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Content ArticlePost-intensive care syndrome (PICS) is a nonspecific syndrome that results from physical, mental, and emotional stresses associated with critical illness and treatment in intensive care units (ICUs). Common features include neuromuscular weakness from immobility, cognitive impairment from sedation, and anxiety, depression, post-traumatic stress syndrome (PTSD), and, as we are learning, additional sequelae for COVID-19 survivors. Symptoms can manifest or persist weeks, months, or years after patient discharge. This eBook from ECRI provides an overview of PICS, the common danger signs health providers and family members should be able to identify, and its potential long term negative effects. Learn about strategies like creating an ICU diary to help mitigate risks, in addition to understanding other recommendations to consider to protect the safety and well-being of patients during their recovery.
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News ArticleNurses and non-medical staff have been stopped from taking patient calls to the NHS coronavirus helpline amid concerns over the safety of their advice. An audit of calls to the telephone assessment service found more than half were potentially unsafe for patients, according to a leaked email shared with The Independent. At least one patient may have come to harm as a result of the way their assessment was handled. The COVID-19 Clinical Assessment Service (CCAS) is a branch of the NHS 111 phone line and is designed to assess patients showing signs of coronavirus to determine whether they need to be taken to hospital or seen by a GP. The helpline was set up at the start of the pandemic to divert patients with symptoms to a phone-based triage to relieve pressure on GPs and prevent them from turning up at surgeries and spreading the virus. GPs, nurses and allied health professionals (AHPs) such as paramedics and physiotherapists were recruited to speak to patients after they were flagged by NHS 111 call handlers. The use of non-medical staff was first paused in July amid concerns about the quality of call handling. Now it has emerged much wider safety issues have surfaced. Read full story Source: The Independent, 18 August 2020
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News Article
Long Covid: 'Life might never be normal again' (video)
Clive Flashman posted a news article in News
Coronavirus patients who have lived with symptoms for up to five months have spoken about the huge impact it has had on their lives. "Long Covid" support groups have appeared on social media and the government says "tens of thousands" of people have long-term problems after catching the virus, such as extreme fatigue. Daliah, from Borehamwood, Hertfordshire, said: "It's scary because we don't know how permanent this is. There are times where I feel like life will never be normal again, my body will never be normal again." The NHS has launched a Your Covid Recovery website to offer support and advice to people affected. See video here -
News Article
Brain fog, phantom smells and tinnitus: my experience as a Covid 'long hauler'
Clive Flashman posted a news article in News
I fell sick on 25 March. Four months later, I’m still dealing with fever, cognitive dysfunction, memory issues and much more I just passed the four-month mark of being sick with Covid. I am young, and I had considered myself healthy. My first symptom was that I couldn’t read a text message. It wasn’t about anything complex – just trying to arrange a video call – but it was a few sentences longer than normal, and I couldn’t wrap my head around it. It was the end of the night so I thought I was tired, but an hour later I took my temperature and realized I had a fever. I had been isolating for 11 days at that point; the only place I had been was the grocery store. My Day 1 – a term people with Long Covid use to mark the first day of symptoms – was 25 March. Four months later, I’m still dealing with a near-daily fever, cognitive dysfunction and memory issues, GI issues, severe headaches, a heart rate of 150+ from minimal activity, severe muscle and joint pain, and a feeling like my body has forgotten how to breathe. Over the past 131 days, I’ve intermittently lost all feeling in my arms and hands, had essential tremors, extreme back, kidney and rib pain, phantom smells (like someone BBQing bad meat), tinnitus, difficulty reading text, difficulty understanding people in conversations, difficulty following movie and TV plots, sensitivity to noise and light, bruising, and petechiae – a rash that shows up with Covid. These on top of the CDC-listed symptoms of cough, chills and difficulty breathing. Read the full article here. -
Content ArticleThis article, published by The Conversation, highlights the mounting evidence that some people who have had COVID-19 but were not hospitalised, are experiencing prolonged illness. Reported after-effects of the virus include; overwhelming fatigue, palpitations, muscle aches and pins and needles. The author of this article looks at the research to date and talks about using twin studies to gain further insight into 'post-COVID syndrome'.
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News ArticleBritish scientists analysing data from a widely-used COVID-19 symptom-tracking app have found there are six distinct types of the disease, each distinguished by a cluster of symptoms. King’s College London team found that the six types also correlated with levels of severity of infection, and with the likelihood of a patient needing help with breathing - such as oxygen or ventilator treatment - if they are hospitalised. The findings could help doctors to predict which COVID-19 patients are most at risk and likely to need hospital care in future waves of the epidemic. Read full story Source: Reuters, 17 July 2020
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Content ArticleEarly clinical experiences have demonstrated the wide spectrum of COVID-19 presentations, including various reports of atypical presentations of COVID-19 and possible mimic conditions. This article, published in the BMJ, summarises the current evidence surrounding atypical presentations of COVID-19 including neurological, cardiovascular, gastrointestinal, otorhinolaryngology and geriatric features.
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Content ArticleWeeks and months after having a confirmed or suspected Covid-19 infection, many people are finding they still haven’t fully recovered. Emerging reports describe lingering symptoms ranging from fatigue and brain-fog to breathlessness and tingling toes. So why does Covid-19 cause lasting health problems? In this podcast, Ian Sample discusses some of the possible explanations with Prof Danny Altmann, and finds out how patients might be helped in the future.
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News ArticleInitial survey findings show the long road to recovery for people who have faced COVID at home without going into hospital New survey findings from over 1,000 people show that those recovering from mild-moderate COVID are struggling for weeks with symptoms, raising concerns that there is not adequate support for people who have not been in hospital with the illness. The ongoing survey is being run by Asthma UK and the British Lung Foundation, through their post-COVID HUB, which they set up, alongside a helpline and WhatsApp service, to support anyone left with breathing difficulties after COVID. Read full article here
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News Article
Contact tracing system rolled-out across Wales
Patient Safety Learning posted a news article in News
A contact tracing system has this week been launched in Wales, initially a telephone based process, followed by an online system next week. Anyone who has a positive coronavirus test result will be contacted by a team of contact tracers and asked for details of everyone they have had close contact with while they have had symptoms. From Monday 8th June, a new online system will be used to support the process. People will have the option to use the system to provide details of their close contacts electronically. The system has been trialled in four health board areas over the last two weeks and more than 600 contact tracers have so far been employed, with more to be employed. Health Minister, Vaughan Gething said “Today’s roll-out of the contact tracing element of our Test, Trace, Protect strategy is a significant step forward in the gradual move out of lockdown.” Read full story Source: HTN, 2 June 2020 -
Content ArticlePaul Garner is Professor at the Liverpool School of Tropical Medicine. He is Director of the Centre for Evidence Synthesis in Global Health and Co-ordinating Editor of the Cochrane Infectious Diseases Group. In this blog for BMJ Opinion, Paul describes how he has struggled in the weeks following his COVID-19 infection and the relapses in fatigues that have occurred after any exertion.
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News Article
Thousands of Covid-19 cases missed due to late warning on smell loss, say experts
Patient Safety Learning posted a news article in News
Tens of thousands of cases of COCID-19 may have been missed because of delays in warning the public that loss of taste and smell is a key symptom that should lead to self-isolation or testing, experts say. The four chief medical officers of the UK have finally made official what many scientists had been saying for weeks: that anosmia, or loss of smell, should be added to the other two main warning symptoms, a continuous cough and high temperature. Those who experience any of the three symptoms should isolate for seven days and their families for 14 days. Prof Tim Spector from King’s College London and his team said data from 1.5 million people who downloaded their symptom-reporting app suggested 50,000 to 70,000 people in the UK had been missed. As early as 1 April, they warned that people with anosmia should self-isolate. They were joined by ear, nose and throat surgeons, who said loss of taste and smell could be one of the few markers for people who were otherwise asymptomatic and potentially able to infect other people without realising they were a risk. Their professional body, ENT-UK, said they had been calling for eight weeks for anosmia to be listed as a marker for asymptomatic carriers. It issued a joint statement with the British Rhinology Society (BRS) on 20 March, it said. “We estimate that many hundreds of thousands of patients in the UK have developed anosmia as a result of COVID-19,” said Prof Claire Hopkins, the BRS president. Read full story Source: Guardian, 18 May 2020 -
Content ArticleSome degree of post-viral fatigue (PVF) or debility is a fairly common occurrence after any type of viral infection.Fortunately, in most cases, this is short lived and there is a steady return to normal health over a period of a few weeks.However, in some cases, a full return to normal health takes months rather than weeks.Additional symptoms may also develop, where the term post-viral fatigue syndrome (PVFS) may be a more appropriate diagnosis. The situation with persisting fatigue following COVID-19 infection appears to be rather more complicated than what happens with other viral illnesses.
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News Article
NHS 111 gets new queuing system to handle coronavirus surge
Patient Safety Learning posted a news article in News
An overflow system has been added to NHS 111 to help deal with the “huge increase” in calls during the coronavirus pandemic. People displaying coronavirus symptoms who are contacting 111 either via telephone or online are now being diverted to the overspill system, freeing up space for non-covid related enquiries. The tool has been developed by software company Advanced — alongside NHSX, NHS England and NHS Improvement — for its patient management system Adastra, which is used by 80% of NHS 111 providers in England. The overspill add on, which started being rolled out earlier this month, can be accessed by clinicians who are working from home, including those who have been redeployed in the NHS, as well as those in 111 call centres. Ric Thompson, managing director of health and care at Advanced, said the new queuing extension was developed to handle the “huge increase in the number of calls to 111 but also the need to bring back many thousands of retired clinicians”. Read full story Source: HSJ, 29 April 2020 -
News Article
National alert as ‘coronavirus-related condition may be emerging in children’
Patient Safety Learning posted a news article in News
A serious coronavirus-related syndrome may be emerging in the UK, according to an “urgent alert” issued to doctors, following a rise in cases in the last two to three weeks, HSJ has learned. An alert to GPs and seen by HSJ says that in the “last three weeks, there has been an apparent rise in the number of children of all ages presenting with a multisystem inflammatory state requiring intensive care across London and also in other regions of the UK”. It adds: “There is a growing concern that a [covid-19] related inflammatory syndrome is emerging in children in the UK, or that there may be another, as yet unidentified, infectious pathogen associated with these cases.” Little is known so far about the issue, nor how widespread it has been, but the absolute number of children affected is thought to be very small, according to paediatrics sources. The syndrome has the characteristics of serious COVID-19, but there have otherwise been relatively few cases of serious effects or deaths from coronavirus in children. Some of the children have tested positive for COVID-19, and some appear to have had the virus in the past, but some have not. Read full story Source: HSJ, 27 April 2020 Do you work in paediatrics? Have you seen similar trends emerging? What are your thoughts on the concerns raised? Join the conversation in the hub community area: -
Content ArticlePaediatric cardiac arrest is unlikely to be caused by a cardiac problem and is more likely to be a respiratory one, making ventilations crucial to the child’s chances of survival. However, for those not trained in paediatric resuscitation, the most important thing is to act quickly to ensure the child gets the treatment they need in the critical situation. This page contains:an EPALS algorithm for paediatric COVID-19 patients.a flowchart on the resuscitation of paediatric COVID-19 patients in hospital.
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Content ArticleHealth tech company DrDoctor has announced that its COVID-19 toolkit is now available, free of license fees to any hospital that requires it. The bespoke toolkit comprises of the recently released Broadcast Messaging and Video Consultation services and, as of today, the new digital Symptom Assessment Tracker.
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Content ArticleSince the severity of disease is closely related to the prognosis, the basic and essential strategies to improve outcomes that we should adhere to remain the early detection of high-risk and critically ill patients This retrospective analysis of casein Jiangsu Province proved a good consistency between early screening of SpO2, RR, HR and early warning model. Therefore, a flowchart integrating early warning model and early screening procedure is recommended for high risk patients recognition and all patients’ screening to make it possible for early intervention. This article includes flow charts for: early recognition of high-risk and critically ill patients management of critically ill patients.
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Content Article
Ambulance trusts: practical guidance
Claire Cox posted an article in Guidance
These resources, set out by NHS England, give guidance for ambulance trusts on the following: assessment and diagnosis management - suspected coronavirus (COVID-19) cases infection Control discharge COVID-19 patient transport services: requirements and funding. -
Content ArticleThis teaching presentation, by Kings Hospital clinical fellows, is based on ‘Kings clinical summary guidelines’ when caring for a patient with diagnosed COVID 19 This presentation includes: Disease progression Diagnosis Bloods Imaging Radiology Guidelines Investigations Treatment Organ Support Prognosis Treatment escalation planning Palliative care PPE Resuscitation Intrahospital transfer.
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Content ArticleThe emergence in December 2019 of COVID-19, caused by a novel coronavirus, and its subsequent spread around the world, led the World Health Organisation to declare a pandemic on March 11, 2020: the first to be caused by a coronavirus . The virus appears to have originated in bats, with spread to humans likely mediated by an intermediate mammalian. This paper by Dr Nicole Le Saux, discusses the current epidemiology for COVID 19 in children.
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Content ArticleThis infographic designed by the team at Greater Glasgow and Clyde NHS, Scotland, sets out what to look out for and the clinical evaluation and treatment of COVID-19.
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Content Article
COVID symptom tracker app
Claire Cox posted an article in Good practice and useful resources
Guys and St Thomas' Hospital NHS Foundation Trust and the National Institute for Health research (NIHR) have developed an app. This app can be accessed by everyone. It will map out symptoms you may have (coronavirus symptoms) even if you feel well. This is part of ongoing research in how this virus is spreading and to understand symptoms.
