1. General treatment
Rest, replenish liquid and vitamins properly, and avoid coughing hard or violently. Keep close watch on patient's condition (Most patients are in a progressive stage 14 days after they fall ill). Examine the chest (with interval of no more than 3 days in the early stage), heart, liver and kidney regularly. Test the degree of blood oxygen saturation of body surface every day.
2. Special Treatment
1) Patient who has a fever of over 38.5 degrees centigrade and aches all over can take some analgesic-antipyretic. Such physical cooling measures as ice compresses or alcohol rubs also recommended.
2) Patient who coughs and produces expectoration can take some anti-tussive and expectorant agents.
3) Patient who has heart, liver or kidney dysfunction should receive corresponding treatment.
4) Patient who has short breath and light hypoxemia should breathe oxygen consistently with help of nasal tube.
Children should avoid using aspirin, for such medicine may lead to Reye syndrome.
3. In early stage of the disease, medicine in the categories of macrolides, fluoroquinolones, B-lactams and tetracycline can be used. If sputum culture or clinic shows infection of drug-resistant coccus, such medicine as demethyl-vancomycin is recommended.
4. Application of glucocorticoids. Only those who have the following symptoms are suggested to use this: 1) Serious poisoning; 2) severe cases. The glucocorticoids should be used regularly and the dose adjusted according to the severity of the illness. Children should be cautious in using this.
5. Traditional Chinese medicine can be supplementary treatment. The principles to be followed: Make the patient's internal organs active by warming and stimulation; differentiate and classify the feverish diseases according to the four processes of the diseases: protection, energy, nourishment and blood; analyze and determine the treatment according to the pathological changes in the three visceral cavities.
6. Antiviral medicine can be used.
7. Medicines to improve one's immunologic function can be used.
8. Treatment and curing of severe cases:
1) Intensive care is necessary for those with obvious breathing trouble or those having been judged as severe.
2) Non-invasive positive pressure ventilation nasal CPAP can be used. The normal pressure level is 4-10cmH20. Proper mask should be selected and used continuously, even in sleeping. The breaking period should not exceed 30 minutes until the illness is mitigated. Standard for using CPAP: breaths>30/min; Sa02<93% while breathing oxygen 3-5 liter/min.
3) Patient with severe breathing trouble and hypoxemia, if Sa02<90% or oxygenation index<200mmHg under the condition of breathing oxygen 5 liters/min, or sees no improvement after non-invasive positive pressure ventilation, or cannot endure such a treatment, should consider receiving the treatment of invasive positive pressure ventilation.
4) Once a shock or MODS occurs, corresponding treatment should be applied immediately. If there is treatment difficulty or insufficient condition, related experts should be called on in time.
*Source material from Ministry of Health.
(China.org.cn April 8, 2003)
