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.

居家發(fā)熱患者防控

冬春季節(jié),呼吸道傳染病高發(fā),普通感冒、流感和新型冠狀病毒感染的肺炎均可導(dǎo)致發(fā)熱,但癥狀各有不同。如普通感冒通常表現(xiàn)為打噴嚏、流鼻涕、咽喉不適等明顯的上呼吸道癥狀,而全身癥狀較輕,不發(fā)熱或僅有短暫發(fā)熱。流感多為高熱,全身癥狀較重,伴有畏寒、頭痛、全身酸痛、鼻塞、流涕、干咳、胸痛、惡心、食欲不振等表現(xiàn)。新型冠狀病毒感染的肺炎以發(fā)熱、乏力、干咳為主要表現(xiàn),少數(shù)患者伴有鼻塞、流涕、腹瀉等癥狀。

根據(jù)國(guó)家衛(wèi)生健康委在2020年1月29日發(fā)布的《新型冠狀病毒防控指南(第一版)》,如果出現(xiàn)發(fā)熱、咳嗽等癥狀,以下任一情況,建議采取居家隔離的方式進(jìn)行觀(guān)察,一是癥狀輕微,體溫低于38℃,無(wú)明顯氣短、氣促、胸悶、呼吸困難,呼吸、血壓、心率等生命體征平穩(wěn);二是無(wú)嚴(yán)重呼吸系統(tǒng)、心血管系統(tǒng)等基礎(chǔ)疾病及嚴(yán)重肥胖者。

《指南》建議,居家發(fā)熱患者應(yīng)注意休息,營(yíng)養(yǎng)均衡,飲食宜清淡;多飲溫水,少飲冰涼飲料,保證脾胃功能正常;避免盲目或不恰當(dāng)使用抗菌藥物;嚴(yán)格正確佩戴口罩,與家人分餐,與家人保持距離1.5米以上;怕冷、發(fā)熱、肌肉酸痛、咳嗽者,可選用具有解熱散寒、清熱解毒、宣肺止咳類(lèi)中成藥;乏力倦怠,惡心、食欲下降、腹瀉者,可選用具有化濕解表類(lèi)中成藥;發(fā)熱伴有咽痛明顯者,可選用具有清熱解毒利咽功能類(lèi)中成藥;發(fā)熱伴有大便不暢者,可加用具有通腑瀉熱類(lèi)制劑。此外,如果居家發(fā)熱患者體溫升高至38.5℃以上,可采取溫濕毛巾或冰貼等物理降溫措施,建議口服解熱鎮(zhèn)痛類(lèi)、清熱解毒類(lèi)中成藥。如果患者體溫持續(xù)2小時(shí)以上不退,出現(xiàn)胸悶、氣短、心率增快、腹瀉或嘔吐加重,建議到定點(diǎn)醫(yī)院、發(fā)熱門(mén)診就診。如果呼吸頻率出現(xiàn)呼吸頻率≥30次/分,伴呼吸困難及口唇發(fā)紺等表現(xiàn),應(yīng)撥打120急救電話(huà),由急救醫(yī)護(hù)人員轉(zhuǎn)運(yùn)到定點(diǎn)醫(yī)院、發(fā)熱門(mén)診救治。