There has been a change once again in the medical protocol of corona patients.This time all those medicines including HCQ, Ivermectin, Vitamins, Favipiravir, Plasma have been removed which were being given to patients for the last one year.
The Directorate General of Health Services under the Union Health Ministry has issued new guidelines.
According to this, a patient without symptoms does not need any medicine anymore. Such patients can be cured by taking a balanced diet and talking to family members.
These guidelines have removed the need for drugs like HCQ, Favipiravir, Ivermectin, Azithomycin, Doxycycline, Zinc and Vitamins etc. for patients with mild symptoms. Whereas for the last one year, these medicines were being administered to corona patients across the country, due to which there was a lot of black marketing of these medicines when the demand increased in the market.
However, these new guidelines of the Directorate General are also contradicting the guidelines of the Indian Council of Medical Research (ICMR) and the All India Institute of Medical Sciences (AIIMS), New Delhi.
Important to think before giving Remdesivir
Regarding Remdesivir and tocilizumab, it has now been said that these two drugs are being used only experimentally.These drugs also have serious side effects.Therefore, doctors have been told that before giving these medicines, it is necessary to think once. High caution is advised when using them.
Clear instructions on fungus, steroids, HR-CT
A separate page has also been given about when and under what conditions to give injection of amphotericin B to the patients of fungus. Similarly, each point has been clarified in simple language regarding the use of steroids and anti-coagulants.
According to this, 6 mg dexamethosone can be given once a day for 10 days.Doctors have been clearly instructed that HR CT and steroid containing drugs should be used with extreme caution.
Asymptomatic patients
Identification: No fever, no cough, no shortness of breath, only report positive.
Treatment: Home isolation and telemedicine are enough. No medicine is required. Nor is there any need for any blood or other medical tests.If there is any other disease already, then its medicine can be continued. Keep eating a healthy balanced diet. Have positive conversations, give time to family members on phone-video calls.
Mild Symptomatic Patients
Identification: No problem in breathing, oxygen more than 94 percent.
Treatment: You can consult telemedicine with home isolation. If there is no space in the house, then you can go to the Covid monitoring center. Eat a healthy balanced diet and talk to the family members on the phone, give them time. In case of fever, difficulty in breathing or lack of oxygen, the patient himself will write the routine and talk to the doctor. Paracetamol for fever and budesonide for cough can be given to such patients. Apart from these, no other medicines or tests are needed.
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With Moderate Symptoms
Detection: Shortness of breath or difficulty in breathing, respiratory rate greater than 24 but less than 30, SPO2 at 90-93 per cent of room air, etc.
Treatment: Such patients can be admitted to the Covid hospital or the district centre. These patients may be given oxygen, pre-existing disease, steroids and anti-coagulant drugs. There is no mention of 2DG or Coronil. If the patient is suffering from COPD (Black Asthma), then oxygen therapy cannot be given to him. In these patients, more attention has to be paid to other diseases like diabetes etc. Steroids will be given only if oxygen is less than 92. Advice for pruning.
For Critical Patients
Identification: Shortness of breath, respiratory rate greater than 30/min, spo2: less than 90% of room air except COPD, etc.
Treatment: Immediate admission to ICU with oxygen therapy should not be delayed. Consider the use of HFNC if the patient does not improve. Still, if there is no improvement, then ventilators can be considered. Start steroid therapy.
Examination of moderate and severe patients only
CBC, blood glucose, urine routine, LFT, KFT, CRP, S ferritin, D-dimer, LDH, CPK. These can also be repeated. If you want to double check then CRP and D-DIMER 48 to 72 hours, CBC, KFT, LFT 24 to 48 hours etc. HR CT chest should only be performed if symptoms worsen.
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