Continous Cough with some amount of mucus
Female patient age 50 Chief Complaints Cough and pain in throat and chest alongwith breathlessness since 7 days days History History of taking medication for same fever subside but cough continue Taking medication for dm 2 since one year But blood sugar is in control Vitals Bp:130/84 App low since one day Bowel and bladder normal Temp:97.8 Spo2 decrease 84-92 range Above 90 when oxygen supply at 2 litre। Falls as oxygen supply remove Physical Examination On examination throat contested bilateral crepts Investigations Esr:60 Hb:10.2 Rbs:160 Diagnosis Covid?? Management Injection augmentin 1.2gm bd Injection pan 40 bd Injection emeset bd Tab: zathrin500 mg od Tab: Doxofylline 400 md bd Tab: Montek lc one bd Syrp: Grillinctus 10 ml bd Fever subside But cough and breathlessness not improve Feel extreme weakness on walking and talking Need further assistance please give valuable opinion
Indeed it is a c/o covid19 pneumonitis Adv xray chest and hrct Confirm by RT pcr Do rest of corelated investigations Put him on inj Remdesivir Inj dexamethasone Inj Ceftriaxozone inj lasix Inj enoxiparum Inj insulin and orally metformin Oral medication as per protocols He needs constant 02 support about 7to10lits by niv
Covid pneumonia is to be excluded first by RTPCR for COVID, HRCT , urgently since SPO2 is dipping. Inflammatory markers and DDimer estimation. Treatment according to protocol.
Blood for CRP, CBC, MANTOUX TEST SPUTUM AFB FOR 3DAY. CHEST X-RAY PA VIEW. AND ALSO HRCT THORAX RTPCR CBNAAT AND COVID 19. Rule out further evolution.
Xray chest , sputum examination for AFB, RTPCR for COVID-19, HRCT, to be done urgently and patient to be treated under Guidelines of ICMR
Ask for chest X-RAY PA view RT-PCR to ruled out COBID-19, CRP LDH SERUM FERRATIN D-DIMER
Covid 19 suspect. Adv- Covid RT-PCR, CBC LDH, D-dimer,HRCT thorax, ECG, 2D echo. Start Ivermectin, Multivitamins, Duolin,Budecort -Neb, Oxygen supplimentation. Inj Remedisivir if covid confirmed.
Buddy u seems to be a great dr what seems from case presentation.. I'm sorry to say u immediately shift ptn under covid19 centre or let the consultant take a call by hospitalization.. More work up is required in this case..
ADVISABLE X. RAY....CHEST .USG / C T. SCAN...
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