Clinical guide

 

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Preliminary check

Do you have severe chest pain?
YES See a doctor... next NO next 2
 
Do you cough up blood?
YES See a doctor... next NO next 3
 
Is the in-breath louder than the out-breath (stridor)?
YES See a doctor... next NO Breathlessness next 4

Breathlessness

Is the patient out of breath when speaking? (note: do their shoulders move to help them breathe)
YES Severely breathless next NO next 5
 
Do you now struggle with a normal activity such as walking, which didn’t happen before?
YES ADL limited by being breathless next NO next 6
 
How many sit to stands OR what distance walked in 2 minutes?
YES Time/ distance?... next next 7
 
What number does the patient point to for breathlessness?
YES Number on scale?... next next 8

Sputum

Can you hear crackles with your ear or stethoscope?
YES sputum needs clearance next NO next 9
 
Can you feel the crackles with your hand?
YES sputum needs clearance next NO next 10
 
Are the crackles high in the lungs?
YES sputum needs clearance next NO next 11
 
Do you hear bronchial breathing or reduced breath sounds?
YES go to doctor next NO next 12
 
Do you feel aches around your shoulders or chest from coughing and bringing up sputum?
YES needs pain relief in sputum clearance next NO next 13
 
Are you drinking enough water?
YES De-hydrated next NO next 14
 
Do you (the patient) have a lot of sputum?
YES Sputum needs clearance next NO next 15
 
Does the amount of sputum bother you?
YES Education in sputum clearance next NO next 16
 
Has your sputum changed colour or is it thicker?
YES next 17 NO next 19
 
Do you have bronchiectasis or COPD?
YES nextConsider going to doctor 18 NO next 18
 
Do you feel ill/ have a temperature?
YES nextConsider going to doctor 19 NO nextDrink water and monitor 19
 
Do you have problem with bringing up sputum?
YES next20 NO next 23
 
Is the problem of bringing up sputum due to pain?
YES Pain causing retention: requires clearance, massage and light exercises... next21 NO next 21
 
Is the problem of bringing up sputum due to weakness?
YES Weakness: use sputum treatment... NO next 22
 
Is the problem of bringing up sputum due to a social reason or embarrassment?
YES Embarrassment: clear chest at home NO next 23
 
Do you wet yourself when coughing?
YES Cough control: and pelvic floor exercises NO next 24
 
Outcome measures (done after treatment): Is the sputum now clearer?
NO Repeat treatment YES next 25
 
Outcome measures (done after treatment): Can the patient now manage their own secretions?
YES : END next NO : Repeat treatment

 

Long Covid

 

Have you had COVID-19 and still feeling its after-effects, or are you back to the same energy level you had before your virus?

 
 

Energy conservation

  • Pace activities, work in stages, review management of time
  • Reinforce pacing, breakdown activities into achievable parts
  • Use high stool for tasks indoors
  • Decrease bending by crossing one leg over the other for socks, trousers, shoes
  • Sit when possible to cook, dress, shower, clean teeth...
  • integrate posture and avoid breath holding during activities
  • keep a note to identify causes of fatigue and ways to solve and cope with it...
  • do the most important things when energy levels are highst and intersperse heavy and light activities

 

Safety check

Is your sickness COVID-19?

Quick check

 

Could you have COVID-19? (temperature/cough/change of taste or smell)

 
 
 

If so, ISOLATE!

 

Without a test, it can be difficult to know what illness a person has. Depending on the person, COVID-19 can have many different signs and many of those signs also are caused by other health problems. Signs can be mild, uncomfortable, or very serious

Trouble breathing?

or severe chest pain

Are there danger signs: trouble breathing or severe chest pain? Is there a high fever (102°F/ 39°C or higher) and medicine for fever isn’t helping?

 

The person needs help in a health facility. Call ahead to know where to go and what to do. Anyone taking care of the person could also be infected, even if they have no signs. Protect yourself and others from getting sick.

Aches and pains?

with sore throat and no taste

 

Are there aches and pains, congested or runny nose, sore throat, cannot taste or smell normally? These are signs of coronavirus but also could be from another virus or illness. It is hard to know for sure without a test, but the care is the same

 

This could be coronavirus or it could be another virus. If available, get a test to know for sure. You can treat at home. No matter what the illness, protect others from getting sick.

Wet cough or sneezing?

Is there a wet cough or sneezing? If coronavirus is not yet in your region then a wet cough, sore throat, runny nose and fever are more likely to be signs of a cold or flu than coronavirus.

 

If the person is older than 55, has heart disease, existing lung problems, or diabetes, the risk of serious illness is greater. Seek medical advice sooner.

Itchy eyes, headaches?

and breathing problems

Does the person often get signs of allergies (congested or runny nose, itchy eyes, headaches, breathing problems) and has no fever? Probably these are just their regular allergies.

If the person gets worse and emergency signs appear, they need help in a health facility. Protect others from getting sick.

Also check here with ADAPT information

Useful safety measures

How to make a mask

How to make a mask

 

Clinical guide (print-out version)

1. Do you have severe chest pain?
Yes = see a doctor; No = 2;

2. Do you cough up blood? Yes = see a doctor; No = 3;

3. Is the in-breath louder than the out-breath (stridor)? Yes = see a doctor; No = 4;

4. Is the patient out of breath when speaking? (note: do their shoulders move to help them breathe) Yes = severe breathlessness; No = 5;

5. Do you now struggle with a normal activity such as walking, which didn’t happen before? Yes = ADL limited by breathlessness; No = 6;

6. How many sit to stands OR what distance walked in 2 minutes? Time/ distance = ?; go to 7;

7. What number does the patient point to for breathlessness? Number on scale = ?; go to 8;

8. can you hear crackles with your ear or stethoscope? Yes = sputum needs clearance; No = 9;

9. Can you feel the crackles with your hand? Yes = sputum needs clearance; No = 10;

10. Are the crackles high in the lungs? Yes = 11; No = sputum needs clearance;

11. Do you hear bronchial breathing or reduced breath sounds? Yes = go to doctor; No = 12;

12. Do you feel aches around your shoulders or chest from coughing and bringing up sputum? Yes = needs pain relief in sputum clearance; No = 13;

13. Are you drinking enough water? Yes = 14; No = de-hydrated;

14. Do you (the patient) have a lot of sputum? Yes = Sputum needs clearance; No = 15;

15. Does the amount of sputum bother you? Yes = Education in sputum clearance; No = 16;

16. Has your sputum changed colour or is it thicker? Yes = 17; No = 19;

17. Do you have bronchiectasis or COPD? Yes = Consider going to doctor; No = 18;

18. Do you feel ill/ have a temperature? Yes = Consider going to doctor, go to 19; No = drink water and monitor, go to 19;

19. Do you have problem with bringing up sputum? Yes = 20; No = 23;

20. Is the problem of bringing up sputum due to pain? Yes = Pain causing retention: requires clearance, massage and light exercises, go to 20; No = 21;

21. Is the problem of bringing up sputum due to weakness? Yes = Weakness: use sputum treatment, go to 22; No = 22;

22. Is the problem of bringing up sputum due to a social reason or embarrassment? Yes = Embarrassment, clear chest at home, go to 23; No = 23;

23. Do you wet yourself when coughing? Yes = Cough conrol and pelvic floor exercises, go to 24; No = 24;

24. Outcome measures (done after treatment): Is the sputum now clearer? Yes = 25; No = Repeat treatment;

25. Outcome measures (done after treatment): Can the patient now manage their own secretions? Yes = (finish); No = repeat treatment;