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1. Introduction

2. Out of Hospital settings, assessments, pathways and treatments for patients with suspected COVID-19 

2.1.  Zoning or Hot and Cold Sites in primary care during COVID-19

2.2.  Respiratory assessment and pathways for patients with suspected COVID-19 in the community across all settings 

2.2.1.  Remote Assessment/Telephone Triage with Patient or Carer

2.2.2.  Pathway diagram 1. Categorising patients with COVID-19 symptoms in the Community

2.2.3.  Pathway diagram 2. Triaging patients with moderate symptoms of COVID-19 but NO pre-existing lung disease or significant comorbidities 

2.2.4.  Pathways for patients with PRE-EXISTING lung conditions or comorbidities 

2.2.5.  Safety netting and managing the follow up of patients with a suspected COVID-19 infection who have been advised they can stay at home 

2.2.6. London guide and care pathway for suspected COVID-19 in Residential and Nursing Care Residents for use by care home staff

2.2.7. Home visits and face to face contact (including admission avoidance)

2.3.  PPE Requirements

2.4.  Cardiopulmonary Resuscitation 

2.5.  Treatments considered appropriate to specific care settings 

2.5.1. Discussing Advance Care Planning and preferred place of care – supporting patients and their families 

2.5.2. Treatments to consider at home or nursing/care home

2.6. Post-discharge

2.6.1. COVID-19 guidance on safety netting post-discharge from hospital for different care settings Clinical decision aid: Suitability for discharge and appropriate safety netting following ED attendance or hospital admission with confirmed/ suspected COVID-19 (use for patients who would be for readmission and full escalation of care) Discharge to care/nursing home following COVID illness Management of Homeless Patients on discharge from Hospital Emergency Departments to GLA COVID

3. Guidance in the use of oxygen therapy in COVID-19 outside of hospital setting 

3.1  Oxygen supply route for out of hospital facilities

3.2  Specific patient cohorts who may require oxygen outside hospital settings 

3.2.1  Patients with suspected or confirmed COVID-19 assessed within primary care hot sites

3.2.2  Patients with suspected or confirmed COVID-19 discharged from emergency departments and/or hospital wards who are for full active treatment (non-palliative) 

3.2.5  Home oxygen prescription for patients with suspected or confirmed COVID-19

3.2.6  Patients with suspected or confirmed COVID-19 at the end of life

Palliative Care

4.1.  Care in the home (including nursing and care home settings) 

4.2.  Non-pharmacological control of symptoms

4.2.1. Breathlessness

4.3. Pharmacological control of symptoms

6. Business as Usual for Non-COVID-19 Respiratory Patients or Smokers

Appendix 1. Guideline on emergency oxygen therapy to treat hypoxic patients with suspected COVID 19 within primary care hot sites v1 (7 Apr 2020) 

Appendix 2. Those considered to be at ‘increased risk’.

Appendix 3. Oxford COVID-19 Evidence Service Findings

Appendix 4. Clinical Frailty Scale (Rockwood, 2005) 

Appendix 5. Additional guidance on pathways for patients with PRE-EXISTING lung conditions or comorbidities

Appendix 6. Resource pack to support implementation of Coordinate My Care plans at pace. 

Appendix 7. Managing your breathlessness at home during the corona virus (COVID-19) outbreak leaflet 

Appendix 8. Management of Homeless Patients on discharge from Hospital Emergency Departments to GLA COVID Care

Appendix 9. Guidance on symptom control using non-oral, non-parental routes of medication administration during COVID-19