FLOW CHART IS A GUIDELINE ONLY
Ask for sats readings at rest and walking test sats readings
- Identify confirmed / suspected Covid-19 patients who can remain at home whilst monitored by ambulatory.
- Identify confirmed / suspected Covid-19 patients who need to return to hospital.
- Identify those patients who no longer need monitoring.
Covid-19 ambulatory pathway.
About 20% of patients who are discharged from the emergency department on this pathway will require readmission. Mortality for patients who fail the walking test can be as high as 20%.
A note on patients with COPD.
Many patients with COPD do not have sats of 88-92% but do in fact have normal sats, so do not assume that the patient with low sats who has COPD represents a patient with ‘normal’ sats for them. They may be severely unwell. If in doubt, do an ABG or admit.
Rapid Walking Test
Take baseline oxygen saturations. Encourage the patient to walk at the highest possible speed for 30 meters on a linear path. Sit the patient down and re-measure oxygen saturations. The test is considered positive if the absolute oxygen saturation has fallen by more than 5%.