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Covid19 corona management -كوفيد19

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OVID-19 Management experience
What we learned from bedside experience in COVID-19 treatment
Dr. Essam A. Salem, ICU Registrar, Meeqat GENERAL.HOSPITAL, Head OF ICU Unit Meeqat General Hospital

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Covid19 corona management -كوفيد19

  1. 1. 1-When to start Antiviral 2-Antibiotics 3-Corticosteroids 4-Tocilizumab 5-Mechanical ventilation 6-The psychological state of the patient 7-Anticoagulants 8-Ivermectin and hydroxylchloroquine 9-Lasix
  2. 2. Once there is a radiological finding in CXR, we must start antiviral treatment even if the swab result have not yet come out. If the swab result came out negative we continued to administrate the Antiviral treatment and retested the patient again for covid19 If fever persisted for more than two days Antiviral treatment was initiated
  3. 3. We discovered early that we have to start broad spectrum Antibiotics if there is CXR findings 1-Vancomycin or Linzolid 2-Meropenam, Imepenim or Tazocin 3-Moxifloxacin 4-Azithromycin
  4. 4. Arguing about wither or not we should follow treatment guidelines of community acquired pneumonia made us always late by one or two steps in COVID19 pneumonia due to secondary bacterial infection
  5. 5. We started administrating IV Methylprednisolone in all cases admitted to the ICU since March 2020 and we think it's one of the main reasons of good treatment outcome Later dexamethasone and methylprednisolone was added to MOH protocol
  6. 6. Methylprednisolone also continued for some patients by a pulmonology consultant to prevent progression of interstitial lung fibrosis in cases complicated by interstitial lung fibrosis
  7. 7. This medication is not in the MOH protocol Tocilizumab showed improvement in cases pre intubation or just intubated Improvement can be observed within few hours
  8. 8. Intubated cases have had very poor outcome intubation should be delayed as much as possible.. High flow nasal cannula * . * NIV
  9. 9. The psychological status of the patient plays a very important role in patient's prognosis Irritable and uncooperative patients are usually intubated early due to their exhausted state caused by unnecessary and purposeless movement and speech.
  10. 10. Anticoagulants play a huge role in preventing and reducing morbidity and mortality related to COVID-19
  11. 11. Hydroxylchloroquine is approved by WHO to be effective in mild cases Ivermectin is used to treat COVID-19 in Egypt, Bangladesh, and Brazil. The medication is not approved by the FDA for COVID-19 cases yet.
  12. 12. Diuretics are very important in prevention of intubation . If we had the slightest doubt about the patient’s cardiac function an ECHO was done to review any indication for diuretics or other supportive cardiac medications .
  13. 13. Don’t be late in starting : -Antiviral -Antibiotics -Corticosteroids. Hesitation in starting the treatment can only harm the patient COVID-19 is a professional killer that can only be stopped by professional and efficient medical practitioners.

OVID-19 Management experience What we learned from bedside experience in COVID-19 treatment Dr. Essam A. Salem, ICU Registrar, Meeqat GENERAL.HOSPITAL, Head OF ICU Unit Meeqat General Hospital

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