Cold epidemic, fiction and reality – e-health innovation

November 10, 2019

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Fiction, or rather anticipation :

December 31, 2018, 7 pm:

The medical community is hard-pressed because of an epidemic of "colds".

Headache, fever, runny nose (red), creating anxiety sometimes see panic in homes.

The consequences being:

-Increased congestion in public and private hospital emergency departments.

-a storming of waiting rooms of medical practices still available at this time.

– Supersaturation of centers 15.

– Emergency medical staff travel to town and country.

– Calls and chain trips of health professionals via firefighters (rescuers, nurses and sometimes doctors)

In short a mobilization of a good part of the professionals of primary care and emergency of the hexagon.

A significant percentage of the total resources are mobilized for this benign condition.

December 31 22 hours.

A medical coordination meets in crisis cell. The connected doctors who are in videoconference, are gathered:

– Teleconsultation platform leaders pioneers in diagnosis, treatment, remote consulting.

Physicians specialized in the algorithmic analysis of clinical situations to clarify the urgency, or not, of the problem. Depending on the data analysis, they can offer a diagnosis, a therapy or a reasoned and cautious advice of self-medication. This virtual doctor is scheduled to be efficient 24 hours a day. He can decide for himself and support a primary care physician of a teleconsultation platform (TC) for example.

Very quickly, the coordination between the crisis cell and the traditional health structures confirms their disorganization because of the bad orientation of the patients. A risk of epidemic worsening related to the movements of the buried with risk of contamination of the caregivers is emerging.

This overheating of the reception structures lengthens the time to take care of true emergencies.

Security is no longer assured for everyone.

Crisis cell triggers Connected Virtual Doctor plan (COVIDO)

It is the solution to manage "at the source" patients suspected of swelling the epidemic flow.

31st December 2018 23h30

The Virtual Physician operation is triggered, the platform works in collaboration with other platforms that offers traditional teleconsultation.

End of anticipation:

Attention all the following has been scientifically established

Here is the real example of a patient interviewed by the algorithm of the Virtual Physician:

The patient, 25-year-old woman neither pregnant nor recently given birth and has a runny nose.

The conjunction of his symptoms frightened him; she flies profusely, has fever, red eyes.

It is supported by our Virtual Physician.

The clinical situation is carefully documented in the application, the following symptoms are easily collected:

Runny nose :

Translucent flow

Flow through both nostrils

Painless discharge

Other signs

Fever

Cough

Sore throat

Flow through the eyes

Sneeze

Here it is simple: our virtual doctor will analyze the data and the automatic analysis by the algorithm concluded to:

-Rhinopharyngitis 79% probability

– allergic rhinitis 2%

The application will then deliver the opinion of the virtual doctor

"He does not seem to have any signs of immediate gravity. However, it will be advisable to contact your doctor within 24-48 hours if the signs continue. If by then, the condition of the person gets worse or if other warning signs appear, consult him within a shorter time.

What you need to monitor:

The doctor will check that there is not a serious infection in evolution. If so, he will put the person on antibiotics if he thinks it is useful. But generally everything ends up returning to order in a few days without treatment "

The virtual doctor also gives advice

Attitude to have

In case of respiratory or ENT problem:

Do not smoke and ask your entourage not to smoke in the place where you are.

Gestures to do

Nose blowing

In case of runny stuffy nose or sneezing, blowing should be done only one nostril at a time

prohibitions

No antibiotic without medical advice

Even (and especially) if you have an infection, do not take any antibiotics on your own or without medical advice.

Drinks

Drink water

Drink water without any limitation in case of thirst and as long as it persists.

Prefer water at room temperature as water out of the refrigerator. It will be absorbed faster.

If you are in a hot country or poor hygiene, drink only water encapsulated.

In case of cough or sore throat:

Hot herbal teas or hot milk with honey help soften the throat. This helps to reduce sore throat and avoid the cough reflex.

In case of cough or diarrhea:

Drink hot drinks; herbal teas; light tea. It takes about 2 liters of liquid a day.

Hot drinks for warming up should be non-alcoholic.

Temperature

In case of heat stroke or fever

The temperature of the room must not exceed 20 °

Discover the person if she is hot.

pharmaceuticals

Medicines in the medicine cabinet

In case of fever

If the fever is greater than 38.5 or if it is troublesome, it is possible to take a fever medication in accordance with the contraindications.

If the fever is below 38.5 or if it is mild, there is no need to take medication to lower it.

mucolytics

In cases of heavy cough or sputum, no cough medicine should be taken. In Revenge it is possible to take mucolytic drugs respecting the contraindications.

fumigations

The fumigations of mint or eucalyptus type Perubore * are effective whatever the cause on the symptoms of the respiratory tracts (cough, sputum, congested nose, sneezing, etc.).

It is also possible to take suppositories containing eucalyptine.

In case of pain (other than in the stomach)

If the pain is severe, it is possible to take a pain medication.

Whenever possible, it is best not to take aspirin-based medication. Only those based on paracetamol or ibuprofen are allowed in this case.

It is recalled that the use of ibuprofen is strictly prohibited during the first and third months of pregnancy. Only paracetamol is usable during these periods.

mouthwashes

Mouthwashes can be useful but only serve to provide relief, they can not alone treat an ENT disease such as angina.

Drops in the nose

You can put drops in the nose, especially if the nasal secretions are yellow or green or thick and sticky?

Attention, it should take only drops or spray made only of saline or seawater, never based on antiseptics or antibiotics. It is up to the doctor to prescribe them

Here are other information provided by our virtual doctor in this case of species:

To learn more about the causes of runny noseRhinitis nose dischargeDefinitionThis is a common and frequent phenomenon, but it must draw attention, especially to children.Important pointsDischarges during colds or rhinitis are mucus secretions in excess through the lining of the nose. His secretions are clear. In general, they cure themselves in 3 to 5 days and the cause is most often viral (the common cold). As long as the secretions remain translucent white there is no need to worry just an effective blot associated with mucolytics.But these secretions can be infected: the flow becomes yellow and thick greenish. We speak of purulent rhinitis. Often there is fever associated. In this case, it is necessary to consult so that the doctor sees if a possible putting under antibiotic is necessary, which is generally not necessary at all, the cold healing all alone in one week.Sometimes finally the secretions are yellow from the start. This is the case of sinusitis.Especially in children, the flow may be on one side only. In this case, it is necessary to consult the doctor during the day because it is necessary to check that it did not sink or stuck an object in a nostril. Do not try to remove or explore it, you need special pliers for that.

Both types of rhinitis:

Acute rhinitisThis is called colds; a viral infection that is most often caused by a rhino virus.Transmission is from one person to another. By a simple sneeze, by postillions, or simply by shaking hands with a person who has just blown his nose in the fifteen minutes before. It is acute rhinitis, contagious, occurring by epidemic. Hence the interest of handwashing, which must be frequent in times of epidemic and when one is in public places.

Chronic rhinitisAnd that is a recurrent cold. Two possible origins to this:The allergic rhinitis that occurs in the spring and the months that follow, more or less strong and tenacious depending on the pollen encountered.

Allergic rhinitis. In fact, we do not know the cause well even if we understand its mechanism related to atrophy (thinning) of the nasal mucosa. The weakened mucosa permanently defends against aggressions like tobacco, dust, pollution, and … Drops in the nose. In fact not all drops, but one that contains vasoconstrictors. The untimely use of these drugs is at the root of many chronic rhinitis in developed countries. In other less favored countries, these rhinitis are due to other diseases such as tuberculosis or syphilis.

Your attitude.

The blowing.You can laugh at it, but blowing your nose requires good technique, especially in children.To blow your nose effectively, you need to make one nostril at a time by pinching a nostril with your thumb and releasing the index finger in fits and starts. This technique has several advantages: first it sends the air into a single nostril which increases the flow of air in the nostril; then it prevents the blockage of air in the nose goes up in both Eustachian tubes and therefore to the middle ear, which prevents germs go back and develop there. A bad blot can indeed favor otitis.In toddlers who can not get the active collaboration, we can only use the baby fly sold in pharmacies.

Relieve symptomsFever medications are helpful for fever and headaches that are often associated with viral rhinitis. In principle only use paracetamol, avoid ibuprofen and especially aspirin.

Take off the secretionsWhile drying, the secretions can stick which makes them difficult to expel. They are usually infected, which combined with a bad bloat, promotes ear infections and sinusitis. We must therefore moisten them. It's the role of the drops in the nose. The simplest is physiological saline, sold without a prescription, either in a 250 ml bottle or as a single dose. It is this last form which is preferable because it is certain that it remains sterile, which is not the case with the bottles. However, physiological saline has the disadvantage of being unpleasant and hated by children. This is why spray forms are interesting: they deliver less liquid, more effectively (under pressure) in the form of micro droplets less unpleasant and penetrate better.Another technique is to fumigate by breathing through the nose: the hot vapors take off the secretions and make them easier to evacuate. List of specialties: Aromasol, Balsofulmine, Inhalant Calyptol, Dolirhume with essential oils, Algerian essence, Gomenol, Perubore and Vicks are on sale in pharmacy and allow to relieve the symptoms. A variant of fumigations, water vapor breathed through the nose.Mucolytics are sometimes prescribed, but their effectiveness is not proven.

End of the scientific content Medvir.

Personal comments

It is the solution to take care of a large part of patients who no longer have to leave their home. They must be cared for, guided and reassured at home …

You have been able to appreciate the cascade of information that the patient has received by consulting this application of virtual medicine from her home with the conclusion of the advice of a simple rest at home, to eat properly and possibly take a little paracetamol.

What efficiency! Compared to a trip to a doctor or an emergency reception center …

The Virtual Physician allowed on this occasion a real education of the patient concerning a banal situation but sometimes being stressful.

One-to-one with a doctor how long do you think it would take to deliver this amount of information? With this new form of care, the consultant is gradually becoming a true patient expert who can provide advice to those around him and who, above all, will be able to dialogue more enlightened with a health professional during a future consultation in head to head, which will only be more efficient.

Thanks to Loïc Etienne, pioneer of this algorithmic intelligence used in medicine. He is the designer and educator of this Virtual Physician called MedVir. This work has required years of work to translate into an application the intellectual journey of the doctor by avoiding the user traps related to disruptive situations such as overwork and stress …

The virtual doctor is then a real health helper who can directly solve a large number of problems and who will guide patients where appropriate to a standard structure of care emergencies. This search for urgency is of major interest. It is particularly taken into account by the application.

The Naomi Musenga case, which Samu had failed to take charge of, may not have been possible had a Medvir device been used.

Teleconsultation structures provide similar benefits to a Medvir-type App. They also provide home care for patients who are not physically able to visit their doctor or emergency department. They can also receive a prescription sent securely.

Such platforms have existed for many years thanks to the help of partners such as mutuals, insurance companies, companies and other communities … who were able to finance them before the TC falls into the common law of medical practices. They were thus able to anticipate the evolution of the regulations which severely constrained these undeniable progress.

Thanks to Marion Lagneau, a pioneer of teleconsultation in this historically difficult context.

The game is won. Everything explodes today with the obvious need to develop teleconsultation for specific situations such as medical deserts dependent persons with reduced mobility home or in nursing home … or in the classic setting of the medical office where the TC must have its place within the face-to-face consultation.

Virtual medicine and teleconsultation are thus coordinating to unload the more expensive health structures and currently on the verge of overheating. The latter will be able to refocus on the management of heavier pathologies or the vital risk can sometimes be engaged and that there is a delay in the care!

Here is ! I promised you to find out about the treatment of this damn cold.

All this for the advice of a simple wash of nose with saline.

Yes, but must we still know how to organize …

I believe I have been complete and have demonstrated the benefits of new communication techniques.

These will educate the patient, make him more responsible and he will be better cared for.

What is true for colds is also true for a large number of clinical situations that can be resolved in the patient's home.

Social security accounts should finally benefit.

These new techniques of medical practice should make obsolete the ubiquitous Veran amendment, which in the context of the Security Budget Bill, wants to create a referral package paid to the hospital to refer patients to doctors … general.

Those who know the current pace of activity of city doctors, will appreciate!

The references :

Dr. Marion Lagneau

Twitter: @crisetchuchote

Dr. Loïc Etienne:

Twitter: @drLoicETIENNE

Dr. Marc Soler & Nicolas Bondu

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