Referring to Hospital Care Most confirmed COVID-19 cases will be mild and uncomplicated and can safely be managed via telehealth. Deteriorating respiratory function is the primary indicator for hospital admission. Do not rely exclusively on pulse oximetry, especially in those with darker skin.
Triggers for moving patient to hospital or palliative care Escalate care if the patient develops: Respiratory compromise, indicated by any of the following: Talking with single words or short sentences Pausing between sentences to catch their breath Respiratory rate greater than 24 breaths per minute Profound exhaustion where pulse oximeter not available to exclude silent hypoxia Haemoptysis Change in oxygen saturation (SaO ): No baseline – SaO less than 92% Baseline greater than 94% 2
2
Baseline greater than 94% Any of: • SaO less than 92% • Drop of 3% or more from baseline • Drop of 3% from resting to after exercise • Exercise Note that the safety of formal exertional desaturation tests such as the 1 minute sit-to-stand test have not been evaluated for COVID-19 and should not be performed routinely. Asking the patient to walk around the room may suffice. • Baseline 94% or less 2
Baseline 94% or less Any of: • SaO less than 88% • Drop of 3% from baseline • Drop of 3% from resting to after exercise 2
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