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Preliminary check


1 Do you have severe chest pain?

yesyes See a doctor... no 2


2 Do you cough up blood?

yesyes See a doctor... 3 no 3


3 Is the in-breath louder than the out-breath (stridor)?

yesyes See a doctor... 4 no Breathlessness proceed 4



4 Is the patient out of breath when speaking? (note: do their shoulders move to help them breathe)

yesyes Severe breathlessness... 5 no 5


5 Do you now struggle with a normal activity such as walking, which didn’t happen before?

yesyes ADL limited by breathlessness... 6 no 6


6 How many sit to stands OR what distance walked in 2 minutes?

yes Time/ distance?... 7


7 What number does the patient point to for breathlessness?

yes Number on scale?... proceed 8



8 Can you hear crackles with your ear or stethoscope?

yesyes sputum needs clearance... 9 no 9


9 Can you feel the crackles with your hand?

yesyes sputum needs clearance... 10 no 10


10 Are the crackles high in the lungs?

yes 11 noyes sputum needs clearance... 11


11 Do you hear bronchial breathing or reduced breath sounds?

yesyes go to doctor... 12 no 12


12 Do you feel aches around your shoulders or chest from coughing and bringing up sputum?

yesyes needs pain relief in sputum clearance... 13 no 13


13 Are you drinking enough water?

yes 14 noyes De-hydrated... 14


14 Do you (the patient) have a lot of sputum?

yesyes Sputum needs clearance... 15 no 15


15 Does the amount of sputum bother you?

yesyes Education in sputum clearance... 16 no 16


16 Has your sputum changed colour or is it thicker?

yes 17 no 19


17 Do you have bronchiectasis or COPD?

yesyes Consider going to doctor... 18 no 18


18 Do you feel ill/ have a temperature?

yesyes Consider going to doctor... 19 noyes Drink water and monitor... 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?

yesPain causing retention: requires clearance, massage and light exercises... 21 no 21


21 Is the problem of bringing up sputum due to weakness?

yesWeakness: use sputum treatment... 22 no 22


22 Is the problem of bringing up sputum due to a social reason or embarrassment?

yesEmbarrassment: clear chest at home no 23


23 Do you wet yourself when coughing?

yesCough control: and pelvic floor exercises no 24


24 Outcome measures (done after treatment): Is the sputum now clearer?

yes25 no Repeat treatment


25 Outcome measures (done after treatment): Can the patient now manage their own secretions?

yes END 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)




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