Month: April 2020

Lung function tests are the widely used tests performed in respiratory clinics all over world to differentiate types of lung diseases. It’s used for diagnostic as well as prognostic purposes. Being an aerosol generating procedure it was stopped in almost all respiratory clinics with the onset of Covid 19 disease. The other procedure routinely used previously which got hit is nebulization.

Both these procedures are so indispensable that doctors want to start them as early as possible, still are scared to do so because of associated risk factors. A consensus is yet to be reached on how and when to start them.

Nebulisation has other alternatives like MDI with spacer.

To do spirometry is a tricky situation for doctors.

1. A doctor needs to wear complete PPE.
2. PPE for helping staffs.
3. Isolated/designated place for spirometry with restricted access to others.
4. Use mouth pieces with bio filters only.
5. Sanitise the spirometer machine, key boards, computer after every use.
6. Use separate moth piece for delivering Broncho-dilators with spacer.
7. Sanitise your spacer after each use.
8. Per-screen your patients for suspected corona infection by taking fever, travel history, contact history, place of residence. Don’t do the procedure if slightest of doubt.
9. Take help of alternative investigations like chest x-ray, blood investigations, auscultation, detailed clinical history and your clinical acumen. Avoid doing the spirometry whenever possible for time being.
10. Most of the respiratory physicians are able to reach a working clinical diagnosis without spirometry, but they will need it to perform in coming future. So start adapting the new way of life with new normals.

Taking precautions is the only way to prevent spread of infection.

Now government ordering all private doctors and clinics to reopen their OPD has resulted in gradually increasing number of Opd cases.

Covid19 patients can be absolutely asymptotic still be able to spread infection to others. In symptomatic patients they can mimic other respiratory infections like influenza etc.

Ideally you should avoid visiting a clinic/hospital for minor problems. Consult your doctor over phone or take advantage of video consultation facilities.

Doctors need to wear PPE inside clinic, also make it available for all the staffs coming in direct contact with patients. Minimum 1 meter distance has to be maintained between 2 patients. Provide mask to all the patients and relatives. Ask your patients, relatives and staffs to use sanitizer after touching any object or person. Disinfect all the chairs, reception counter, billing counter, beds using 0.1% sodium hypochlorite solution. Depute a staff for this purpose who keeps spraying on regular interval.

In case you are our patient, I.e. Dhanwantari Allergy & Asthma Clinic, Dhaka road, Chhatauni chowk, motihari, bihar, India; reach us @ 844-845-55-45 for tele enquiry. For video consultation use the app @ www.docon.co.in/info-card/vivekkumar

Remember, hospitals are potential source of infection spread. No doctor can say whether you are having corona infection or not. Even tests are coming out to be negative which is called “false negative”. PCR based tests are much better compared to rapid blood antibody based tests. Few patients need repeated tests to get diagnosed. So, it’s better to treat all subjects as suspected. Keep maintaining the social distance even with asymptotic persons.