Suggested contents of a symptom management kit and recommended starting doses for patients with severe coronavirus disease 2019*
| Symptom | Treatment | Recommended starting order | Quantity for kit |
|---|---|---|---|
| Pain or dyspnea | Hydromorphone 2 mg/mL | 0.5–1.0 mg subct q30min p.r.n.† | 10 vials |
| Nausea or delirium | Haloperidol 5 mg/mL | 1 mg subcut q2h p.r.n.‡ | 10 vials |
| Sedation | Midazolam 5 mg/mL | 1–2 mg subcut q15min p.r.n.§ | 10 vials |
| Secretions | Scopolamine 0.4 mg/mL | 0.4 mg subcut q4h p.r.n. | 10 vials |
| Fever | Acetaminophen 650 mg suppositories | Administer q6h PR p.r.n. | 10 vials |
| Urinary retention | Foley catheter 16 French | Insert catheter p.r.n. | 1 kit |
| Dry mouth | Mouth swabs | Mouth care q.i.d. and p.r.n. | 10 swabs |
Note: PR = per rectum, p.r.n. = as needed, q4h = every 4 hours, q6h = every 6 hours, q15min = every 15 minutes, q30min = every 30 minutes, q.i.d. = 4 times per day, subct = subcutaneous.
↵* Adapted with permission from the Champlain Palliative Symptom Management Medication Order Form – Long-term Care.
↵† May start at 0.25 mg in a patient who is opioid naive, frail or older.
↵‡ Relative contraindication in Parkinson disease.
↵§ Higher doses can be used for refractory dyspnea.