References
Paramedics and pneumonia associated with COVID-19
Abstract
Paramedics are at the frontline of healthcare delivery and this includes during the current coronavirus pandemic. This pandemic poses specific problems for paramedics, which include not only treating and transporting infected patients, but also issues around decontamination and disinfection of ambulances and medical equipment. Of particular concern is the pneumonia associated with the 2019 novel coronavirus. Data on COVID-19 pneumonia are developing. Ongoing research demonstrates that almost all serious consequences of COVID-19 feature pneumonia, especially in older people and those with comorbidities. Paramedics can have a profound effect on the care of patients with pneumonia. Effective management of COVID-19 pneumonia by the paramedic should centre around prompt recognition, early administration of oxygen and intravenous fluids and transfer to hospital. In some situations, paramedics may need to be involved in the delivery and maintenance of airway adjuncts in patients with COVID-19 pneumonia.
Pneumonia is an episode of acute inflammation involving lung tissue and can be of bacterial or viral origin. In the UK, the most common cause of community-acquired pneumonia (CAP) is Streptococcus pneumoniae (Strep. pneumoniae). Strep. pneumonia infections can lead to impaired gaseous exchange, global hypoxaemia, cardiovascular complications, sepsis and death.
The epidemic of 2019 novel coronavirus (officially called SARS-CoV-2) has expanded from its place of origin, Wuhan in China, to countries around the world. Some of these countries have seen onward transmission (Lipsitch et al, 2020). SARS-CoV-2 is a virus in the zoonotic coronavirus family. This virus, previously unknown in humans, is now causing the disease commonly referred to as COVID-19. Zoonotic diseases are infectious diseases that have spread from non-human animals to humans (Torok, 2016).
Coronaviruses cause respiratory and intestinal infections in animals and humans (Cui et al, 2019) but were not thought to be highly pathogenic to humans until the outbreak of severe acute respiratory syndrome (SARS) in 2002 and 2003 in Guangdong province in China (Cui et al, 2019). Like other coronaviruses, SARS-CoV-2 uses the angiotensin-converting enzyme 2 (ACE2) as a receptor to gain entry into cells, and subsequently infects bronchial epithelial cells and lung cells called type II pneumocytes (Qian et al, 2013; Boniotti et al, 2016; Saif et al, 2019).
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