Diagnosis and treatment of pneumonia


Fig. 1. Right upper lobe lobar pneumonia (scheme with x-rays in the front position).

Diagnosis of pneumonia is based on the clinical data and the results of x-ray examinations (Fig.1).
The differential diagnosis should be carried out with tuberculosis, sarcoidosis, tumors and other diseases, especially in the case of symptoms of toxicosis and relatively scarce local manifestations in the lungs at the beginning of the disease pneumonia.
Treatment of acute pneumonia should be complex. Patients with pneumonia should be treated in hospital. Need bed rest, good care, high-calorie, rich in vitamins, easily digestible food, a sufficient amount of fluid (soups, fruit and mineral water, juices, fruit drinks, hot milk with soda, tea with lemon, raspberry etc., Important condition of successful treatment of pneumonia - clean the air in the room where the patient.
For the treatment of pneumonia prescribe antibiotics and sulfa drugs (in the absence of contraindications to their use).
Penicillin in acute pneumonia is injected intramuscularly in a dose of 150 000 IU every 4 hours. Streptomycin is injected intramuscularly in a dose of 500 000 UNITS, 2 times a day. Valid alternation of injections of penicillin administered dentists of 300,000 UNITS every 4 hours. Novotallin and other drugs penicillin extended to the injected 1-2 times per day. Semi-synthetic penicillins, such as oxacillin, applied inside, in the dose of 0.5 g every 4-6 hours. Ampicillin is used inside or parenteral. Perhaps a combination of antibiotics and sulfa drugs.
Sulfa drugs appoint indicative outline: initial dose of 2 g 1-2 day to 1 g every 4 hours, 3-4th day on 1 g every 6 hours, 5-6th day of 0.5 g every 6 hours. The course of treatment 24 - 28, If necessary, dose rate can be increased.
Sulfanilamida better to assign after eating in combination (for example, a single dose of 1 g gain of 0.5 g norsulfazola and 0.5 g sulfadimezina); to the best of removing their kidneys reception sulfa drugs must be combined with abundant drinking (better alkaline).
Sulfanilamida of the prolonged action (sulfadimetoksin, Popadin, magibon and others) designate: 1-2 day to 2 g 2 times a day, following days of 0.5 g 2 times per day. Antibiotics quickly reduce intoxication, patients feel better. Clinical improvement does not yet specify recovery. Anatomical changes are backward development is much slower. After decreasing the temperature and improving the condition of patients sometimes (as instructed by the doctor) should be back in a few days to continue therapy with antibiotics and sulfa drugs. In case of unauthorized termination drug bacteriostatic action of antibiotics prematurely removed and pathogens again have the opportunity for growth and development. Complications arise, the disease may take a chronic course.
For the treatment of pneumonia important organization of care, particularly the observance of bed rest. Pneumonia is a non-contagious disease.
Medical personnel need to watch for any changes in the patient's condition: in the period of temperature decrease is possible sharp drop in blood pressure and the development of vascular collapse. In these cases, you may need urgent therapeutic services. When mental agitation, delirium is set for a sick systematic round-the-clock surveillance.
Observance of hygiene rules is obligatory (see Nursing). If the patient separates sputum, it is necessary to collect in a separate bowl, which after removal of sputum boiled or treated with disinfectant solutions.
From symptomatic funds for pneumonia use of acetylsalicylic acid 0.5 g 3 times a day, thermopsis in medicine or tablets 0.01 g 3 times a day, ammonia-drops on 10-12 drops 3-4 times a day and others, eufillin 0.15 g 2 times per day, kordiamin, camphor and other cardio-vascular equipment.
When pneumonia is widely used oxygen therapy, banks and mustard on the affected side.
Physical therapy is used with the phase of the disease and the patient. Lessons appointed after lowering the temperature, the establishment of normal pulse rate, improving patient. Start with basic breathing exercises, so that in the corresponding period of illness is to extend the complex of therapeutic measures (Fig. 2 and 3).


Fig. 2. Static breathing exercises that are performed in positions of lying (1), sitting (2)standing (3): a - breath; b - exhale.


Fig. 3 (right). Dynamic respiratory exercises that are performed in the prone position (1), sitting (2)standing (3 and 4): a - breath; b and exhale.