Primary Care Update - April 27, 2020

Primary Care Update

April 27, 2020

If you received this from a colleague and wish to receive updates directly

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From Your Elgin Palliative Care Outreach Team

(Dr. Kevin Mardell, Lead Physician &

Cameron Benoit, Manager)

Please read their letter to you containing many resources and download the new (Dec 2019) PCOT Referral Form

This is an excellent article on a palliative approach for patients with COVID-19

If you are interested in joining the palliative care outreach team as a physician please email k.mardell99@gmail.com or Cameron.benoit@lhins.on.ca

Personal Protective Equipment (PPE)

Community Donations of PPE

We are grateful to our local business and volunteer community and Paul Jenkins at the St. Thomas Chamber of Commerce. Please see this document for how to access donated PPE and where to direct people approaching you about donating cash or PPE or comfort items. Check all the work they've done #SEWSTRONG and support/spread their hashtag and site, with thanks on social media

Non-Urgent PPE needs (i.e., running low but not critical)

Go through usual vendors to attain
Access local donations. If unable to attain then...
Submit a request to the Ontario Health West Portal

URGENT PPE shortages

Submit your request through the Ontario Health West Portal to your local PPE Hub -- select Elgin and then 'primary care' in the appropriate drop-down box. A three-day supply of PPE will be provided based on availability of supply. If you receive a response saying "request declined" : this is for internal inventory communication that allows the central virtual warehouse to track inventory that needs to be sent to the Hub. Since our Hub is also storing a limited supply of Donated PPE, the Hub volunteers will contact you immediately if Donated Supply is available.

Reminder: Mandatory Reporting of PPE Inventory to MOHLTC

Anyone providing health care or social services requiring PPE must report their inventory levels daily to the Ministry of Health by completing the Ontario PPE Survey (password: PPEsurvey2020). Please follow these instructions .

Reporting of PPE to the OMA

The OMA asks you to respond regularly to the OMA PPE Survey so they can continue to effectively advocate on your behalf to access PPE for community-based physicians.

Using and Conserving PPE

Please ensure your office is using PPE appropriately as per the OMA's recommendations .

CLINICAL RESOURCES

What does "Symptomatic" mean this week?

Symptomatic patients are considered individuals with the following:

Fever (Temperature of 37.8°C or greater); OR
Any new/worsening acute respiratory illness symptom (e.g. cough, shortness of breath (dyspnea), sore throat, runny nose or sneezing, nasal congestion, hoarse voice, difficulty swallowing); OR
Clinical or radiological evidence of pneumonia.

Atypical symptoms/signs of COVID-19 (sudden, new or worsening)

Unexplained fatigue/malaise
Delirium (acutely altered mental status and inattention)
Falls
Acute functional decline
Exacerbation of chronic conditions
Digestive symptoms, including nausea/vomiting, diarrhea, abdominal pain
Chills
Headaches
Croup
Unexplained tachycardia, including age specific tachycardia for children
Decrease in blood pressure
Unexplained hypoxia (even if mild, i.e., O2 sat <90%)
Lethargy, difficulty feeding in infants (if no other diagnosis)

Download the Updated (April 27 version) Algorithm for

Assessment Centre Referral in Elgin

(please replace previous copies)

COVID TOOLS for Primary Care Providers in Southwestern Ontario

Virtual Pronouncement of Death - Process Map from OMA.

Southwest Musculoskeletal Rapid Access Clinic (Low Back Pain): Emergent and urgent referrals should be directed to the emergency department and/or a surgeons’ office for further screening and evaluation. RAC appropriate individuals can be referred through the usual process, as the central intake office is fully staffed and functioning. Read more here.
Here are two patient handouts for low back pain:

Caregivers for persons with dementia - helpful support during COVID-19 from McCormick Home.

Pharmacotherapy - includes drug substitutions in case of shortages -- inhalers, salbutamol back order (from Thames Valley FHT pharmacists).

Canadian Thoracic Society (CTS)
Position statements on asthma and COPD address therapeutic questions to help you optimize the management of your patients during COVID-19.
COVID-19 resource website gives you free access to information, guidelines, position statements, education and training materials, wellness resources and more.

COVID19 Clinical and Practice Guidance Tool for Primary Care - Centre for Effective Practice provides a series of clinical tools and health information resources. Content is updated daily.

Contraception and Abortion are considered essential services during a pandemic. See these resources on access to and provision of Contraception and Induced Abortion (including updated protocols for Medical Abortion virtually if needed).

DBT Training is back free from Wellkin with Dr. Javeed Sukhera. REGISTER HERE for this 3 hour training session (May 4 OR May 11 1-4pm) back by popular demand. "Practical DBT Skills for Community Settings' provides an overview of core Dialectical Behavioural Therapy skills for community practitioners from diverse health disciplines. After reviewing key concepts, Dr. Sukhera will discuss DBT techniques including chain analysis and validation in more depth. Through case discussion, participants will practice applying a DBT informed approach to enhance compassionate care for individuals suffering with mental illness/addiction.
Wellkin is also offering Tele/Virtual Counselling Support for Children/Youth and Families in Elgin and Oxford Counties. Families our Youth can click the link to request service or you can help do this with them in your office. They can also call 1-877-539-0463. You can download this poster with the live link as well.

Patient Resources

The Southwest Self Management Program has moved all its patient programs and groups online. Patients can browser and self register at www.swselfmanagement.ca. I recommend all patients do the 'Getting the Most From Your Healthcare Appointment'.

MyChart allows patients to access their hospital records. They can now enroll themselves. Patients can click here, or visit https://healthrecordsonline.ca/register in order to enroll for a MyChart account (if they are over the age of 12 and are requesting an account on behalf of themselves).

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If there are non-hospital COVID-19 related issues/solutions i n your region, please escalate them to your

Regional Pandemic Clinical Lead

Dr. Kellie Scott

Elgin

kellie.d.scott@gmail.com