Nagaland
Health department issues guidelines for home isolation
By EMN
Updated: May 17, 2021 11:34 pm
Dimapur, May 17 (EMN): The department of Health and Family Welfare has issued guidelines for home isolation of mild/asymptomatic Covid-19 cases.
Patients eligible for home isolation
- The patient should be clinically assigned as a mild/asymptomatic case by the treating medical officer.
- Such cases should have the requisite facility at their residence for self-isolation and for quarantining the family contacts.
- A caregiver should be available to provide care on a 24×7 basis. A communication link between the caregiver and hospital is a prerequisite for the entire duration of home isolation.
- Elderly patients aged more than 60 years and those with co-morbid conditions such as Hypertension, Diabetes, Heart disease, chronic lung/liver/kidney disease, Cerebro-vascular disease etc shall be allowed home isolation after proper evaluation by the treating medical officer.
- Patients suffering from immuno compromised status (HIV, Transplant recipients, Cancer therapy etc.) are not recommended for home isolation and shall only be allowed home isolation after proper evaluation by the treating medical officer.
- The caregiver and all close contacts of such cases should take Hydroxychloroquine prophylaxis as per protocol and as prescribed by the treating medical officer.
Instructions for the patient
- Patient must isolate himself from other household members, especially elderly and those with co-morbid conditions like hypertension, cardiovascular disease, renal disease etc.
- Patients should be kept in a separate well-ventilated room with cross ventilation and windows should be kept open to allow fresh air to come in.
- Patients should at all times use triple layered medical masks. Discard masks after 8hours of use or earlier if they become wet or visibly soiled. Both caregiver and patient may consider using N95 masks.
- Patients must take rest and drink lots of fluids. Frequently wash hands with soap and water
- Don’t share personal items with other people. Follow respiratory etiquettes all the time.
- Ensure cleaning of surfaces in the room that are frequently touched (tabletops, doorknobs, handles etc.)
Self- monitoring of blood oxygen saturation with an oximeter is strongly advised, it said.
If pulse oximeters are not available, a single breath holding test may be done. (Patient has to take a full but not too deep breath and hold it as long as possible). Based on duration of breath holding patients are categorised into:
- 25 seconds – Normal cardiopulmonary reserve.
- 15 to 25 seconds – limited cardiopulmonary reserve (Review with the medical officer)
- 15 seconds – very poor cardiopulmonary reserve (Shift to hospital)
Instructions for care-givers
- The caregiver should wear a triple layer medical mask.
- N95 mask may be considered when in the same room with the ill person.
- Hand hygiene must be ensured following contact with an ill person.
- Avoid direct contact with body fluids of the patient, particularly oral or respiratory secretions.
- Patient/Caregiver will keep monitoring their health. Immediate medical attention must be sought if serious signs or symptoms develop.
Treatment for patients with mild/asymptomatic disease
- Patients must be in communication with a treating physician and promptly report in case of any deterioration.
- Continue the medications for other co-morbid illness after consulting the treating physician.
- Patients to follow symptomatic management for fever, running nose and cough, as warranted.
- Patients may perform warm water gargles or take steam inhalation twice a day.
- In case of falling oxygen saturation or shortness of breath, the person should require hospital admission and seek immediate consultation of their treating physicians/surveillance team.
When to seek medical attention
- Patient/caregiver will keep monitoring their health. Immediate medical attention must be sought if serious signs or symptoms develop. These could include:
- Difficulty in breathing
- Dip in oxygen saturation (SpO2 less than 94% on room air )
- Persistent pain, pressure in the chest,
- Mental confusion or inability to arouse
- High grade fever/ severe cough, particularly if lasting for more than 5 days.
When to discontinue home isolation
- Patients under home isolation will stand discharged and end isolation after at least 10 days having passed from onset of symptoms (or from date of sampling for asymptomatic cases) and no fever for three days.
Mild diseases
- Upper respiratory tract symptom and/or fever without shortness of breath or hypoxia.
Must dos
- Physical Distancing, indoor mask use, strict hand hygiene.
- Symptomatic management (hydration, anti-pyretics, anti-tussive, multi-vitamins)
- Stay in contact with treating physicians.
- Monitor temperature and oxygen saturation (by applying a SpO2 probe to fingers).
May dos
- Therapist based on low certainty of evidence:
- Tab Ivermectin (200mcg/kg once a day for three days). Avoid pregnant and lactating women.
- Tab HCQ (400mg BD for one day f/b 400mg OD for four days) unless contraindicated.
- Inhalational Budesonide (given via metered dose inhalers/ dry powder inhaler) at a dose 800 mcg BD for five days) to be given if symptoms (fever and / or cough) are persistent beyond five days of disease onset.
By EMN
Updated: May 17, 2021 11:34:36 pm