Antibody testing

The Government announced that patients who are having a blood test and wish to be tested can request this. We would suggest that if a patient does wish to be tested they are provided with the necessary form and information required to understand the test and the interpretation of a positive or negative result. The […]

Palliative care for patients with Covid-19

It is likely that we will be caring for many end of life patents in the community due to Covid-19. Experts have been compiling resources to support general practice, for example: NICE and RCGP have both produced guidance regarding palliative care, including symptom management. There is a palliative care section in the NHS London: Primary […]

Management of Covid-19 related, suspected or confirmed pneumonia

NICE have produced a very helpful guideline ‘Covid-19 rapid guideline: managing suspected or confirmed pneumonia in adults in the community’ that covers: Deciding about hospital admission. Managing breathlessness. Antibiotic treatment. Oral corticosteroids. Safety-netting and review. Key NICE messages regarding antibiotic use: Do not offer an antibiotic for treatment or prevention of pneumonia if Covid-19 is […]

Monitoring patients with Covid-19

Key messages We recommend that practices develop a system for remote follow up of patients with suspected Covid-19 in the community, including those discharged into the community with ongoing symptoms. The operating model must consider the immense demand and reduced workforce. We are currently exploring technical solutions for self-reporting and stratifying patients so that practices […]

Triaging suspected Covid-19 patients

Key messages  1. Patients’ symptoms can be triaged into mild, moderate and severe. 2. There are very useful triage pathway diagrams and further information in NHS London: Primary and Community care resource pack during Covid-19. For example: Pathway diagram 1. Categorising patients with Covid-19 symptoms in the community. Pathway diagram Triaging patients with moderate symptoms […]

Do I need an O2 saturation to complete the assessment? How do I obtain the reading?

Key messages An O2 saturation test is only required if it may change management. However, be aware that a normal respiratory rate may be falsely reassuring as there are increasing numbers of anecdotal reports of patients without dyspnea who on testing are severely hypoxic. The Roth score should NOT be used. It has resulted in […]

Assessment of the severity of Covid-19 infection

Key messages Most patients with Covid-19 can be managed remotely with advice on symptomatic management and self-isolation. Although such consultations can be done by telephone in many cases, video provides additional visual cues and therapeutic presence. Breathlessness is a concerning symptom, though there is currently no validated tool for assessing it remotely. Safety-netting advice is […]

The clinical course of Covid-19 – suspecting the diagnosis

Key messages Our understanding of this condition is increasing, but there is still much uncertainty. Many patients with acute Covid-19 have involvement of their respiratory system, characterised by dry cough, dyspnoea, hypoexaemia and abnormal imaging results. There are many different presenting symptoms; only 15% of patients present with fever, cough, and dyspnea. There has been […]