Authored by the National Commission for Prevention and Control of Infections and Antimicrobial Resistance of the Luz Saúde group Monitor and record symptoms If you are infected with the SARS-CoV-2 virus, you should monitor the development or worsening of your symptoms: At least twice a day; Always record the monitoring results; You can use the symptoms self-monitoring sheets from the Direção Geral da Saúde or the cards available at MY LUZ . What are the symptoms to evaluate and how to do it? You should be aware of your general condition , state of consciousness (awake or sleepy), color of your lips (pink or purplish), skin (red or pale and sweaty) and breathing (normal or accelerated), which are easy to assess. But these should ideally be complemented with the following measurements: Temperature ; Blood pressure ; Oxygenation or oxygen in the blood; Number of heart beats per minute (heart rate); Number of breaths per minute (respiratory rate). For heart rate and respiratory rate you only need a clock with a seconds dial, or a cell phone stopwatch. Heart rate can be measured by feeling your heart beats in the pulse. You can count the beats for one minute. If you prefer, count for only for 15 seconds and multiply the obtained value by 4. Respiratory rate can be measured by observing the movements of the chest. As before, you can count the movements for one minute or, if you prefer, count for only 15 seconds and multiply the value by 4. Measuring temperature, blood pressure and assessing blood oxygenation require specific equipment, which is a kind of “survival kit” for these COVID-19 pandemic times. Survival kit for monitoring symptoms Thermometer There are several types of thermometers. Having a thermometer, whatever it is, is necessary to measure the temperature; Fever is considered when the temperature reaches or exceeds 38 o C. However, temperatures above 37.8 o C are already suspect and deserve attention. Blood pressure meter The blood pressure meter measures systolic (or maximum) blood pressure and diastolic (or minimum) blood pressure; Maximum blood pressure is usually higher or equal to 100 mmHg; Some people, especially women, have lower blood pressure values, which is normal as long as they have no other symptoms; Blood pressure meters also provide information on heart rate; Learn how to measure blood pressure correctly ; Blood pressure meters are mainly sold in pharmacies and some large stores. Oximeter An oximeter is a small device that is placed on the finger and allows to check the blood oxygenation status. It also gives information about the heart rate; Under normal conditions, and when there are not previous respiratory disorders, the value of oxygen saturation in the blood is over 96%; Oximeters are sold mainly in pharmacies and some large stores. Warning signs These are warning signs to watch out for: Changes in skin or lips color , pale, cold and sweaty skin; Excessive drowsiness , being aroused when called upon or with painful stimuli (for example pinching the skin), or no response; Breaths above 14 per minute , at rest and not having fever; Heart rate above 100 beats per minut e, at rest and not having a fever; Maximum blood pressure (systolic) below 100 mmHg , when it is not the person normal value. What to do If you start to feel worse, ask for help to assess any warning signs and follow the steps explained below. And stay calm. To assess the severity of the warning signs and determine what to do, you can: Score from 0 to 3, according to the indications below, respiratory rate, heart rate, maximum blood pressure, temperature and state of consciousness; Add the individual values and obtain a total score; If you obtained a total score greater than 3 and less than 5, you should consult a doctor , call Luz 24 ( 217 104 424 ) or call the Linha de Saúde 24 ( 808 242 424 ); If you obtained a total score equal to or greater than 5 you must call 112 . 0 points Respiratory rate – 9 to 14 movements / minute Heart rate – 51 to 100 beats / minute Maximum blood pressure – > 100 mmHg Temperature – 36 o C to 38 o C State of conscience – Awake 1 point Respiratory rate – 15 to 20 movements / minute Heart rate – 101 to 110 beats / minute Maximum blood pressure – 81 to 100 mmHg Temperature – 38.1 o C to 38.5 o C State of conscience – Awakened to the call 2 points Respiratory rate – 21 to 29 movements / minute Heart rate – 111 to 129 beats / minute Maximum blood pressure – 71 to 80 mmHg Temperature – > 38.6 o C State of consciousness – Awakened only with pain 3 points Respiratory rate – 21 to 29 movements / minute Heart rate – 111 to 129 beats / minute Maximum blood pressure – 71 to 80 mmHg Temperature – > 38.6 o C State of consciousness – Not awakened If you have an oximeter and oxygenation decreases to less than 96% (when this is not your usual value), especially if you have difficulty breathing, you should also ask for medical help. If the value is less than or equal to 92%, you must call 112. Reference Subbe CP, Kruger M, Rutherford P, Gemmel L. Validation of a modified early warning score in medical admissions. QJM 2001;94:521–6. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
