Due to the spread of a koronavirusny infection and its transformation into a global problem, particular importance ways of observation of the patient and control of a course of this disease are. Ways of monitoring in the conditions of a pandemic can considerably will cause a stir from those in a quiet situation as at mass arrival of victims there is a certain deficiency of forces and means of health service. In this article we will consider main types of monitoring at a koronavirusny infection and feature of their use in the conditions of mass incidence.
In clinical practice distinguish several types of monitoring: clinical monitoring, tool monitoring and laboratory monitoring. As a rule, these ways are shared, supplementing data of each other that allows the doctor to create more objective picture of weight and disease.
Clinical monitoring, that is collecting complaints and the anamnesis, physical assessment of a condition of the patient, in classical medicine remains a main type of monitoring, and all others serve only for confirmation of this or that diagnostic hypothesis and observation (together with clinical monitoring) for the patient in dynamics. At the same time, at mass arrival of patients great value take screening forms of monitoring when rather easy and available tool way of assessment of a condition of the patient is used, and then by his results the conclusion about need of survey of such patient is drawn by the specialist. The pulsoksimetriya or thermometry can act as such methods at a koronavirusny infection. Patients at whom fervescence or decrease in indicators of saturation of hemoglobin of an arterial blood oxygen comes to light go for detailed survey by the specialist, performance of methods of tool diagnostics and so on.
However, clinical monitoring will be a main type of monitoring when maintaining patients with a koronavirusny infection in out-patient conditions. It will be connected first of all with the fact that all patients who will be treated on an outpatient basis cannot organize performance of many tool diagnostic methods, in particular, a X-ray analysis of bodies of a thorax and a computer tomography, besides, these methods of a research are not shown to most of patients with the easy course of an infection. Therefore the task of the specialist who will perform treatment and observation of patients at home includes timely recognition and identification of a heavy course of a koronavirusny infection and its complications at which additional tool diagnostic methods can be required.
Tool methods of monitoring represent researches which are used generally at treatment of the patient in a hospital. Treat them: measurement of noninvasive arterial blood pressure, pulsoksimetriya, kapnografiya, monitoring of an ECG, monitoring of a respiration rate, temperature and other methods. These methods are used generally in intensive care units and an intensive care where there are special monitors which are carrying out continuous tracking a condition of vital functions of the patient. The monitoring applied when carrying out artificial ventilation of the lungs and other special methods of treatment which are carried out in the conditions of intensive care unit and resuscitation also belongs to this look.
Speaking about tool methods of monitoring, it is worth mentioning portable pulsoksimetra which use allows to control saturation of hemoglobin of an arterial blood oxygen at patients at home, in reception and somatic offices of hospitals and also the patient or his relatives after instructing passing. This the way available now allows to reveal in due time an anoxemia and to take measures for rendering the help to the patient.
The third, very important type of monitoring — laboratory monitoring. The Koronavirusny infection is among the infections confirmed by means of a laboratory research. Besides, treatment of patients with severe forms of COVID-19 will demand performance to these patients of various laboratory researches, including a research of an acid-base state and gas composition of blood. All this will demand significant forces and funds from the party of laboratory service. Now various biochemical and hematologic markers of a heavy course of a koronavirusny infection are actively studied and they will also decide on the help of laboratory service.
Thus we considered main types of monitoring at a koronavirusny infection and feature of their use in the conditions of a pandemic.