In the period of a pandemic, health care workers emergency first rescue, when a person complains of fever, shortness of breath, possible symptoms of a coronavirus infection and begins to panic. The task of physicians is not only to stabilize the patient, determine it to hospital or leave at home treatment, but to reassure.
Mos.ru talked to the paramedics, ambulance and emergency care name A. C. Puchkova. They go on calls and help patients with coronavirus infection or suspected to have it. Doctors told, in which case the patient will be sent to the CT center, and in some hospitalityat in a hospital, why do you need shampoo for protective eyewear and how to cope with stress, when every working day, health risks.
How has your work changed with the start of a pandemic?
Roman Kuznetsov: Increased load on ambulances, calls became more. I work in Coveney team, we leave an average of 20 calls per day. Previously, there were about 15 visits.
Maria Kulikova: had nine or 10 shifts a month, I work at half rate. But the most difficult time was from mid-March to late April. It is now felt that the incidence is on the decline. Probably due to the fact that a regime of self-isolation.
— How much time now have to wait for an ambulance? If increased waiting time after the start of the pandemic?
Maria Kulikova: No, the waiting time is negligible. We on the screen a call comes in, it is done right and in a timely manner. Of course, it all depends on distance, but mostly drive no more than 20 minutes. And if the call is an emergency, we try to meet in the 13-14 minutes.
Roman Kuznetsov: All the machines on the line, the staff enough, so always arrive on time to patients.
— You work mostly on calls with suspected coronavirus. And how to determine potentially diseased COVID-19?
Roman Kuznetsov: At the ambulance station there is an operational Department and dispatch service. They ask the people who call for an ambulance and direct the calls to us. In the notes we have written: COVID-19 confirmed or suspected him. Among the main symptoms — fever, dry cough, loss of smell and taste. The usual symptoms of acute respiratory illness.
it Happens that before calling an ambulance, Muscovites are turning to the doctor on duty in the clinic. This happens in case if a person has no shortness of breath, chest pain, loss of consciousness.
Maria Kulikova: Yes. On the first day of the disease, you can do a consultation with a doctor from the clinic. He will carry out an initial examination, give the necessary medical advice, destinationsit treatment, and then, if there is deterioration, you should call an ambulance.
— Some patients often call an ambulance if you suspect an infection?
Roman Kuznetsov: In different ways. Come, children, elderly, and youth. All the same.
Maria Kulikova: I believe that the young are easier to tolerate the same pneumonia than people over the age of 55 years. Moreover, grandparents often have any comorbidities that exacerbate the course of this disease. But there are older patients that are also quite normal disease suffer.
How is your working shift?
Maria Kulikova: My shift starts at 09:00 and ends at 09:00 the next day. When I come to work, you should see your health car, ready to further my daily duty. First, all equipment must be serviceable, in working condition, needs to be in the presence of all necessary medicines, equipment for manipulation. Remedies be sure to check that they were also.
— You work in protective suit? How often to change it?
Roman Kuznetsov: Definitely, put on a protective suit in the car and then go on the call. The costume consists of a jumpsuit, respirator, mask, goggles, two pairs of gloves. Is it hot and stuffy, but we adapt. For example, there is a special antibot, they can spray from the back side of points. Smear some shampoo, too, to avoid sweating. All doctors know these techniques.
Maria Kulikova: After each call, the means of protection are utilized according to our standard. We have special packages that are emitted at certain tanks. The substation is equipped with a room for disposal.
In any challenge, regardless of whether the patient has the symptoms of SARS coronavirus confirmed whether necessarily need gloves, goggles and a medical mask. Even if the person complains of abdominal pain, it is better to protect yourself. Patients may say that a stomach ache, you come and see any symptoms of SARS. Sick they can just feel.
— How to build a working with a patient? What algorithm of actions if there is suspicion of a coronavirus?
Roman Kuznetsov: We assess the patient’s condition, watching the symptoms and medical history. Find out if he went somewhere who had any contact with. If the history and clinical picture strongly suspect it COVID-19, then mild patient remains at home and sign the consent for outpatient treatment. Then we transfer the patient to the clinic, from there comes the doctor prescribes a treatment and observes the patient. In mild course of the disease the body temperature is kept at 37 degrees, it is possible to sweat��I smell, and no shortness of breath.
With moderate shortness of breath already growing, there is high fever (38.5 degrees), saturation falls below normal (blood saturation with oxygen). In this case, we suspect pneumonia and taking a patient to the nearest hour of KT-center. Doing a CT scan, if necessary, the doctor from the hospital calls the ambulance to transfer the patient to the hospital.
Maria Kulikova: Yes, but if you identify minor lung damage, pneumonia, then the decision of the doctor patients are prescribed medication and sent home for treatment.
Roman Kuznetsov: In severe dyspnea, chest pain, high temperature, and confused consciousness we immediately take the patient to the hospital. To do this, refer to the Department of hospitalization, inform the presumptive diagnosis and the condition of the patient. Based on this, the Manager tells us where we are going with the patient.
— How to conduct yourself patients? They refuse to be hospitalized or want to go to the hospital?
Roman Kuznetsov: Are different people, someone wants to the hospital when it is not required, and someone there, when you need it. Most people know what’s going on, we all explain.
Maria Kulikova: at First I felt panic, when it was just beginning. Maybe in early March, the people thought: “How can I have to appear coronavirus, I never had contact with anyone”. Then we explained everything and told. Somewhere from end of March all became calmer, probably because the government and the media well informed people about the situation.
— Help emergency workers volunteers? What are the duties they’re assigned?
Maria Kulikova: Yes, volunteers helped us a lot. For us they organized the power at the substation, moral support. I remember coming, happy Easter. The organization they have, I believe, at the highest level.
Roman Kuznetsov: To the substation came to us volunteers, was asked what how to help. Brought us free Lunches, pizza, it’s nice.
do You practically communicate every day with potentially sick with coronavirus, health risks. Tell us how you cope with fatigue and stress?
Maria Kulikova: can Not say that for me it is difficult, perhaps, I’m used to this kind of work. Was just increased load, and it was felt, was the physical fatigue. About the risk of infection try not to think. At home I switch off from work, a personal business. If you get stuck, it would be unbearable. The family supports me, I have a daughter.
Roman Kuznetsov: the Most difficult thing now, just understand that you too can get infected. Have to get serious about protection. In OSTspecialized work as usual. Have yourself a stress I do not watch. Came, worked, did their job and went home. Get enough sleep — and all is well, the main thing — to sleep.
— What security measures do you follow to protect your loved ones?
Maria Kulikova: We live as usual, something supernatural do not. Of course, not necessarily my hands, but it’s always been, it is not started during a pandemic. Mode isolation we support, any trip to the store wearing masks and gloves. And the bags we have constantly antiseptics, all as expected.
Roman Kuznetsov: I also live at home. My husband is a doctor (working in an administrative position), he understands everything.
When and why did you decide to become a emergency doctor? What do you like about this job?
Roman Kuznetsov: life is So complicated. I was an paramedic and has 10 years of work.
Maria Kulikova: And I followed in the footsteps of their relatives. On the ambulance worked my grandmother and mother. I work for myself for 11 years, during this time, did not regret his decision. I consider myself a good helper for their loved ones. I can give advice on treatment and to provide medical care.
And during a pandemic at the slightest symptom of SARS family, relatives and friends call me and ask advice on how best to proceed in this situation. I explain everything so as not to create any panic, so they all moved easily and adequately to all concerned.