Crisis Standard of Care | Annette Dekker, MD

Doctors Annette Dekker and Mel Herbert discuss crisis standards of care.

Bruce W. -

I have been able to send most of my COVID patients home. What outpatient treatment, if any, is recommended? I will usually give OTC pain/fever meds, albuterol and a suggestion for a pulse ox. I notice a lot of zinc and azithromycin (presumably for infiltrates) out there.

Mel H. -

I think you got it right, no evidence for ZINC or routine Azithromycin. As always the key is return precautions. At the last live there was some discussion about aspirin and even anticoagulation if they are higher risk (not much evidence for either yet) and dexamethasone if hypoxic. In many places we are sending people home we were admitting in the first wave (like hypoxic patients and given them home O2). They should get dexamethasone in my opinion (if oxygen requiring). We are also getting more comfortable NOT treating those infiltrates with antibiotics, EVERYONE has infiltrates. But if they are super sick or get worse, we do. Wish there was more science to this...

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