Acute shortness of breath pathway
Acute Respiratory Infection Screening and Isolation (including COVID-19)
For patients requiring BiPaP / CPAP/or intubation
A
Any High Risk Criteria met in the last 14 days or COVID positive
B
Any new or worsening acute Respiratory Symptoms
AED to Destination Unit/Ward Flow
A & B
A
B
A & B
Both - Yes
Yes - only
Yes - only
Both - No
AIIR
Single room
Single room
(Negative Pressure
(Door closed or
Routine Bed flow
(Door closed)
Room)
variance)
Contact
Medical Mask +
Contact
+
Standard Precautions
Contact
+
Airborne Precautions
(unless other
+
Airborne Precautions
(For 14 days from last
transmissible infections)
Airborne Precautions
exposure)
+ medical mask
Red Stream
Orange A Stream
Orange B Stream
Green Stream
Patient
AED Senior to assess and
presents to
Red Stream or
Admit to PRO Room 3
evaluate initial goals of care
Rapid Test
Initiate trial of NIV in AED
Discuss with Resp/Gen
Is this patient for ward
Discus with
Is the patient for ICU
AED with
Med SMO or other
NO
orange stream
(EVD 1)
with patient/whanau (if
for COVID
if appropriate
level care?
DCCM
level care?
Acute SOB
able)
speciality team
If PRO 3 ful , use
YES
AED Senior on floor
YES
Room 1
MUST be contacted
If Room 1 ful ,
Ensure Resp/Gen Med/
use Resus 1
Review COVID risk and
DCCM team are notified
stream to designated
NO
Is NIV to continue?
NO
(close resus 2)
ward
Red or orange Stream
Arrange safe transfer to
YES
ward
Arrange safe transfer
Green Stream
Type 2
Acute
Other cause:
Diagnosis
Respiratory
Exac CHF +/-
Pulmonary
Surgical/
Failure
Exac COPD
Oedema
Gynae
Al COVID risk streams
Red or
Red or
Red or
Red or
Green
orange
orange
Green
orange
Green
orange
Green
Stream
stream
stream
Stream
stream
Stream
stream
Stream
72
Bed request
Bed request
72
Bed request
Bed request
CCU
Routine
Destination
SR1a
SR1a
(Bipap)
SR1a
SR1a
Ward
DCCM
CVICU
7a
7a
7a
7a
or
74 (ORL-Trache)
If 7a is full →
consider
If 7a ful → 68
Cardiology
d/w
patients that
outlier in7a
78 (Gen Surg)
admitting
could be moved
team
to 68
PCI - CIU
83 (Neuro Surg)
Discuss with CVICU SMO
regarding placement post
Care Team
procedure in CVICU or 7A
Respiratory
Respiratory
Cardiology
Appropriate Speciality Service
(if CPAP required)
Gen Med if ceiling of treatment
Gen Med
indicates appropriate
Version: 10 September 2021
Document owner: Mark Freidericksen, SCD AED/CED
Approver: Ian Dittmer, SLT IMT
