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Why have I been referred to a ‘virtual ward’? You have been admitted onto the Bristol, North Somerset and South Gloucestershire ‘virtual ward’ because you have symptoms of coronavirus. Coronavirus is a viral illness, which for most people is mild, but for some people, it can become serious, sometimes quickly. This means that together, we want to work with you to monitor and keep a close eye on you – particularly your breathing, how fast your heart is beating and the level of oxygen in your blood. Keeping a record of these measurements will help us to decide what is the best treatment for you. We cannot predict who will become seriously unwell, but we know it most often happens towards or during the second week of the illness so it is really important we monitor you over the next 14 days to ensure you remain safe.We have given you a small device called a ‘Pulse oximeter’ to take your oxygen levels and pulse rate, and you will submit these to us via the ‘virtual ward’. 308610021717000Please keep this device safe, and away from children. It’s for use by adults only.What is a pulse oximeter?A pulse oximeter helps you monitor how fast your heart is beating, shown with a heart symbol – heart rate - and the level of oxygen in your blood (as a percentage). Your oxygen level is one of the ways the doctor or nurse can keep an eye on your progress with COVID-19. How do use a Pulse Oximeter? Cold hands, movement, dirt on the sensor and nail varnish can produce an inaccurate reading, so please follow these instructions: 1. Remove any nail polish or false nails and warm your hand if cold. 2. Make sure you have been resting for at least five minutes before taking your measurement. 3. Sit down and rest your hand on a flat surface such as a table or pillow at the level of your heart. 4. Switch the pulse oximeter on and place it on your finger. It works best on your middle or index finger. Do not use your thumb. Ensure the screen will be above your fingernail. It should not be used on your ear. 5. Keep the pulse oximeter in place for at least a minute, or longer, until the result has not changed for five seconds. 6. Record the highest reading in the diary. Be careful to identify which reading is your heart rate and which is your oxygen level. 7. Compare the reading to the traffic lights below and follow the instructions.8. Remove the device. It will turn off automatically. If you would like to watch a short video on how to use the oximeter please use the links below; English the results from the pulse oximeter The first time you use the pulse oximeter, you will have your baseline reading which you need to add into the highlighted area of the diary. Once you have recorded this you should take following readings at 8 o’clock in the morning and 3 o’clock in the afternoon use the traffic light system at the bottom of this document to decide what you should doIf you have a smart phone or smart speaker it may be helpful to set daily reminders to help you take your readings at the recommended times.Record all readings in the diary (below). You will need to monitor your symptoms until the Virtual Ward team are happy that you are well enough to stop. Returning the pulse oximeter We only have a limited number of pulse oximeters to loan out. If you no longer need it, it is essential that you return it to us in the bag provided so it can be safely cleaned and given to other people. We will arrange to collect this from you.Traffic lights system and what to do021590Oxygen level is consistently 92% or under; meaning more than once within an hour. Phone the SPA on 0300 125 6789 during the day (08:00am – 6pm) or 111 in the out of hours period (6pm to 8.00am) 7 days a weekGood readings that show you may be improving. Continue to measure twice dailyCall 999 for urgent assessmentWhat is my Oxygen level using the pulse oximeter?Oxygen level is 93-94%Oxygen level is 95% and above;0Oxygen level is consistently 92% or under; meaning more than once within an hour. Phone the SPA on 0300 125 6789 during the day (08:00am – 6pm) or 111 in the out of hours period (6pm to 8.00am) 7 days a weekGood readings that show you may be improving. Continue to measure twice dailyCall 999 for urgent assessmentWhat is my Oxygen level using the pulse oximeter?Oxygen level is 93-94%Oxygen level is 95% and above;If1905004363085Call the Covid Virtual ward team as soon as possible if: Your oxygen level is 93% or less on a one off readingYour resting pulse rate is greater than 120 beats per minuteYou feel you are getting significantly worse despite stable oxygen levels and pulse rateYou are having difficulty breathing when getting up to go to the toilet or similarYou sense that something is wrong (general weakness, extreme tiredness, loss of appetite, reduced urine output, unable to care for yourself – simple tasks like washing and dressing or making food)08:00-18:00 0300 1256789Out-of-hours 111 Please state you are a ‘Covid-19 Virtual Ward Monitored’ patient00Call the Covid Virtual ward team as soon as possible if: Your oxygen level is 93% or less on a one off readingYour resting pulse rate is greater than 120 beats per minuteYou feel you are getting significantly worse despite stable oxygen levels and pulse rateYou are having difficulty breathing when getting up to go to the toilet or similarYou sense that something is wrong (general weakness, extreme tiredness, loss of appetite, reduced urine output, unable to care for yourself – simple tasks like washing and dressing or making food)08:00-18:00 0300 1256789Out-of-hours 111 Please state you are a ‘Covid-19 Virtual Ward Monitored’ patient190499362585Ring 999 if:You are unable to complete short sentences at rest due to breathlessnessYour breathing suddenly worsens within an hourOR if these more general signs of serious illness develop:you are coughing up bloodyou have blue lips or a blue faceyou feel cold and sweaty with pale or blotchy skinyou have a rash that does not fade when you roll a glass over ityou collapse or faintyou become agitated, confused or very drowsyyou have stopped peeing or are peeing much less than usual00Ring 999 if:You are unable to complete short sentences at rest due to breathlessnessYour breathing suddenly worsens within an hourOR if these more general signs of serious illness develop:you are coughing up bloodyou have blue lips or a blue faceyou feel cold and sweaty with pale or blotchy skinyou have a rash that does not fade when you roll a glass over ityou collapse or faintyou become agitated, confused or very drowsyyou have stopped peeing or are peeing much less than usualIf you become more unwell, please follow the advice in the boxes below:Frequently asked questions How long will I have access to the Virtual Ward team?You will be able to contact the Virtual ward team for up to 14 days or longer if agreed.What happens if I am discharged from the Virtual Ward team and become worried about having symptoms of coronavirus?If you develop new symptoms after getting better, depending on the symptoms you are experiencing, you should follow the advice above and contact either your Virtual Ward Team or NHS 111 or 999.If a family or friend becomes unwell – can they call the Virtual Ward team?Your family/friend should follow the advice above and contact either their GP or NHS 111 or 999 according to their symptoms.How long can I keep the pulse oximeter monitor for?You will keep the oximeter for as long as you have access to the Virtual Ward team – normally this is until your symptoms improve (after 10-14 days).What should I do if I have any problems using my pulse oximeter?Please contact the Virtual Ward team at your earliest convenience so they can organise a replacement monitor to be sent to you. If this is in working hours, the team will also check on how you are feeling. If you feel unwell and it is out of working hours, please initially contact NHS 111 for advice.Where can I find the latest NHS guidance about COVID-19?Please see the NHS website at Monitoring COVID-19 DiaryRemote Monitoring COVID-19 DiaryFirst NameSurname D.O.BNHS Number: Age:Lives Alone? Carer at Home? Days since first symptom*DateTimePulsePR bpmOxygen LevelSpO2Temp**Feeling: better/same/worseBreathing: better/same/worseInitial reading(baseline) *That is, if you start recording pulse oximetry five days after first symptoms started, write record “5” under day **Record and fill in temperature if you have a thermometerRemote Monitoring COVID-19 DiaryFirst NameSurname D.O.BNHS Number: Age:Lives Alone? Carer at Home? Days since first symptom*DateTimePulsePR bpmOxygen LevelSpO2Temp**Feeling: better/same/worseBreathing: better/same/worseInitial reading(baseline) *That is, if you start recording pulse oximetry five days after first symptoms started, write record “5” under day **Record and fill in temperature if you have a thermometerRemote Monitoring COVID-19 DiaryFirst NameSurname D.O.BNHS Number: Age:Lives Alone? Carer at Home? Days since first symptom*DateTimePulsePR bpmOxygen LevelSpO2Temp**Feeling: better/same/worseBreathing: better/same/worseInitial reading(baseline) *That is, if you start recording pulse oximetry five days after first symptoms started, write record “5” under day **Record and fill in temperature if you have a thermometerRemote Monitoring COVID-19 DiaryFirst NameSurname D.O.BNHS Number: Age:Lives Alone? Carer at Home? Days since first symptom*DateTimePulsePR bpmOxygen LevelSpO2Temp**Feeling: better/same/worseBreathing: better/same/worseInitial reading(baseline) *That is, if you start recording pulse oximetry five days after first symptoms started, write record “5” under day **Record and fill in temperature if you have a thermometer ................
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