Screening Protocol

Clinical judgement is essential. The stability of any co-morbid illness and a patient’s social circumstances should be considered.

Clinical judgement supported by the CRB65 score should be applied when deciding whether to treat at home or refer to hospital.

Are at low risk of death and do not normally require hospitalisation for clinical reasons.

Are at increased risk of death, particularly with a score of 2, and hospital referral and assessment should be considered.

Are at high risk of death and require urgent hospital admission.

The patient’s social circumstances and wishes must be taken into account in all instances.

The CURB65 score should be interpreted in conjunction with clinical judgement.

Are at high risk of death. These patients should be reviewed by a senior physician at the earliest opportunity to refine disease severity assessment and should usually be managed as having high severity pneumonia.

Should be assessed with specific consideration to the need for transfer to a critical care unit (high dependency unit or intensive care unit).

Are at moderate risk of death. They should be considered for short-stay inpatient treatment or hospital supervised outpatient treatment.

Are at low risk of death. These patients may be suitable for treatment at home.

Regular assessment of disease severity is recommended. The ‘post take’ round by a senior doctor and the medical team provides one early opportunity for this review.

Should be reviewed medically at least 12 hourly until shown to be improving.