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. 2020 May 15;20(3):251-255.
doi: 10.7861/clinmed.2020-0188.

Respiratory advice for the non-respiratory physician in the time of COVID-19

Jonathan Bennett  1 , Mohammmed Munavvar  1 , Paul Walker  1 , Gerrard Phillips  2
Affiliations

Respiratory advice for the non-respiratory physician in the time of COVID-19

Jonathan Bennett et al. Clin Med (Lond). .

Abstract

COVID-19, the disease caused by the SARS-CoV-2 beta-coronavirus, has changed clinical practice in a matter of weeks. Among the physician specialties, respiratory physicians have been at the forefront of the response to this new challenge. Here we provide advice for non-respiratory physicians on the ward-based care of patients with this disease. This includes recommendations on hydration, thromboprophylaxis, nutritional support and on the importance of the early detection of deterioration, setting ceilings of care and use of anticipatory drugs where appropriate. We also discuss oxygen support modalities, proning, safe working practices and a new approach to multi-professional working. We include references to a number of important research studies.

Keywords: COVID-19; Respiratory; coronavirus.

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Figures

Fig 1.
Fig 1.
SPACES poster for ward display.
Fig 2.
Fig 2.
Example of a local management aid: escalation of respiratory support decision aid. Developed by S Knapp, L Walker, J Parker and M Steiner for University Hospitals, Leicester. CPAP = continuous positive airway pressure, NIV = non-invasive ventilation, RF = respiratory failure, RR = respiratory rate.
Fig 3.
Fig 3.
Example of a local management aid: use of oxygen therapy for adult inpatients during COVID-19 pandemic – clinical guidance to help ensure efficient usage of oxygen. Developed by S Knapp, L Walker, J Parker and M Steiner for University Hospitals, Leicester. CPAP = continuous positive airway pressure, EoL = end of life, NIV = non-invasive ventilation.
See this image and copyright information in PMC

References

    1. Wang T, Chen R, Liu C, et al. Attention should be paid to venous thromboembolism prophylaxis in the management of COVID-19. Lancet Haematol 2020, in press (DOI: 10.1016/S2352-3026(20)30109-5. - PMC - PubMed
    1. British Thoracic Society BTS guidance on venous thromboembolic disease in patients with COVID-19. BTS, 2020. Available from www.brit-thoracic.org.uk/about-us/covid-19-information-for-the-respirato....
    1. Hunt B, Retter A. and McClintock C. Practical guidance for the prevention of thrombosis and management of coagulopathy and disseminated intravascular coagulation of patients infected with COVID-19. Thrombosis UK, 2020. Available from: https://thrombosisuk.org/covid-19-thrombosis.php.
    1. Royal College of Physicians National Early Warning Score (NEWS) 2: Standardising the assessment of acute-illness severity in the NHS. RCP, 2017. Available from: www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2.
    1. Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005;173:489–95. - PMC - PubMed