For COVID-19 patients with stable conditions and stable vital signs, after being transferred to the CRU ward, a team of rehabilitation physicians, therapists, and nurses will conduct rehabilitation treatment for them. Under certain electrocardiogram (ECG) and blood oxygen monitoring, CRU conducts a systematic and comprehensive assessment and safe and effective rehabilitation for these patients. At the same time, CRU staff should pay attention to safety protection at work to avoid infection. All rehabilitation treatments should exclude contraindications, and the basic principle is not to increase the burden of patients with clinical infection protection.
A comprehensive, detailed, and adequate rehabilitation assessment must be developed to fully grasp the indications and contraindications.
An individualized and comprehensive rehabilitation plan with integrated Chinese and Western medicine must be formulated.
A gradual rehabilitation treatment must be carried out under the monitoring of ECG and blood oxygen.
During the entire medical process, doctors, therapists, and nurses need to follow strict infection prevention and control measures to avoid medical staff infection.
The entire rehabilitation treatment should be safe and effective, and attention should be paid to adverse reactions in the treatment process. In the course of treatment, if the person has any unsuitability, immediately terminate the treatment, report to the rehabilitation physician, complete the examination, and actively take treatment measures.
Patients are transferred from the COVID-19 isolation ward to the CRU isolation ward for comprehensive rehabilitation intervention. The specific workflow is shown in Figure 7.1.
The work management model of CRU integrated Chinese and Western medicine is to adhere to the combination of Chinese and Western medicine and complement each other’s advantages. In the CRU ward, it is necessary to realize the full rehabilitation of COVID-19 patients with integrated traditional Chinese and Western medicine. At the same time, formulate and improve CRU’s diagnosis and treatment specifications to improve clinical efficacy on the basis of ensuring safety and effectiveness. It is necessary to integrate multidisciplinary
Figure 7.1 Workflow chart of a COVID-19 rehabilitation unit.
resources to establish a COVID-19 rehabilitation platform to maximize the advantages of multiple disciplines, carry out the treatment of COVID-19 in a three-in-one model of prevention-treatment-rehabilitation to achieve seamless, continuous, full-cycle management of COVID-19. Finally, remote rehabilitation guidance for patients at home and in communities is emphasized to be an effective extension. This will accelerate the achievement of national health to community work to improve the social satisfaction of patients and their families and promote social harmony and progress.
Diagnosis and Treatment Plan
Assess COVID-19 Patients in Detail
First, an overall comprehensive assessment was performed, including the following aspects:
- 1) The patient’s general condition, vital signs, underlying disease, the severity of the disease at present, laboratory investigation, lung imaging examination, pulmonary function testing, nucleic acid testing results, the feasibility and necessity of rehabilitation treatment and benefit and risk, etc.
- 2) Dysfunction of rehabilitation evaluation, including dyspnea assessment (Borg dyspnea index improved self-evaluation scale, improve the medical Research Council dyspnea scale [mMRC], etc.), assessment of ability to remove bronchial secretions, measurement of respiratory muscle strength and cardiopulmonary function evaluation (6-minute walking distance measurement, motion tablet, or power cycling experiment), Hamilton anxiety scale and depression scale, daily life activities ability, and set George’s Hospital Respiratory Questionnaire (SGRQ).
Based on the assessment results, the team worked together to develop a patient-specific rehabilitation program. The entire evaluation and treatment process must be conducted in a complete, adequate, and safe manner for infection control. As shown in Figure 7.2.
Hold a CRN Teamwork Group Meeting
The purpose of the meeting is to assess the patient’s dysfunction and overall function and discuss the main problems existing in the patient. In addition, the short-term and long-term rehabilitation goals should be formulated based on the patient’s assessment results and main problems.