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      Propuesta de abordaje y organización de las consultas de Pediatría de Atención Primaria en la pandemia por SARS-CoV-2 (otoño-invierno 2020-2021) Translated title: Proposal for the approach and organization of the pediatric consultations of Primary Care in the pandemic due to SARS-CoV-2 (autumn-winter 2020-2021)

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          Abstract

          La Asociación Española de Pediatría de Atención Primaria (AEPap) ha elaborado un documento con propuestas para la organización de las consultas de Atención Primaria en la próxima temporada invernal, y así poder garantizar la atención a los pacientes pediátricos, con y sin sospecha de infección por SARS-CoV-2. En dicho documento se insiste en la importancia de que la primera valoración del paciente sea telefónica para orientar a las familias sobre la idoneidad de una visita telemática o de una visita presencial y, en caso de ser así, recibir indicaciones sobre la zona del centro de salud y horario de atención en función de los síntomas, para mantener las medidas de protección y seguridad, tanto del paciente como del personal sanitario. AEPap y SEPEAP proponen que en los centros de salud se organicen dos circuitos, uno para atender pacientes con sospecha de infección por SARS-CoV-2 y otro circuito para valorar el resto de las patologías y llevar a cabo el Programa de Salud Infantil (PSI). Para ello, también insta a las Administraciones públicas a mejorar las herramientas de la telemedicina para garantizar el intercambio seguro de información y así poder realizar consultas no presenciales para evitar contagios en el centro sanitario, dotar a los centros de salud de personal sanitario, administrativo y de limpieza suficiente. También es muy importante que los profesionales sanitarios dispongan de técnicas diagnósticas para descartar las infecciones pediátricas más frecuente en época invernal (rinovirus, virus respiratorio sincitial, gripe, rotavirus) y agilizar el resultado de la reacción en cadena de la polimerasa (PCR) para COVID-19 y así evitar aislamientos innecesarios.

          Translated abstract

          The Spanish Association of Primary Care Pediatrics (AEPap), has prepared a document with proposals for the organization of primary care consultations in the next winter season, and thus be able to guarantee care for pediatric patients, with and without suspected infection by SARS-CoV-2. This document insists on the importance that the first assessment of the patient is by telephone to guide families on the suitability of a telematic visit or a face-to-face visit and, if so, receive instructions on the area of the health center and hours of attention based on symptoms, to maintain protection and safety measures for both the patient and the health personnel. The AEPap and the SEPEAP propose to organize two circuits in health centers, one to evaluate patients with suspected SARS-CoV-2 infection and another circuit to assess the rest of the pathologies and carry out the Children's Health Program. For this, it also urges public administrations to improve telemedicine tools to guarantee the safe exchange of information and thus be able to carry out non-face-to-face consultations to avoid infections in the health center, provide health centers with health, administrative, cleaning and medical personnel sufficient. It is also very important that healthcare professionals have diagnostic techniques to rule out the most frequent pediatric infections in winter (rhinovirus, RSV, flu, rotavirus) and speed up the PCR result for Covid-19 and thus avoid unnecessary isolations.

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          Most cited references20

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          Screening and Severity of Coronavirus Disease 2019 (COVID-19) in Children in Madrid, Spain

          This case series describes the testing for and treatment of children with coronavirus disease 2019 (COVID-19) in Madrid, Spain.
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            The different clinical characteristics of corona virus disease cases between children and their families in China – the character of children with COVID-19

            ABSTRACT This study aims to analyze the different clinical characteristics between children and their families infected with severe acute respiratory syndrome coronavirus 2. Clinical data from nine children and their 14 families were collected, including general status, clinical, laboratory test, and imaging characteristics. All the children were detected positive result after their families onset. Three children had fever (22.2%) or cough (11.2%) symptoms and six (66.7%) children had no symptom. Among the 14 adult patients, the major symptoms included fever (57.1%), cough (35.7%), chest tightness/pain (21.4%), fatigue (21.4%) and sore throat (7.1%). Nearly 70% of the patients had normal (71.4%) or decreased (28.6%) white blood cell counts, and 50% (7/14) had lymphocytopenia. There were 10 adults (71.4%) showed abnormal imaging. The main manifestations were pulmonary consolidation (70%), nodular shadow (50%), and ground glass opacity (50%). Five discharged children were admitted again because their stool showed positive result in SARS-CoV-2 PCR. COVID-19 in children is mainly caused by family transmission, and their symptoms are mild and prognosis is better than adult. However, their PCR result in stool showed longer time than their families. Because of the mild or asymptomatic clinical process, it is difficult to recognize early for pediatrician and public health staff.
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              COVID-19 in Children and the Dynamics of Infection in Families

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                Author and article information

                Journal
                pap
                Pediatría Atención Primaria
                Rev Pediatr Aten Primaria
                Asociación Española de Pediatría de Atención Primaria (Madrid, Madrid, Spain )
                1139-7632
                September 2020
                : 22
                : 87
                : 241-250
                Affiliations
                [6] Toledo orgnameCentro de Salud de Illescas España
                [5] Zaragoza orgnameCentro de Salud Ruiseñores España
                [4] Toledo orgnameCentro de Salud Santa Bárbara España
                [3] Madrid orgnameCentro de Salud San Andrés España
                [8] Getafe Madrid orgnameCentro de Salud El Greco España
                [7] Palma de Mallorca Baleares orgnameCentro de Salud Escorxador España
                [1] Burriana. Castellón orgnameCentro de Salud Burriana II España
                [9] Valencia orgnameCentro de Salud Nazaret España
                [2] Pasajes. Guipúzcoa orgnameCentro de Salud Pasaia San Pedro España
                Article
                S1139-76322020000400002 S1139-7632(20)02208700002
                662cf27e-784c-4482-9466-6f7e390b856d

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 10
                Product

                SciELO Spain

                Categories
                Documento de Consenso

                Atención Primaria,Infecciones por coronavirus,Organización y administración,Pediatría,Coronavirus infections,Organization and administration,Paediatrics,Primary Care

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