Outpatient treatment of patients with COVID-19: Normative documents and/or clinical thinking
- Authors: Vasiliev V.V.1,2, Romanova E.S.1, Startseva G.Y.1, Kuznetsov N.I.1
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Affiliations:
- North-Western State Medical University named after I.I. Mechnikov
- Pediatric Research and Clinical Center for Infectious Diseases
- Issue: Vol 25, No 4 (2021)
- Pages: 31-36
- Section: Case report
- URL: https://journals.rcsi.science/RFD/article/view/83780
- DOI: https://doi.org/10.17816/RFD83780
- ID: 83780
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Abstract
The legal framework for the provision of medical care, its evaluation and control of quality in Russia requires the attending physician to strictly comply with the provisions of regulatory documents. At the same time, clinical practice shows that the recommended algorithms for the provision of care do not allow in all situations to provide medical care of adequate quality. Analysis of the clinical example shows that in the era of the COVID-19 pandemic, in addition to compliance with the established rules, a thorough assessment of a specific clinical situation in the dynamics of development is necessary and timely correction of treatment and diagnostic measures, including those in excess of the established requirements, are required. The methods of remote monitoring of the patient’s condition need to be improved, since in their current form they do not provide an objective assessment of the patient’s condition. Face-to-face examinations of patients with COVID-19 receiving medical care at home should be carried out at least every 72 hours, regardless of the result of the remote assessment. The absence of the effect of therapy within three days may be an indication for transferring the patient to a higher level of medical care.
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##article.viewOnOriginalSite##About the authors
Valery V. Vasiliev
North-Western State Medical University named after I.I. Mechnikov; Pediatric Research and Clinical Center for Infectious Diseases
Email: vcubed@ya.ru
ORCID iD: 0000-0002-7336-8805
SPIN-code: 5644-9877
ResearcherId: O-4773-2014
MD, Dr. Sci. (Med.), Professor
Russian Federation, 41, Kirochnaya street, Saint-Petersburg, 191015; Saint-PetersburgElena S. Romanova
North-Western State Medical University named after I.I. Mechnikov
Email: asrom@yandex.ru
ORCID iD: 0000-0002-9887-8561
SPIN-code: 9435-6838
Scopus Author ID: 707096
MD, Cand. Sci. (Med.), Assistant Professor
Russian Federation, 41, Kirochnaya street, Saint-Petersburg, 191015Galina Yu. Startseva
North-Western State Medical University named after I.I. Mechnikov
Email: star661@rambler.ru
SPIN-code: 8392-2950
Scopus Author ID: 442573
MD, Cand. Sci. (Med.), Assistant Professor
Russian Federation, 41, Kirochnaya street, Saint-Petersburg, 191015Nikolay I. Kuznetsov
North-Western State Medical University named after I.I. Mechnikov
Author for correspondence.
Email: meri-kuz-48@mail.ru
SPIN-code: 2558-9273
MD, Dr. Sci. (Med.), Professor
Russian Federation, 41, Kirochnaya street, Saint-Petersburg, 191015References
- Prikaz Minzdrava Rossii 19.03.2020 #198n (red. 22.07.2021) “O vremennom poryadke organozatsii raboty meditsinskikh organizatsii v tsekyakh realizatsii mer po profilaktike I snizheniyu riskov rasprostraneniya novoi koronavirusnoi infektsii COVID-19” [Internet]. Available from: http://www.consultant.ru/document/cons_doc_LAW_348101/. Accessed: Oct 26, 2021. (In Russ.)
- Vremennyye metodicheskiye rekomendatsii. Profilaktika, diagnostika i lecheniye COVID-19. Versiya 11 (07.05.2021) [Internet]. Available from: https://base.garant.ru/400738625//. Accessed: Oct 26, 2021. (In Russ.)
- Pines JM. Profiles in patient safety: Confirmation bias in emergency medicine. Acad Emerg Med. 2006;13(1):90–94. doi: 10.1197/j.aem.2005.07.028
- Graber MA. Heuristics and medical errors. Part 2. How to make better medical decisions. Russian Family Doctor. 2021;25(1):45–52. (In Russ.). doi: 10.17816/RFD62009
- Romanova ES, Vasilyev VV, Startseva G, et al. Cause of death based on systematic postmortem studies in patients with positive SARS-CoV2 tissue PCR during the COVID-19 pandemic. J Intern Med. 2021;290(3):655–665. doi: 10.1111/joim.13300
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