Selected transcript of UK Covid-19 decision support tool

UK Covid-19 decision support tool.md

Selected transcript of image at tweet https://twitter.com/MattGarrahan/status/1249336901313667074

Age

• Under 50: 0 points
• 50–60: 1 point
• 61–65: 2 points
• 66–70: 3 points
• 71–75: 4 points
• 76–80: 5 points
• Over 80: 6 points

Clinical Frailty Scale

These include dementia and physical ability.

1. Very fit
2. Well
3. Managing well
4. Vulnerable
5. Mildly frail
6. Moderately frail
7. Severely frail
8. Very severely frail
9. Terminally ill

Comorbidities

2 points:

• In last 3 years, cardiac arrest from any cause
• Chronic condition causing (a) 3 or more hospital admissions in the last year; or (b) 4 or more weeks of continuous admission for current inpatients

1 point (each) :

• Congestive heart failure (…)
• Chronic lung disease (…)
• Hypertension
• Severe and irreversible neurological condition including dementia
• Chronic liver disease (…)
• End stage chronic renal failure (…)
• Diabetes mellitus requiring medication Uncontrolled or active malignancy

Total score is the sum of these 3 sections, subtracting 1 for "female sex"; there's a disclaimer about clinical discretion.

Treatment groups

Group 1: 8 points or fewer

• Treatment: ICU-based care
• Failure of first-line mgmt: Palliation or ECMO
• Notes: Usual criteria for ECMO and under 60 years

Group 2: More than 8 points

• Treatment: Ward-based care
• Failure of first-line mgmt: Step 3
• Notes: Consider trial of CPAP

Group 3

Patients not normally for full active management or failed CPAP trial

• Treatment: Facemask oxygen
• Failure of first-line mgmt: Palliation
• Notes: Consider domiciliary care

Deviations from ARDS guideline

(Lots of untranscribed details)