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REMEDY : BNSSG referral pathways & Joint Formulary

COVID Oximetry @ Home Virtual Ward

Checked: 13-01-2021 by vicky.ryan Next Review: 14-06-2021

COVID Oximetry pathway

Silent Hypoxia is a key COVID risk: leading to significant clinical implications.

This pathway relates to where a patient is diagnosed with Covid, is symptomatic and is either 65 or over or is under 65 and Clinically extremely vulnerable receive updated guidance in line with new national restrictions - GOV.UK (www.gov.uk) or is on the Learning Disabilities register

Clinical judgement to be applied if the patient does not fit in the above criteria

Onboarding

Patients to be provided with a pulse oximeter, safety netting information and contact details to report oximetry readings and symptoms

The patient information leaflets that are given to patients alongside their machine.

Monitoring

  1. Patients will report their SPO2 readings to SPA twice a day (at 08:00 and 15:00) for 14 days, both during weekdays and weekends
  2. Patients on an amber pathway will be monitored by Sirona clinicians
  3. Patients on a green or amber pathway whose SpO2 drops to 92% or lower will be advised to call 999 stating they are on the COVID virtual ward
  4. Patients on a green pathway whose SpO2 drops to 93-94% during in-hours (8:00-18:30) will be contacted by SPA to check their state and will then contact their GP via the back phone for further assessment M-F or OOH on weekends
  5. If patients on a green pathway experience a SpO2 drop to 93-94% during out-of-hours (18:30 - 8:00) the patient will contact 111.

Discharge

Patients will be discharged from the virtual ward after 14 days if their SpO2 levels remain 95% or higher

 

Referral

Patients with SpO2 92% or lower to be assessed for suitability for hospital admission (i.e. reasonable expectation that this will improve mortality from COVID illness for hospital admission for treatment for COVID)

Patients suitable for admission will be called through to the IUC weekday professional line (0117 2449283 Monday to Friday 8:30 – 18:30) or 999 if clinically appropriate

Patients with SpO2 93% or higher will be referred to the COVID Virtual Ward via BNSSG SPA: 0300 125 6789 or by emailing the referral form to sirona.bnssg.covidvw@nhs.net

The EMIS Covid Pulse Oximeter Electronic Patient Referral Form is available for use on the OneCare EMIS Resource Publisher, or for download and manual import into your EMIS system at https://teamnet.clarity.co.uk/Library/ViewItem/ec9e74d2-b7ad-4b57-bca9-ac9a00d742bd

Resources

Full version of the RECAP-V0 score (REMOTE COVID-19 ASSESSMENT FOR PRIMARY CARE)