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Is it Covid? How FirstCare nurses triage symptoms …and what to do next.

Posted by Suzanne Marshall RN on 23/10/20 13:33
Suzanne Marshall RN

Suzanne Marshall RN, FirstCare’s Head of Clinical Governance provides her latest guidance on identifying Covid-19 and explains how her team of nurses deal with callers presenting possible symptoms.

Our nurses and advisers receive a huge number of calls every day from FirstCare Members who are employed by organisations across the UK.

At that initial point of contact, our primary task is to fully understand the caller’s circumstances, so we can provide appropriate support and log the reasons for their time off work.

We use a process called ‘triage’ to ascertain what are the best actions to take. These might range from some simple self-help tips, through to referral to a specialist or even immediate intervention of the emergency services. Our goal is to ensure Members get the right care as soon as possible and, when the time is right, get them back to work safely.

Whatever the caller’s situation, reassurance and clear guidance are essential. Unsurprisingly, since the first outbreak of Covid-19 in the UK, a significant proportion of calls have been from Members who are concerned that they or their loved one have been infected. Many people remain confused about the symptoms of Covid and indeed the measures they should take if an infection is suspected or confirmed.

As knowledge of the coronavirus evolves and government policies change, we review our triage system and update the guidance we provide our frontline clinical staff.

This post includes the latest information (October 23rd 2020) we are providing FirstCare customers about how the our nurse advisor team are assessing potential cough, cold, flu and COVID symptoms. It details the advice that we give on self-management and what to do if COVID-19 is suspected. Information is also provided on how we classify the most appropriate absence reason to support our Clients in managing COVID within their organisations. Please feel free to share this post with colleagues and loved ones.

What are the differences between Colds, Flu and COVID-19?

People with coronavirus have a wide range of symptoms, ranging from mild to severe, although some will have none, but can still be infectious. Symptoms may appear up to two weeks after exposure to coronavirus, but usually around day five.

Upper respiratory symptoms, like runny nose and sinus congestion, are very uncommon in COVID-19. Therefore, a runny nose is not a reason to get tested for coronavirus. Other signs and symptoms of COVID-19, different from flu, may include change in or loss of taste or smell and feeling breathless can be a sign of a more serious coronavirus infection.

COVID and the FirstCare Nurse Service

  1. The only way to know for sure that the employee has COVID-19 is by testing. FirstCare do not perform any testing but can advise callers on how to get tested via the organisations local policy or the NHS.
  2. You can have a positive COVID-19 test with all the three main symptoms, or positive but with no symptoms at all (this is called asymptomatic).
  3. The nurses can only assess what they are being told by the service user, although they are trained to probe further using the bespoke triage questions and other relevant questions to the case.
  4. Following triage, the nurse’s primary role is to give advice on how to manage their symptoms. The nurses are unable to diagnose as we do not carry out any COVID testing.
  5. In regard to refraining from work with COVID or suspected COVID, the advice we give to the caller is always taken from the current government guidance.
  6. The nurse will have a discussion with the caller to assign the reason as accurately as possible, and we do try to influence their decision, however the caller has the final say on how they wish the absence to be recorded. We are experiencing those who do not want it recorded as COVID and others that insist.
  7. We are aware that the cold and flu season has started and that it’s going to be challenging for our team to differentiate between the viruses To support with this, the nurses have undergone training on the difference between a cough/cold, flu and the COVID virus.
  8. NB: The absence advisors’ role is to log what the caller says, and they do not give advice.
  9. Under the legal requirements of GDPR FirstCare cannot share the reason for the absence if the service user does not give us consent

Government Guidance October 2020

nhs

FirstCare Nurse Triage

The upper respiratory triage questions include but are not limited to:

 

  1. Do you have a high temperature (fever)?
  2. Do you have a new continuous cough?
  3. Do you have a new loss of smell or taste?
  4. Are you so breathless that you are unable to speak more than a few words?
  5. Are you breathing harder or faster than usual when doing nothing at all?
  6. Are you so ill that you've stopped doing all your usual daily activities?
  7. Have you suddenly become confused, or much more confused than normal?
  8. Has a doctor told you that getting an infection might be very serious?

Self-Management advice

  • For pain or a sore throat, Paracetamol or Ibuprofen may be taken. Caution must be used with existing medical conditions so always check with the pharmacist if you are able to take these medications; and always read the Patient Information Leaflet for guidance on the dose, frequency and side effects.
  • For congestions menthol or steam inhalations may help.
  • Avoid caffeine, alcohol and smoking
  • Take a light but nutritional diet, such as chicken soup
  • For flu bed rest is recommended until the fever, aches and pains begin to subside
  • Our Company Medical Advisor recommends that everyone takes a Vitamin D supplement and considers taking zinc as well. These will improve the body’s immune system.
  • Treating a high temperature - get lots of rest, drink plenty of fluids (water is best) to avoid dehydration – drink enough so your urine is light yellow and clear. Take paracetamol if you feel uncomfortable
  • Treating a cough - avoid lying on your back. Lie on your side or sit upright instead. To help ease a cough, we suggest a teaspoon of honey.
  • Get the flu vaccination

FirstCare_Diagram

bbc

References:

https://www.cdc.gov/flu/symptoms/flu-vs-covid19.htm

https://111.nhs.uk/

https://www.gov.uk/coronavirus