed public places. Try to avoid taking public transport when going to and from the hospital. If you must take it, you should strictly protect yourself, wear a qualified mask all the time, and keep a safe social distance. During the epidemic period, patients should strengthen nutrition intake, exercise reasonably and enhance their own resistance. The diet structure is mainly high-quality protein diet.

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(3) Strengthen the management of key groups

Make overall arrangements for the medical staff in the hospital, and focus on health consultation and diagnosis and treatment of common diseases and chronic diseases according to the actual situation of the control area and the number of key people. If the treatment effect is poor, the diagnosis and treatment conditions are insufficient, and the condition has not improved or deteriorated, it should be transferred to a higher-level hospital for further diagnosis and treatment. If it is really necessary to go out for medical treatment after hospital evaluation, it should be transferred to a designated hospital according to relevant regulations. When COVID-19 positive cases are found, the patients will be transported to the designated hospital in COVID-19 in a closed loop, and the terminal disinfection work will be done well.

(4) Strengthen transshipment scheduling.

Ambulances are on duty 24 hours a day, and special ambulances are designated to pick up and drop off patients in closed control areas, and the "last meter" of medical treatment is resolutely opened. Establish a closed-loop management mechanism for ambulances, arrange special personnel to participate in the fixing of transport personnel and vehicles, and arrange a single room (with a separate bathroom) to live during work, so as not to live together, visit each other, eat in the lobby or shop and eat outside. All personnel involved in transshipment travel at two o'clock and one line between the place of residence and the hospital. Carry out terminal disinfection of transfer vehicles and medical devices in strict accordance with relevant national requirements.

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(five) the implementation of classification.

1, fever patients, fever clinics, whether there is a nucleic acid test report or not, all should do nucleic acid testing, and the test results will be observed before feedback. Strict closed-loop management is implemented for patients with fever.

2, critically ill patients, do a good job in hospital beds and critically ill beds, increase treatment resources. It is necessary to set up the necessary emergency room and buffer ward, smooth the green passage, and implement the responsibility system of first diagnosis. For critically ill patients who cannot be excluded from COVID-19, medical staff should do a good job in protection and treatment at the first time, and should not shirk or refuse treatment for any reason. At the same time of active rescue, nucleic acid testing should be carried out. Need to be hospitalized after treatment, first in the transition ward isolation treatment, excluding COVID-19 and then transferred to the general ward. Do a good job in the transportation of critically ill patients and shorten the time of pre-hospital first aid.

3. For patients with chronic diseases, the prescription dose can be extended to 12 weeks according to the condition, and remote guidance can be strengthened by telephone and WeChat follow-up to strengthen the daily management of patients with chronic diseases and meet the daily medication, treatment and medical consultation services. Straighten out the treatment process of patients with chronic diseases and ensure the sustainability of treatment.

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4. Medical personnel who need to be vaccinated with rabies vaccine, tetanus vaccine and other emergency vaccination groups should do personal protection and carry out emergency vaccination services.

(6) Strengthen closed-loop management.

When COVID-19 infection cases, nosocomial infection outbreaks or other situations requiring closed-loop management occur in medical institutions, it is necessary to classify the high and low risk levels in the hospital, coordinate the scientific deployment and reasonable arrangement of human resources, strengthen the health management and monitoring of staff in the hospital, improve the medical service and logistics management processes, and carry out scientific, rapid, stable and orderly response and disposal.