Not going to the emergency department " has become a problem for many people recently. Faced with an overcrowded emergency department, it may be delayed; go, not only the long queues but also the risk of cross-infection. So, under what circumstances do the elderly, people with underlying diseases, pregnant women, and children need to go to the emergency department? Peking Union Medical College Hospital emergency department attending physician Liu Shuang answered!

Old people

The severe mortality rate of COVID-19 infection in the elderly is much higher than that in young people. Compared with the young people in the 18-29 age group, the mortality rate of the 60-75 age group is 60 times that of the younger people, and the mortality rate of the age people over 85 is 340 times that of the young people!

Many elderly symptoms of COVID-19 infection are very secret and atypical, such as pneumonia after infection, but no cough or fever, only changes of consciousness, fatigue, and drowsiness, which is now often known as "silent hypoxia". After the elderly are infected with the novel coronavirus, there are also a variety of secondary bacterial infections, if improper care, blindly giving excessive water intake after fever, and may induce heart failure. Therefore, the elderly should be more careful in their care after an illness.

The elderly should seek medical advice as soon as possible if the following conditions occur:

1. Body temperature increased by 38.5℃ for more than 3 days.

2. 2. Compared with before the disease, eating became worse, the amount of urine was significantly reduced, or new fecal incontinence occurred.

3. Reaction / mental state is significantly dull than before, drowsiness, communication disorder, rejection, do not know where they are, and can not complete what can be done before (such as walking, chatting).

4. New breath-holding, breathing difficulties, can not lie flat.

5. Cough or wheezing aggravation, and even appear with white hair and purple lips.

6. People around him heard the obvious sputum sound in the old man's throat, and it was difficult to cough it out.

7. Oxygen saturation is normal at ordinary times, but the oxygen saturation is 93% after the onset. 8. If the elderly are also complicated with chronic lung disease, heart disease, diabetes, and other basic diseases, it is not appropriate to drink too much water or forcibly food at home. If the symptoms of basic diseases are aggravated, they should seek medical treatment in time.

Population with the underlying disease

Chronic lung disease, heart disease, diabetes mellitus, chronic kidney disease, and chronic immune function suppression are the most common risk factors for the emergence of severe COVID-19 infection. Once people with these diseases are infected with a novel coronavirus, it must be closely observed, even if the physical strength can support it, it is best not to take care of children or pets, daily temperature, heart rate, blood pressure, and blood oxygen measurement.

People with underlying diseases are advised to seek medical advice as soon as possible if the following conditions occur:

1. You may also have breath-holding or breathing difficulties when going to the toilet or doing mild activities.

2. Blood pressure is increased or decreased 20mmHg than usual basic blood pressure, and dizziness and fatigue occur.

3. New chest pain, chest tightness, palpitations, and can not improve after rest, or difficulty to lie supine.

4. The body temperature lasts for 38.5℃, and the body temperature does not improve after taking antipyretics, and even appears symptoms such as blurred consciousness, poor food intake, and reduced urine volume. Normal oxygen saturation is normal (95%), but the self-measured oxygen saturation is <94% after onset, or normal underlying lung disease (oxygen saturation <95%), but the oxygen saturation is lower than the usual level.

Pregnant

Seek medical attention as soon as possible if she has the following symptoms:

1. High fever that lasts for more than 39℃, and the effect is not good after taking antipyretics.

2. Persistent severe headache and the pain will not disappear after taking medication or rest.

3. Dizziness or fainting, or even a temporary loss of consciousness.

4. Feel shortness of breath, tight throat or chest, feel difficulty breathing when lying flat, and need to put up a pillow to fall asleep.

5. New chest pain, such as tightness or pressure in the center of the chest, or in addition to the chest, the pain can spread to the back, neck, or arm, or hemoptysis.

6. Sudden changes in the heart rate, such as feeling the heart pounding, irregular pulse measurement, and not better after rest. In the process of heartbeat change, and feel dizziness and fatigue.

7. Severe nausea and vomiting. The sudden severe discomfort of the stomach, far beyond the usual (early pregnancy (nausea and vomiting).

8 Sudden onset of abdominal pain that has worsened over time.  Reduce or stop conscious fetal movement.  New vaginal bleeding or fluid during pregnancy.

Children

Compared with previous strains, Omicjon infection has caused a significant decrease in the severe death rate around the world, and the current severe death rate is around 1%. But because its infection is very widespread in the population, especially in children, the transmission has significantly increased over previous strains. Although the mortality rate of children infected with COVID-19 is very low, it may also lead to severe illness in children, especially those with underlying diseases, and the risk of severe illness will increase. Similar to adults, children with obesity, diabetes, asthma, chronic lung disease, or immunosuppression may also be at an increased risk of severe illness.

Seek medical attention as soon as possible if the child develops the following symptoms:

1. Continuous high fever for more than 3 days.

2. Short of breath (less than 2 months, 60 times/min; 2 to 12 months, except the effects of fever and crying, 50 times/min; 1 to 5 years old, 40 times/min; over 5 years old, 30 times/min).

3. Activity or consciousness level decreased, such as lethargy, stimulation can not be awake, continuous crying, and even convulsions.

4. Food refusal or eating difficulty, repeated vomiting or diarrhea, and urine volume is significantly reduced.

5. Pale skin or lips, and purple limbs.

6. For children with other diseases, it is recommended to seek medical advice in time.