居家发热患者防控
冬春季节,呼吸道传染病高发,普通感冒、流感和新型冠状病毒感染的肺炎均可导致发热,但症状各有不同。如普通感冒通常表现为打喷嚏、流鼻涕、咽喉不适等明显的上呼吸道症状,而全身症状较轻,不发热或仅有短暂发热。流感多为高热,全身症状较重,伴有畏寒、头痛、全身酸痛、鼻塞、流涕、干咳、胸痛、恶心、食欲不振等表现。新型冠状病毒感染的肺炎以发热、乏力、干咳为主要表现,少数患者伴有鼻塞、流涕、腹泻等症状。
根据国家卫生健康委在2020年1月29日发布的《新型冠状病毒防控指南(第一版)》,如果出现发热、咳嗽等症状,以下任一情况,建议采取居家隔离的方式进行观察,一是症状轻微,体温低于38℃,无明显气短、气促、胸闷、呼吸困难,呼吸、血压、心率等生命体征平稳;二是无严重呼吸系统、心血管系统等基础疾病及严重肥胖者。
《指南》建议,居家发热患者应注意休息,营养均衡,饮食宜清淡;多饮温水,少饮冰凉饮料,保证脾胃功能正常;避免盲目或不恰当使用抗菌药物;严格正确佩戴口罩,与家人分餐,与家人保持距离1.5米以上;怕冷、发热、肌肉酸痛、咳嗽者,可选用具有解热散寒、清热解毒、宣肺止咳类中成药;乏力倦怠,恶心、食欲下降、腹泻者,可选用具有化湿解表类中成药;发热伴有咽痛明显者,可选用具有清热解毒利咽功能类中成药;发热伴有大便不畅者,可加用具有通腑泻热类制剂。此外,如果居家发热患者体温升高至38.5℃以上,可采取温湿毛巾或冰贴等物理降温措施,建议口服解热镇痛类、清热解毒类中成药。如果患者体温持续2小时以上不退,出现胸闷、气短、心率增快、腹泻或呕吐加重,建议到定点医院、发热门诊就诊。如果呼吸频率出现呼吸频率≥30次/分,伴呼吸困难及口唇发绀等表现,应拨打120急救电话,由急救医护人员转运到定点医院、发热门诊救治。
Prevention and Control for Fever Patients at Home
Winters and springs see high incidences of respiratory infections. Common cold, influenza and COVID-19 can all lead to fever, but they are different in other symptoms. The symptoms of a common cold are obvious in the upper respiratory tract, such as sneezing, runny nose, and sore throat, and also there may be some mild general symptoms with transient fever or no fever. People with influenza may have severe general symptoms, often including high fevers, and other signs such as feeling chills, headaches, body aches, runny or stuffy nose, dry cough, chest pain, nausea, and lack of appetite. The symptoms of COVID-19 mainly are fever, fatigue, and dry cough. A few patients also have runny or stuffy noses, diarrhea and other signs.
According to the Prevention and Control Protocol for Novel Coronavirus (1st Edition), home quarantine is recommended for those with symptoms of fever and cough if any of the following is met: (1) body temperature below 38℃, mild symptoms without obvious shortness of breath, tachypnea, chest distress, or breathing difficulties, and steady vital signs including breath, blood pressure and heart rate; (2) no severe underlying disorders in the respiratory or cardiovascular system, and no severe obesity.
As advised in the Protocol, fever patients at home should get good rest, keep a light and well-balanced diet, and take warm water instead of cold drinks to ensure normal functions of the spleen and stomach. Blind or improper use of antibiotics should be avoided. Separate meals are encouraged at home. They should wear a mask correctly, and maintain at least 1.5-meter distance from other family members.
For symptoms of feeling chills, fever, myalgia and cough, Chinese patent medicines (CPMs) for releasing heat, dissipating cold, detoxifying, and diffusing the lung to suppress cough could be taken; for fatigue, nausea, loss of appetite, and diarrhea, CPMs for resolving dampness and releasing the exterior; for fever and obvious sore throat, CPMs for releasing heat, detoxifying, and soothing the throat; and for fever and poor bowel movement, Chinese medicine preparations for relaxing the bowels and purging heat could be added.
If the temperature of a fever patient at home rises above 38.5℃, such measures as warm and wet towels and ice sticks could be used for physical cooling, and oral administration of CPMs for releasing heat, easing pain, and detoxifying is recommended.
If the high temperature remains for more than 2 hours and the symptoms of chest distress, shortness of breath, as well as increased heart rate, diarrhea or vomiting are developed, it is advised to visit a designated hospital or fever clinic.
If the respiratory frequency is higher than 30/minute, and there are symptoms of breathing difficulties and blue lips, call 120 for first aid to send him/her to a designated hospital or fever clinic by medical personnel.
