How computer tomography centre works

May 10

Special CT centres have opened at city polyclinics to diagnose patients with acute respiratory viral infections, community-acquired pneumonia and COVID-19.

The main task of such centres is to reduce the workload of Moscow hospitals and the waiting time in hospital emergency rooms amid the coronavirus epidemic. Yelena Shaklycheva-Kompanets, Chief Physician at City Polyclinic No 69, spoke about the work of the new computer tomography centre in her polyclinic.

Deadline: 24 hours

The decision to open outpatient centres in polyclinics to diagnose COVID-19 was made at the initiative of the clinical committee.

The CT centre in Polyclinic No 69 opened its doors on 11 April after quick and efficient preparations.


No breaks, no days off

The CT centre works around-the-clock. Three GPs, four laboratory assistants in radiology and nurses work in shifts at Polyclinic No 69. The radiologist decrypts scans and has no contact with patients. Doctors of the reference centre double-check the diagnoses made by the radiologist. The shifts last 12 hours.

A patient with suspected COVID-19 usually spends one to two hours at the polyclinic. During this time, he or she has a CT scan and other necessary tests and meets with a doctor.

“While the doctor examines the patient, enters data into the electronic medical record and discusses the symptoms, the nurse takes a blood sample, a COVID-19 smear and carries out an ECG test. When we prescribe therapy, it is important for us to know if the patient has heart problems,” says the Chief Physician.

The centre admits approximately 70 to 110 patients per day. According to statistics, most of them have viral pneumonia and are diagnosed with COVID-19. There are very few patients with bacterial pneumonia. But after diagnosis, they are also treated under the supervision of doctors.

If symptoms are mild, the patient, regardless of his or her place of residence, immediately receives free medicines for the entire course of treatment at the polyclinic. Information about the new patient is entered in the EMIAS system, and doctors involved in home visits or through telemedicine begin to monitor their condition.

If the symptoms are severe, the ambulance brings the patient to hospital directly from the clinic.

“When making a decision, various factors are taken into account: the patient’s general condition and age as well as chronic diseases. For example, we may have a patient with light pneumonia symptoms, but he or she is over 70 and has a number of chronic illnesses, such as heart disease. Such a patient certainly needs to be hospitalised,” Yelena Shaklycheva-Kompanets explains.

The X-ray can see everything

Computer tomography today is the best way to identify patients with severe symptoms. A smear can detect the presence or absence of the coronavirus but does not show the extent of the disease.

“If the patient suddenly begins to manifest respiratory failure, then computer tomography is needed as early as possible. This is vitally important so that we can assess the severity of the patient’s condition, and the quicker it is done, the faster we can get involved and make the right decision,” the Chief Physician explained. “Pneumonia caused by COVID-19 has very special signs. If computer tomography shows the typical signs of the coronavirus pneumonia, we already know how to treat, monitor and medicate this patient.”

How the computer tomography centre works

There are three ways to get to the CT centre, but it is up to the doctor to decide whether to conduct a scan. The therapist observing the patient with an acute respiratory viral infection or coronavirus can refer him or her for computer tomography. Doctors call their patients every day, and in the event that the patient's condition worsens, he or she undergoes a CT scan.

The doctor who makes home visits can also send the patient for CT if a patient has increasing shortness of breath. The health worker measures the oxygen content in the patient’s blood using a special device, observes the patient and makes a decision.

Also, the ambulance can bring patients to the CT centre, including from a neighbouring area.

Safety comes first

A polyclinic converted into a CT centre is divided into the “clean” and “dirty” zones. Doctors and nurses work in special protective suits, goggles and respirators in the “dirty” zone. When changing from one zone to another, the staff completely change clothes. Dirty clothes are put in special containers with a disinfectant solution. Medical workers can also take a shower.

All surfaces that patients come into contact with are regularly disinfected.

“On entering the building each patient is given gloves and masks. They also have to disinfect their hands. After each patient, disinfectant sprays must be applied on all surfaces that he or she touched, such as a CT scanner and all equipment,” says Shaklycheva-Kompanets.

In addition, a routine cleaning takes place every four hours.

Patients with different forms of the disease are examined in different rooms. They also have no contact with one another in waiting areas.

All polyclinic personnel undergo regular tests for the coronavirus.


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