Features of emergency care for patients with covid-19 associated pneumonia

Authors:

Kachkovskii Mikhail Arkadievich, Grand PhD in Medical sciences, Professor, Department of internal diseases, Private Educational Organization of Higher Education Medical University “Reaviz”, 227 Chapaevskaya Street, 443001 Samara, Russian Federation; e-mail: KachkovskyMA@reaviz.ru

Malakhov Vyacheslav Gennadievich, PhD in Medical sciences, Associate Professor, Chief Physician, Samara City Ambulance Station, 2 Bolnichnaya Street, 443096 Samara, Russian Federation; e-mail: Malahovvg@mail.ru

Galimov Rafael Akhmetovich, resident of the Department of neurology and neurosurgery, Samara State Medical University, 89 Chapaevskaya Street, 443099 Samara, Russian Federation; paramedic of the mobile team, Samara City Ambulance Station, 2 Bolnichnaya Street, 443096 Samara, Russian Federation; e-mail: rafael-19mail.ru

Kimakovskaya Anna Nikolaevna, student, Private Educational Organization of Higher Education Medical University “Reaviz”, 227 Chapaevskaya Street, 443001 Samara, Russian Federation; paramedic of the mobile team, Samara City Ambulance Station, 2 Bolnichnaya Street, 443096 Samara, Russian Federation; e-mail: kimackowskaia.an@yandex.ru.

Kozlova Irina Ivanovna, student, Private Educational Organization of Higher Education Medical University “Reaviz”, 227 Chapaevskaya Street, 443001 Samara, Russian Federation; e-mail: kozlovairina@yandex.ru.

Annotation:

Introduction. The article presents the work of the ambulance service in the context of the COVID-19 pandemic.

Aim. To study the specifics of providing emergency medical care to patients with COVID-19 associated pneumonia.

Materials and methods. An analysis was made of 12 857 cases of emergency medical teams calls to patients with COVID-19 associated pneumonia for the period from May 1, 2020 to June 30, 2021. The study included data from 5 090 men (39.6 %) and 7 767 women (60.4 %), aged 1 to 98 years (mean age 59.4±16.2 years).

Results and discussion. Calls to elderly patients prevailed — 5 060 people (39.4 %) — and middle-aged patients — 3 253 (25.3 %). The ambulance teams were called to children and adolescents under 18 years old in only 134 cases (1.0 %). The largest number of emergency medical teams calls per day occurred during the second wave of the coronavirus infection pandemic in October 2020, reaching 94 calls per day. In 6 510 people (50.6 %), a positive reaction to the RNA of the SARS-CoV-2 virus was previously detected by polymerase chain reaction, 1 595 people (12.4 %) were contacts for COVID-19. Febrile temperature was detected in 3 230 people (34.6 %), over 39 degrees Celsius — in 1 304 patients (13.3 %). In 892 cases out of 5 053 (17.7 %), SpO2 was less than 90 %, indicating acute respiratory failure. In 108 patients (0.8 %), blood pressure was below 90 mm Hg. A significant amount of lung tissue damage according to computed tomography (50-75 %) was detected in 152 patients (7.0 %), subtotal (> 75 %) — in 34 patients (1.6 %) in 2 173 studies.

Summary. During periods of new waves of coronavirus infection, the intensity of work of stations and ambulance teams increases significantly. The main contingent of patients with COVID-19 associated pneumonia are elderly patients, most of them have febrile and high temperature, significant and subtotal damage to the lung tissue. This determines the need for a clear routing of patients with hospitalization according to indications to hospitals that have intensive care units on staff.

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