COVID-19: information for the respiratory community
Information, guidance and resources to support the respiratory community during the COVID-19 pandemic. This page is updated as new information becomes available - please check back regularly. Please see further information on identifying patients for shielding here.
Last update 23/3/2021
NICE guideline for the management of COVID-19 for children, young people and adults in all care settings.
March 2021
READ MOREBTS and the Intensive Care Society have produced updated guidance on the use of CPAP, HFNO and NIV for patients with acute hypoxaemic respiratory failure associated with COVID-19
In view of the clinical experience during the current wave of the pandemic, and in alignment with the NICE guidance (Clinical guide for the optimal use of oxygen therapy during the coronavirus pandemic) the joint BTS/ICS guidance has been updated. This advises that oxygen prescribing targets on RSUs should be adjusted to 92-96%. The trigger for transfer remains at 94%.
This information includes an updated respiratory support pathway. Patients with COVID-19 may be looked after on general wards, Respiratory Support Units (RSUs) or critical care units and this document offers guidance for which patients could be looked after in non-critical care settings and what criteria should be used for escalation to areas with higher acuity treatments.
19 January 2021
Advice on acute sector workforce models during COVID-19, which includes information on RSUs was published by NHSE in December 2020.
The GIRFT Clinical practice guide for improving the management of adult COVID-19 patients in secondary care was published in December 2020.
7/1/2021
BTS has produced information for respiratory health care professionals in relation to the current COVID-19 vaccination programme and covers issues that may arise in discussion with patients.
19 February 2021
BTS has endorsed the latest GIRFT publication:
"Clinical practice guide for improving the management of adult COVID-19 patients in secondary care".
14/12/2020
Commissioning guidance to assist local healthcare systems to establish post-COVID assessment clinics for patients experiencing long-term health effects following COVID-19 infection.
NICE COVID-19 rapid guideline: managing the long-term effects of COVID-19
26 April 2021
READ MOREBTS has produced brief guidance for Community Respiratory Services in relation to COVID-19 which is available here.
Last update 30/3/21
During the COVID-19 pandemic it is important to reduce the variation in individual ward/service/organisational practices and try as much as possible to adopt a shared, safe standard for staff looking after ward patients.
SPACES (Sharing Patient Assessments Cuts Exposure for Staff) is a standarised approach to the management of ward care. It is based on the principles of "Maximum patient contact - minimum staff exposure".
SPACES can help keep staff safe and reduce PPE use. It is for everyone working on a ward with suspected or proven COVID-19 cases, and particularly for multi-professional teams.
Please ensure that you read the information on the SPACES approach here.
Download a poster that you can display in your COVID ward here.
Last update 6/4/2020
Checked 21/04/2021 - no changes made
Updated BTS/ICS Guidance on respiratory care in patients with acute hypoxaemic respiratory failure associated with COVID-19 is available here.
14/12/20
Guidance from the British Society for Thoracic Imaging is available here. This includes:
Considerations for CTPA in COVID-19
National COVID-19 chest imaging database
11 January 2021
BTS has produced the following guidance for follow up of patients with a clinico-radiological diagnosis of COVID-19 pneumonia.
Last updated 6/5/20
Checked 16/4/21 - no changes made
BTS/ICS Guidance on the Respiratory support of patients on medical wards is available here.
NHSE alert in relation to oxygen flow and demand safety issues
Clinical guide for the optimal use of Oxygen therapy during the coronavirus pandemic
Clinical guide for the management of surge during the coronavirus pandemic: rapid learning
ARTP guidance for oxygen utilisation
Last updated 4/1/2021
BTS has produced advice for healthcare professionals treating patients with COPD which is available here.
NICE Rapid Guideline: community based care of patients with COPD
Last update 14/4/2020
Updated BTS Guidance on Venous Thromboembolic Disease in patients with COVID-19 is available here.
Last updated 8/2/2021
RCPCH/BPRS/NHSE have issued new advice on shielding for children and young people here.
The following guidance is also available for those working in paediatric respiratory medicine:
BPRS Guidance for management of children with tracheostomies and those on long-term ventilation during the endemic phase of the coronavirus (COVID-19) pandemic
RCPCH/BPRS/BPAIIG Guidance for the clinical management of children admitted to hospital with suspected COVID-19
Guidance for paediatric intensive care
Royal College of Paediatrics and Child Health COVID-19 guidance
Last updated: 13/11/2020
BTS has produced advice for healthcare professionals treating patients with asthma which is available here. Please note that this information refers to the NICE Severe Asthma COVID-19 guideline.
Last update 26/11/2020
BTS guidance on the community management of patients receiving Long-Term Ventilation (LTV) during COVID-19 is available here
Updated 25 June 2020
Advice from PHE and HPS is that nebulisation is not a VIRAL droplet generating procedure. The droplets are from the machine (liquid bronchodilator drug particles), not the patient. Nebulisation is not therefore considered a 'viral' aerosol generating procedure.
Last update 23/3/20
BTS has produced information in relation to the supply of inhalers which is available here.
Last update 15/1/2021
Updated recommendations for day case bronchoscopy services during the COVID-19 pandemic have been produced to cover services during the restoration and recovery COVID-19 endemic phase - now available here.
Last update 13/5/2020
Updated lung cancer and mesothelioma service guidance during the COVID-19 pandemic: the restoration and recovery COVID-19 endemic phase - available here.
Differentiation of the Cs in lung cancer: Cancer vs. COVID
Guidance from the Lung Cancer CEG on the distinction between lung cancer and COVID-19
Last update 30/11/20
The NICE guideline on Interstitial Lung Disease has been published and is available here.
BTS guidance for managing patients with ILD is available here. This information will be updated regularly.
Shielding people with ILD
BTS has been working with RCP London, Action for Pulmonary Fibrosis, the BLF/AUK Partnership and SarcoidosisUK to ensure that all patients with ILD are given the appropriate advice on shielding in line with recent government information. Please find further information regarding this here.
Last update 15/4/20
Information produced by BTS as part of the OSA Alliance is available here.
Last update 16/12/2020
Latest guidance - 17 September 2020
Guidance on adapted delivery of pulmonary rehabilitation to patients surviving COVID-19
Checklist for COVID-19 recovery programme, for use during exercise, is available here
Guidance for pulmonary rehabilitation - reopening services
Checklist of safety precautions for remotely supervised interventions available here.
It is advised to stop classes to reduce the risk to patients, and to enable staff redeployment to acute community settings. Consider alternative methods of rehab such as online and web‐based resources.
This resource pack is intended to be used as a resource for professionals conducting remote assessments during the COVID-19 pandemic.
The following resource pack has been put together to support pulmonary rehabilitation whilst face to face PR is not possible.
Last update 12/1/21
NICE COVID-19 rapid guideline: managing suspected or confirmed pneumonia in adults in the community
NICE COVID-19 rapid guideline: antibiotics for pneumonia in adults in hospital
Updated 1/5/20
Critical Care Preparation and Management in the COVID-19 Pandemic is now available.
Information for those working in intensive care medicine is available here.
Airway management guidance is available here.
ICS Guidance for Prone Positioning of the conscious COVID patient 2020
BAPEN/BTS/ICS guidance on Route of Nutrition Support in Patients Requiring NIV & CPAP During the COVID-19 Response
Enhanced care: guidance on service development in the hospital setting
Last update 21/5/20
BTS guidance on provision of pleural services during the COVID-19 pandemic is available here.
Please see the ARTP guidelines for COVID-19.
ARTP guidance on COVID-19 infection control issues for lung function.
Last update 26/5/20
NHSE clinical guide for the management of respiratory patients is available here.
The latest NHS guidance for secondary care is available here
This includes the following specialty guide:
Clinical management of persons admitted to hospital with suspected COVID-19 infection
Last update 10/6/20
The following sites provide information specific to Primary Care during the COVID-19 pandemic.
The Primary Care Respiratory Society COVID-19 advice
PCRS Pragmatic guidance for management of asthma and COPD
The PCRS has a forum for asking related queries here.
NHS England COVID-19 Primary Care advice is available here.
Further information is available from the Royal College of General Practitioners.
Last update 30/3/20
Specialty clinical guidance on palliative care is available here.
Last update January 2021
Guidance from Faculty of Occupational Medicine regarding healthcare workers with underlying health issues available here.
The FOM has now published a risk reduction framework for NHS staff at risk of COVID-19 infection.
Last update 1/6/20
In these extraordinary times we are hearing of many examples of colleagues providing meaningful support to their teams and other colleagues, and systems being put in place for mentoring and leadership beyond usual boundaries. We also know that social media is proving to be a fertile source of support and sharing of experience. But it is still a concern to many that they are not able to pay attention to their own needs and that resilience sometimes slips.
There are several excellent sources of support on-line, and we do not wish to replicate or duplicate. Let us know what you might find helpful, but in the meantime, we have two links below to sites that contain a wealth of wellbeing resources
A resource pack produced by the Intensive Care Society for supporting wellbeing is available here.
The British Medical Association advice for supporting wellbeing during the COVID-19 pandemic is available here.
The NHS wellbeing support website and helpline: 0300 131 7000.
Education for Health Wellbeing Support helpline
Last update 15/4/20
With thanks to: Dr Morag Farquhar (University of East Anglia (UEA), Dr Gail Ewing and Professor Gunn Grande (University of Manchester).
Last update 24/3/20
Patients concerned about the risk of infection should be advised to take precautions as outlined by Public Health England.
We have listed information for people with respiratory disease here.
The Clinical guide for acute kidney injury in hospitalised patients with COVID-19 outside the intensive care unit during the coronavirus pandemic has now been published.
BTS advises respiratory colleagues that:
the message to 'run Covid-19 patients dry' seems to be associated with higher levels of Acute Kidney Injury and that approach is cautioned. The aim is for euvolaemia.
The NICE COVID-19 rapid guideline on acute kidney injury in hospital is available here.
Last updated 7/5/2020