ARTP COVID19 Guidelines

10 March 2020 (Last updated: 15 Aug 2025 10:54)

Please see the updated guidelines published on 18th March here - https://www.artp.org.uk/News/artp-covid19-update-18th-march-2020

The COVID19 infection is likely to change from “containment” to “delay” phase and possible “crisis phase” in the coming weeks (timing currently uncertain). ARTP members are being asked and are asking for advice for their hospitals, patients and staff. ARTP have rapidly put together some guidance which is to help ARTP membership to consider solutions to some of the problems posed.

All NHS organisations are putting their own contingency plans together which no doubt most lung function labs will follow, however, we are outlining specific guidance based on expert opinion, prepared in haste. These recommendations and suggestions may change over time as the virus impact hits the UK.

The guidance covers the following key points;

Who should you test?
How should you test them?
What should departments do in the event of escalated COVID19?

Area	Issue	Delay Phase Advice	Crisis Phase Advice
Who to test?	Is the test routine or urgent?	Decrease numbers attending the department (e.g. postpone non-urgent tests, consider “virtual options” for CPAP review patients, remote monitoring of CPAP & NIV if possible) Urgent includes; cancer and preoperative patients for urgent surgery where lung function is essential.	Emergency only, cancellation of all non-urgent (e.g. Cancer, pre-operative, )
	Does the patient have COVID19 symptoms?	Contact patients before appointment by phone to confirm symptoms & contact with COVID19. Discourage attendance. Dismiss patients attending with COVID symptoms and advise to self-quarantine using 111 advice line.	Assume all patients and staff infected with COVID19. Urgent patients may already have COVID19 and will need testing for urgent clinical reasons.
Which tests?	Which tests should be offered?	Spirometry, gas transfer, lung volumes, blood gases, CPET, other urgent procedures in exceptional cases.	Blood gases (ABG, CBG), oximetry and urgent spirometry only, decided upon a case by case basis.
How to test?	What infection control measures should be taken?	Routine Lung Function infection control measures should suffice (bacterial filters, wiping down contact parts with alcohol wipes between patients, etc.)	Routine Lung Function infection control measures should suffice with PPE as directed by hospital infection control team.
	Extra infection control measures	All staff to wash hands appropriately whenever arriving or leaving the department and before and after any patient contact. Personal protective equipment to be deployed if recommended by your hospital infection control team.	All staff to wash hands appropriately whenever arriving or leaving the department and before and after any patient contact. Personal protective equipment to be deployed if recommended by your hospital infection control team.
How to deploy staff?	Senior Bands (6-8)	Can be used to deliver specialist services (NIV, oxygen, blood gases – supporting respiratory wards and HDU/ITU facilities)	Can be used to deliver specialist services (NIV, oxygen, blood gases – supporting respiratory wards and HDU/ITU facilities)
	Bands (2-5)	To deliver reduced routine service in accordance with local protocol.	Can be redeployed contacting patients at home to perform virtual CPAP reviews, post out required consumables to patients etc.
High risks	Reversibility testing	Use a sealed system e.g. spacer for delivery of inhaled medication. Avoid use on patients with unknown COVID19 status in out-patient public areas, if known COVID19 only use is patient isolated areas	Use a sealed system e.g. spacer for delivery of inhaled medication. Avoid use on patients with unknown COVID19 status in out-patient public areas, if known COVID19 only use is patient isolated areas
	Patients with multiple co-morbid conditions / other high risk factors (as per public health advice)	Cancel appointments on all with multiple co-morbid conditions	Cancel all patients except urgent

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