introduction
Dr. Manuel Mirón Rubio, Head of the HaH Service, Torrejón
University Hospital in Spain shares his experience with the current COVID-19
situation and how the Hospital at Home program in his hospital is involved in
the process.
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BLOG ENTRY
BY MANUEL MIRON - SATURDAY, 14 MARCH 2020
I work as a doctor at the Torrejon Hospital (Madrid, Spain) Hospital at Home service, one of the first hospital affected by the coronavirus crisis in my country.
From the beginning of this crisis, hospital managers thought that the hospital at home unit was an essential strategy to reduce hospital overload. We have designed an early discharge plan for patients affected by the coronavirus. This plan includes patients with pneumonia improving after 48h of admission.
The criteria for being admitted in HaH unit include:
- Baseline SatO2 > 90%
- Respiratory rate < 24 pm
- Heart rate < 100 bpm
- Systolic blood pressure >90 mmHg
- Axilar temperatura < 37.2ºC (this criterion could be revised because we have observed that some febril patients are in an excellent clinical condition).
- Stable neurological status
- Improving, (not severe) transaminases and LDH levels
- Improving (not severe) lymphopenia levels
- Improving C-reactive protein levels
- Ability and commitment of both patient and caregiver for understanding and aplying estrict isolation measures at home.
- General HaH criteria
Since March 6th, we have admitted 19 patients at our HaH unit, with different ages, conditions and severity. Three have already been discharged, and 16 remain admitted. Up to now none of them have been readmitted due to complications or clinical worsening.
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ABOUT THE AUTHOR
Manuel Mirón Rubio is Internal Medicine Specialist. Coordinator of the Spanish Registry of OPAT. Author of several national and international publications related to the model of home hospitalization in relation to both clinical aspects and organization and cost analysis. Author of two books on hospitalization at home. Adviser for the development of home hospital programs in Spanish hospitals providing information and operational plans. Member of the group of experts appointed by the Spanish Society of Home Hospitalization to promote this healthcare model in the National Health System. More than 30 presentations and moderations in round tables related to hospitalization at home in events held throughout the Spanish geography. More than 50 communications in scientific events. Director of several training activities on home hospitalization. Teacher of graduate and postgraduate training activities.