Table 1:

Suggested contents of a symptom management kit and recommended starting doses for patients with severe coronavirus disease 2019*

SymptomTreatmentRecommended starting orderQuantity for kit
Pain or dyspneaHydromorphone 2 mg/mL0.5–1.0 mg subct q30min p.r.n.10 vials
Nausea or deliriumHaloperidol 5 mg/mL1 mg subcut q2h p.r.n.10 vials
SedationMidazolam 5 mg/mL1–2 mg subcut q15min p.r.n.§10 vials
SecretionsScopolamine 0.4 mg/mL0.4 mg subcut q4h p.r.n.10 vials
FeverAcetaminophen 650 mg suppositoriesAdminister q6h PR p.r.n.10 vials
Urinary retentionFoley catheter 16 FrenchInsert catheter p.r.n.1 kit
Dry mouthMouth swabsMouth 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.