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Covid-19 Management 04/Apr/2020

 

 
   

 

Management of suspected case of COVID-19 at initial point of entry: Refer to detailed Guidelines in the COVID-19 2020 National Guidelines in our Clinical Tools Section

NB Infection Prevention Control measures to be adhered to throughout interacting with the patient.

  • Provide face-mask to the patient
  • Heath care workers to put on full Personel Protective Equipment as per PPE Policy & IPC Guidelines *
  • Take a full history so that you can exclude other diagnoses e.g. travel history PCP, bacterial pneumonia, pulmonary embolism, cardiac failure
  • Assess symptoms/signs -? Fever ≥ 38°C ? Cough ? shortness of breath ? nausea, vomiting, diarrhoea?
  • Measure respiratory rate
  • Oxygen saturation? <90%- will need admission
  • Collect nasopharyngeal sample to test for COVID-19 infection.

MILD CASE: Room Air Oxygen >=90%, Respiratory rate<25 breaths /minute, Pulse<120 beats/minute, Temperature<38oC, Normal Mental State.

If symptoms are mild, patient can be advised on how to take care of themselves at home- practice cough etiquette, social distancing etc

MODERATE TO SEVERE CASE: Room air saturation <90% at rest, respiratort rate >26breaths/ minute Temperatur.38.10C, Abnormal mental state

If symptoms are moderate, severe and patient is in the high risk category i.e. elderly >60 years, has chronic conditions like HIV, diabetes, heart disease,cancers prepare for admission

In preparation for admission:

  • Give patient Oxygen via nasal prongs
  • Do the following tests: blood cultures, FBC, U &Es, LFTS, CXR?

Medicines:

  • Give Ceftriaxone 2gm IV stat and then Ceftriaxone 1gm twice a day for 7 days plus Azithromycin 500mg orally stat and then Azithromycin 250mg daily for 4 days (adults/adolescents)
  • Give Ceftriaxone (50-80mg/kg) plus Azithromycin (10mg/kg) as above (children)

Refer for admission to the appropriate ward