Thread by @drvgallo

A brief summary of the decision algorithm to hospitalise a patient with suspect #COVID19 in Italy. Relevant to @trishgreenhalgh guidelines for #GP remote assessment

A thread
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Patients in respiratory distress affected with #COVID19 arrive with up to severe #hypoxia but usually normocapnia. Therefore no respiratory distress nor hyperventilation

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Therefore Emergency doctors decide to admit otherwise healthy patients with oxygen saturation below 94% (young patient) or 90-94% (older patient or with chronic lung conditions). For those not falling below the threshold they perform the 40 steps test

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This is a test where you ask the patient to walk at brisk pace for 40 steps. If the oxygen saturation falls by 10%, then the patient is admitted. If it doesn’t the patient is instructed to go home with a #saturometer and a #thermometer

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The patient should repeat the 40 steps test and measure the body temperature twice/day and come back to the hospital only if the situation worsen

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In a preparatory phase, equipping at risk patients with #thermometers and #saturometers sounds like a good idea for improving the GP-telemedicine

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