The other day, the Anhui Provincial Health and Family Planning Commission published the Notice on Strengthening the Management of Intravenous Infusion in Medical Institutions, identifying 53 common diseases and illnesses that do not require infusion treatment. Personally, I think the measures introduced in Anhui province play a good demonstration role in regulating the management of intravenous infusion, which should be popularized by our medical workers and all sufferers!
All of us should strictly grasp the indications for the use of intravenous infusion, following the principles of drug use advocated by the World Health Organization “can be taken orally, not injected, can be injected intramuscularly, not intravenous”. According to the 2009 National Adverse Drug Reaction Monitoring Report, injectables accounted for 59% of all adverse reactions, of which infusions accounted for the majority. Because the drug through the intravenous injection directly into the blood circulation, not through the body’s natural barrier filter, if there are adverse reactions, often faster and more serious. In addition, infusions are medically invasive operations, equivalent to a minor surgery. Insoluble particles in the infusion fluid enter the circulation and are highly susceptible to pulmonary granuloma, pulmonary edema, venous inflammation and allergic reactions. Therefore, intravenous infusion is recognized as the most dangerous method of drug administration. If the patient has normal gastrointestinal function, oral medication should be the first choice. Intravenous fluids should only be used in three cases when the patient has difficulty swallowing, severe absorption disorders (e.g., vomiting, severe diarrhea, etc.), and when the condition is critical and rapidly progressing and it is desirable for the drug to reach high concentrations in the tissues for emergency treatment.
The following is a list of these 53 common diseases.
Internal medicine
1, upper respiratory tract infections: common cold, viral pharyngitis
2, acute tracheobronchitis, temperature below 38 ℃
3, bronchial dilation without acute inflammation
4.Bronchial asthma in chronic persistence and remission
5, pulmonary tuberculosis (except disseminated tuberculosis)
6, interstitial lung disease without significant respiratory distress
7, chronic obstructive pulmonary disease in remission
8, uncomplicated chickenpox, mumps, rubella
9, hypertension subacute
10, chronic superficial gastritis
11, non-infectious diarrhea without water and electrolyte disorders
12, simple Helicobacter pylori infection
13, Mild colitis
14, peptic ulcer without complications
15.Mild hepatic impairment with clear etiology
16.Multiple visits without organic lesions to consider functional gastrointestinal disease
17.Acute cystitis
18.Spontaneous pneumothorax without comorbidities
19.Simple atrial premature, ventricular premature
20.Endocrine metabolic diseases without acute complications
21.Alzheimer’s disease, facial spasm, motor neuron disease, multiple tics, sleep disorders, anxiety, depression, migraine without special complications
22.Epilepsy (except for persistent status epilepticus and frequent seizures)
23, no special complications of cerebrovascular disease of primary and secondary prevention (non-acute phase of cerebrovascular disease)
24.Nephrogenic anemia, nephrotic syndrome, chronic glomerulonephritis, proteinuria without special complications
Gynecology
1.Pelvic inflammatory disease sequelae
2, chronic cervicitis
3, asymptomatic uterine fibroids
4.Vestibular gland cysts
5.Vaginitis, vulvodynia
6.Primary dysmenorrhea
7.Menstrual irregularities without combined anemia
Pediatrics
1.Upper respiratory tract infection: within 3 days of illness, body temperature below 38℃, good mental status.
2, pediatric diarrheal disease: mild dehydration can be oral rehydration.
3, capillary bronchitis: mild wheezing.
4.Hand, foot and mouth disease or herpes pharyngitis: those who have no fever, good mental status and low blood count.
Surgery
1.After excision of body surface masses
2.Mild body surface infection (no fever, normal blood picture)
3.Mild soft tissue contusion
4.After small body surface debridement
5.Superficial phlebitis
6.Age-related osteoarthritis
7.Non-acute stage lumbar disc herniation and spinal stenosis
8, closed non-surgical treatment of extremity fractures
9.Chronic strain disorders
10.Chronic cystitis
11.Chronic prostatitis
12.Prostate hyperplasia
13.Kidney stones without comorbidities
14.Spermatorrhea
15.Acute rhinitis, all kinds of chronic rhinosinusitis, allergic rhinitis, acute sinusitis without complications
16, acute simple pharyngitis, chronic pharyngitis, acute simple tonsillitis
17, acute laryngitis (except severe), chronic laryngitis
18, acute and chronic otitis externa, acute and chronic otitis media without complications, eczema of the external ear canal, tympanitis