By rray, 25 April, 2023 Pts w COVID 19 Advise regarding self quarantine and transmission mitigation Ensure adequate supplies of home meds Consider remote phone online f u
By rray, 25 April, 2023 If non life threatening Supplemental O2 to target pulse ox 88 to 92 sat check frequent ABG VBG for uarr PaCO2 acidosis If uarr work of breathing or impaired gas exchange Consider ventilation NIV preferred if not contraindicated High flow nasal tx benefits
By rray, 25 April, 2023 If life threatening acute resp failure oxygenate ventilate NIV preferred if not contraindicated target pulse ox 88 to 92 sat check frequent ABG VBG for uarr PaCO2 acidosis
By rray, 25 April, 2023 Oxygenate ventilate follow serial blood gases and SaO2 give short acting BDs start systemic steroids Admit to MICU if using NIV ventilator
By rray, 25 April, 2023 Plan d c for stable pts o Start maintenance tx w long acting BDs ASAP prior to d c determine maintenance tx according to GOLD COPD groups o Add short acting BD for sx rescue o Check inhaler technique o Check pt understanding of withdrawal of steroids abx
By rray, 25 April, 2023 Start restart long acting BD ASAP Continue long acting BD during exac or start ASAP before hospital d c Long acting BDs include LAMAs aclidinium glycopyrrolate revefenacin tiotropium DPI MDI umeclidinium LABAs arformoterol formoterol olodaterol salmeterol
By rray, 25 April, 2023 Once stabilized determine level of care continue tx o Resp unit MICU indications severe SOB not responding to initial emergency tx MS persistent worsening PaCO2