Why are the elderly prone to "silent hypoxia"? How to identify and avoid serious illness during home health observation? Is it necessary to have a finger-clip oximeter at home? What situations require medical treatment after "Yangkang"? In response to recent hot issues of public concern, the reporter interviewed Tian Rong, deputy director of the Department of Respiratory Medicine at Beijing Geriatric Hospital.
1. Why are the elderly prone to serious illness without obvious symptoms, and prone to "silent hypoxia"?
Tian Rong: Common clinical manifestations of hypoxia are chest tightness, difficulty breathing, and shortness of breath. Manifestations such as nail beds and cyanosis of the lips can be seen.
The reason why the elderly sometimes have less obvious reactions to hypoxia is that, on the one hand, the elderly react more slowly than young people and are not so sensitive to the manifestations of hypoxia. On the other hand, when the condition is severe, it may cause mental and cognitive disorders in the elderly, which may affect the description of the condition to family members and cause caregivers to fail to detect the elderly person's hypoxia.
Therefore, when providing home care, special attention must be paid to the health status of the elderly, especially the elderly and the disabled and dementia.
2. What are the key points of health monitoring for the elderly when they are at home? What situations require medical attention?
Tian Rong: The organ function, immunity of the elderly are lower than those of young people, and they are often accompanied by one or more underlying diseases. Some elderly people still have incomplete vaccinations because they have been at home for a long time. Therefore, the elderly are a high-risk group for severe illness and are the focus of health monitoring.
If you have difficulty breathing, shortness of breath, etc. while staying at home, it may be a symptom of severe pneumonia caused by the new coronavirus infection. At this time, timely medical treatment is required.
For patients with high fever infected with new coronavirus , their body temperature will generally drop to normal within 3 days. If their body temperature is still higher than 38.5 degrees Celsius after 3 days of symptomatic treatment at home, they need to seek medical treatment in time.
Patients with underlying diseases who have clinical manifestations of acute exacerbation of underlying diseases also need timely medical treatment.
In addition, for the elderly, we should also pay attention to changes in his mental state and diet. If there is any disorder, the caregiver must pay special attention to it and send him to the doctor in time.
3. When we are at home, we often lack corresponding monitoring methods. How can we identify and avoid serious illness in time?
Tian Rong: We can observe changes in respiratory rate and monitor transcutaneous blood oxygen saturation to identify possible severe cases.
Increased respiratory rate can reflect the worsening of the condition of new coronavirus pneumonia patients. The normal adult respiratory rate is 12 to 20 times per minute. When severe COVID-19 occurs, the respiratory rate can exceed 30 times per minute. The respiratory rate of children is faster than that of adults. For infants less than 2 months old, the respiratory rate exceeds 60 times per minute. For infants aged 2 to 12 months, the respiratory rate exceeds 50 times per minute. When the respiratory rate of children aged 1 to 5 years old exceeds 50 times per minute, it indicates that the child's condition is more serious. For the elderly, if the respiratory rate exceeds 30 times per minute, special attention is needed.
can also identify patients with severe COVID-19 by detecting transcutaneous blood oxygen saturation. Normal people's blood oxygen saturation ranges from 95% to 100%. When the blood oxygen saturation does not exceed 93%, it indicates severe disease. Therefore, we recommend that the elderly, especially those with chronic cardiopulmonary diseases, keep a finger-clip pulse oximeter at home.
For patients with chronic cardiopulmonary disease who suffer from long-term hypoxia, because their basic blood oxygen saturation is lower than the normal value, the patient has tolerated the chronic hypoxic state, and the change of the condition cannot be judged solely by the transcutaneous blood oxygen saturation ≤ 93%. When the condition worsens, it must be judged based on the patient's previous blood oxygen saturation value and his or her own symptoms and signs.
4. Will everything be fine after "Yangkang"? What situations prompt the need for medical examination?
Tian Rong: We did receive some patients in the outpatient clinic. The COVID-19 antigen or nucleic acid had turned negative when they were treated, but symptoms such as cough and chest tightness still did not improve. After chest CT examination, it was found that they developed COVID-19 pneumonia after being infected with the COVID-19 virus. This condition occurs not only in the elderly but also in some younger patients.
Therefore, after "Yangkang", we should also pay attention to the situation of prolonged cough that does not heal. If the cough symptoms are not relieved for a long time and affect sleep and rest, you should go to the hospital for corresponding examination in time to prevent minor lesions and serious diseases.
At the same time, there are still some patients who continue to have low-grade fever after "Yangkang". They should also go to the hospital for chest CT, blood routine and other examinations to see if there is new coronavirus pneumonia or other pulmonary infectious diseases.
Source: Beijing Daily client
