How to assess a patient over the phone – ICST

How to assess a patient over the phone

Tutorial presented by Dr Avkash Jain, GP in CAVUHB and Community Director for PCIC.


During a telephone consultation, assess the likelihood of COVID-19 infection by the presence of the following symptoms:

  • New dry cough
  • Fever/chills
  • Impaired sense of taste/smell
  • Lethargy
  • Breathlessness

Ascertain the severity of the patient’s symptoms, particularly whether they are showing signs of deterioration. Deterioration, particularly after 7-days increases the risk of mortality in patients with COVID-19, especially when they are in a high risk group.

During a telephone consultation watch out for common red flag features:

  • Unable to finish a sentence due to breathlessness (note: evidence suggests that people may not present with breathlessness despite significant hypoxia)
  • Breathing harder or faster than usual, or having to lean forward to support themselves to breathe
  • They have an audible wheeze
  • Significant deterioration in functional status – stopped doing usual daily activities
  • Patient reports having blue lips

If the patient presents with any red flags, escalation to hospital may be necessary and this should be discussed with the patient.

Alternative options include:

  • Escalation to video consultation where available, for a visual assessment of the patient.
  • Attendance for a face-to-face consultation for a full clinical assessment of the patient.
  • The patient is comfortable and coping well at home, there are no red flag symptoms and the patient is in the low risk category for COVID-19. Safety netting advice is provided to the patient and they remain at home.

How to assess a patient over the phone

Tutorial presented by Dr Avkash Jain, GP in CAVUHB and Community Director for PCIC.


During a telephone consultation, assess the likelihood of COVID-19 infection by the presence of the following symptoms:

  • New dry cough
  • Fever/chills
  • Impaired sense of taste/smell
  • Lethargy
  • Breathlessness

Ascertain the severity of the patient’s symptoms, particularly whether they are showing signs of deterioration. Deterioration, particularly after 7-days increases the risk of mortality in patients with COVID-19, especially when they are in a high risk group.

During a telephone consultation watch out for common red flag features:

  • Unable to finish a sentence due to breathlessness (note: evidence suggests that people may not present with breathlessness despite significant hypoxia)
  • Breathing harder or faster than usual, or having to lean forward to support themselves to breathe
  • They have an audible wheeze
  • Significant deterioration in functional status – stopped doing usual daily activities
  • Patient reports having blue lips

If the patient presents with any red flags, escalation to hospital may be necessary and this should be discussed with the patient.

Alternative options include:

  • Escalation to video consultation where available, for a visual assessment of the patient.
  • Attendance for a face-to-face consultation for a full clinical assessment of the patient.
  • The patient is comfortable and coping well at home, there are no red flag symptoms and the patient is in the low risk category for COVID-19. Safety netting advice is provided to the patient and they remain at home.

In-person assessment

Mark as Understood

Resources

All Wales Guideline for the Management of patients with confirmed or suspected COVID-19 in the Community

More like this

Top tips for assessing respiratory status remotely

Meeting the needs of people with learning disabilities during the COVID-19 pandemic

Clinical presentation of COVID-19

© Institute of Clinical Science and Technology (ICST) 2020

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