Covid-19: a remote assessment in primary care
Covid-19: a remote assessment in primary care
复制标题
Covid-19：初级保健的远程评估
作者：
T. Greenhalgh;G. Koh;J. Car
#您需要知道的是
一名37岁的医疗助理出现咳嗽。第二天，她醒来时发烧(她测量的温度是37.4摄氏度)和呼吸急促。她在家里治疗了几天，感到越来越疲倦，食欲不振，持续干咳。在生病的第五天，她出现了轻微的腹泻，胸部感觉相当紧绷。她测量了自己的体温，体温已经上升到38.1摄氏度。感觉不舒服，她联系了她的全科医生外科医生寻求建议。她希望有人听她的胸部，但接待员告诉她不要来手术，并让她选择电话或视频咨询。她以前远离轻度哮喘(偶尔服用沙丁胺醇)。五年前，她服用西酞普兰治疗焦虑症。她是三个孩子的单亲父母。
2019年新型冠状病毒病(新冠肺炎)是一种紧急和正在蔓延的威胁，其临床和流行病学特征仍在记录中。12为了遏制新冠肺炎，正在发生从面对面会诊向远程会诊的转变。因此，临床医生面临着一种新的疾病和与患者互动的新方式。
本文将就如何在电话预约和视频预约之间进行选择，如何进行远程“问诊”会诊，以及在安排随访和下一步行动时应注意的问题提出一些指导原则。它不包括远程分诊或如何设置…
### What you need to know
A 37 year-old healthcare assistant develops a cough. Next day, she wakes with a fever (which she measures at 37.4°C) and shortness of breath. She manages her condition at home for several days, experiencing increasing tiredness, loss of appetite, and a persistent dry cough. On the fifth day of her illness, she develops mild diarrhoea, and her chest feels quite tight. She takes her temperature, which has gone up to 38.1°C. Feeling unwell, she contacts her GP surgery for advice. She would like someone to listen to her chest, but the receptionist tells her not to come to the surgery and offers her the choice of a telephone or video consultation. She was previously well apart from mild asthma (on occasional salbutamol). Five years ago, she took citalopram for anxiety. She is a single parent of three children.
Novel coronavirus disease 2019 (covid-19) is an urgent and spreading threat whose clinical and epidemiological characteristics are still being documented.12 With a view to containing covid-19, a shift from in-person to remote consulting is occurring. Clinicians are thus faced with a new disease and a new way of interacting with patients.
This article will present some guiding principles on how to choose between telephone and video appointments, how to conduct a “query covid” consultation remotely, and considerations when arranging follow-up and next steps. It does not cover remote triage or how to set up …