Clinical guidelines
COVID-19 assessment, treatment and management
- COVID-19 Clinical Screening Assessment Tool (PDF 176 kB)
A statewide COVID-19 Clinical Screening Assessment tool has been developed with the intent to enable Hospital and Health Services (HHSs) to appropriately assess the suitability for COVID-19 screening. - National Covid-19 Clinical Evidence Taskforce flowcharts and guidance
- Paediatric COVID-19 management guidelines
The following clinical guidelines have been developed by Children’s Health Queensland for the management of children with acute SARS-CoV-2 infection and/or Paediatric Multisystem Inflammatory Syndrome Temporally Associated with COVID-19 (PIMS-TS). - Guiding statement for impact of COVID-19 on rehabilitation services
The purpose of this document is to highlight potential impacts the COVID-19 pandemic may have on people accessing timely rehabilitation assessment and treatment during the pandemic, and accessing rehabilitation services post COVID-19 infection, including longer-term post- COVID-19 Condition (‘Long COVID’) management.
COVID-19 therapeutic management
This document has been developed by the Queensland Health COVID-19 Therapeutics Working Group (CTWG) to provide clinicians with guidance in the assessment and management of hospitalised patients with COVID-19. These are living guidelines and will be updated frequently as new evidence emerges. Please refer to the version control table at the end of the document for information concerning updates.
The oral antivirals (molnupiravir and nirmatrelvir + ritonavir) may be prescribed according to the List of Approved Medicine (LAM) criteria as per the Pharmaceutical Benefits Scheme (PBS) criteria.
From November 2022 the medication access request portal (MARP) will replace the request to access forms emailed to COVID Therapeutics Working Group (CTWG) for QH public hospital facilities only. The paper RTA forms for private hospital facilities will remain unchanged.
Please refer to the MARP user guide on how to access and navigate the portal.
MARP can only be accessed whilst logged into QLD Health network.
- COVID-19 Therapeutic Drugs Patient Consent Form – adult (PDF 193 kB)
This document is designed to assist clinicians to document formal written consent prior to treatment.
- COVID-19 Therapeutic Drugs Patient Consent Form – paediatrics / young person (PDF 200 kB)
This document is designed to assist clinicians to document formal written consent from a young person’s parent/caregiver prior to treatment.
COVID-19 medications
Molnupiravir
- Molnupiravir prescribing guideline (PDF 112 kB)
This guideline has been developed by the Queensland Health COVID-19 Therapeutics Working Group (CTWG) to provide clinicians with information and guidance around the use of molnupiravir in patients diagnosed with COVID-19. These are living guidelines and will be updated frequently as new evidence emerges. Please refer to the version control table at the end of the document for information concerning updates - Molnupiravir patient information (PDF 120 kB)
- Molnupiravir Informed consent: patient information (PDF 372 kB)
- Molnupiravir forms
- Molnupiravir forms are no longer required to be submitted to CTWG@health.qld.gov.au as per the molnupiravir prescribing guideline.
Nirmatrelvir plus ritonavir (Paxlovid®)
- Nirmatrelvir plus ritonavir prescribing guideline (PDF 1025 kB)
This guideline has been developed by the Queensland Health COVID-19 Therapeutics Working Group (CTWG) to provide clinicians with information and guidance around the use of nirmatrelvir plus ritonavir in patients diagnosed with COVID-19. These are living guidelines and will be updated frequently as new evidence emerges. Please refer to the version control table at the end of the document for information concerning updates - Nirmatrelvir plus ritonavir patient information (PDF 141 kB)
- Nirmatrelvir plus ritonavir Informed consent: patient information (PDF 485 kB)
- Nirmatrelvir plus ritonavir forms
- Nirmatrelvir plus ritonavir forms are no longer required to be submitted to CTWG@health.qld.gov.au as per the Nirmatrelvir plus ritonavir prescribing guideline.
Remdesivir
- Remdesivir prescribing guideline (PDF 336 kB)
This guideline has been developed by the Queensland Health COVID-19 Therapeutics Working Group (CTWG) to provide clinicians with information and guidance around the use of remdesivir in patients diagnosed with COVID-19. These are living guidelines and will be updated frequently as new evidence emerges. Please refer to the version control table at the end of the document for information concerning updates - Remdesivir patient information (PDF 127 kB)
- Remdesivir Informed consent: patient information (PDF 274 kB)
- Remdesivir forms
Access to remdesivir is regulated via the National Medical Stockpile (NMS). States are required to report usage, including eligibility criteria and outcomes to the NMS. This form has been developed to facilitate reporting and should be submitted for each patient via email to CTWG@health.qld.gov.au as soon as practicable after commencement.- Request to Access Remdesivir Form - Severe disease requiring oxygen (Adults) (PDF 623 kB) (this link is for Private facilities ONLY, QH facilities use the MARP)
- Request to Access Remdesivir Form – Mild-moderate disease (Adults) (PDF 648 kB) (this link is for Private facilities ONLY, QH facilities use the MARP)
- Request to Access Remdesivir Form – Paediatric Patients (PDF 585 kB) (this link is for Private facilities ONLY, QH facilities use the MARP)
Tixagevimab plus cilgavimab (Evusheld®)
Tixagevimab plus cilgavimab (Evusheld®) National Medical Stockpile stock is currently available through hospital pharmacies at no cost to eligible patients until 31st December 2022.
The QLD prescribing guidelines outline eligibility criteria, access, dosing and administration.
- Tixagevimab plus cilgavimab (Evusheld®) prescribing guideline (PDF 808 kB)
This guideline has been developed by the Queensland Health COVID-19 Therapeutics Working Group (CTWG) to provide clinicians with information and guidance around the use of tixagevimab plus cilgavimab. These are living guidelines and will be updated frequently as new evidence emerges. Please refer to the version control table at the end of the document for information concerning updates - Tixagevimab plus cilgavimab (Evusheld®) Informed consent: patient information (PDF 193 kB)
- Tixagevimab plus cilgavimab forms
Access to tixagevimab plus cilgavimab is regulated via the National Medical Stockpile (NMS). States are required to report usage, including eligibility criteria and outcomes to the NMS. The forms have been developed to facilitate reporting and should be submitted for each patient via email to CTWG@health.qld.gov.au as soon as practicable after administration.- Request to Access Tixagevimab plus cilgavimab Evusheld) Form – Adults (PDF 652 kB) (this link is for Private facilities ONLY, QH facilities use the MARP)
- Request to Access Tixagevimab plus cilgavimab Evusheld) Form – Paediatric patients (PDF 604 kB) (this link is for Private facilities ONLY, QH facilities use the MARP)
- 30 Day tixagevimab and cilgavimab (Evusheld®) Outcome Data (PDF 996 kB) (this link is for Private facilities ONLY, QH facilities use the MARP)
Use of casirivimab plus imdevimab (Ronapreve®) or sotrovimab (Xevudy®) should be guided by NCCET recommendations.
- Sotrovimab Request to Access form (Adults ) (this link is for Private facilities ONLY, QH facilities use the MARP)
- Sotrovimab Request to Access form - Paediatric (this link is for Private facilities ONLY, QH facilities use the MARP)
Note: Prescribing hydroxychloroquine
Under the Medicines and Poisons (Medicines) Regulation 2021, a prescription for hydroxychloroquine is not lawful unless written by an authorised prescriber.
Prescribers are authorised to prescribe hydroxychloroquine if:
- they are one of the following specialist practitioners: dermatologist, emergency medicine physician, haematologist, immunologist, infectious disease physician, intensive care physician, nephrologist, paediatrician, rheumatologist, specialist physician in general medicine, a dentist who is a specialist registrant in oral medicine; or
- they are a medical practitioner or nurse practitioner who is continuing treatment with hydroxychloroquine that was initiated by one of these specialist practitioners.
Medical practitioners and nurse practitioners who are continuing treatment with hydroxychloroquine must mark the prescription with the words ‘Continuing treatment’.
For information on TGA-approved medicines for COVID-19 please visit the TGA website. Further advice to guide their use in Queensland will be provided soon.
Maternity and neonatal
COVID-19 Guidance for maternity and neonatal services
This site refers to the Maternity and Neonatal Clinical Guidelines page and contains information specific to the care of mothers and babies during the COVID-19 pandemic including flowcharts for neonates of suspected or confirmed COVID-19 mothers, operational frameworks for COVID-19 maternity and neonatal services as well as videos and consumer information.
Paediatric care and advice
Preliminary evidence suggests children have a lower susceptibility to SARS-CoV-2 than adults, play a lesser role in transmission, and have a much lower risk of severe infection.
Children, adolescents, and young adults with underlying medical conditions are an exception, with some studies showing that these patients have an increased likelihood of developing severe disease and complications when infected with SARS-CoV-2. However, these studies do not reflect the epidemiology related to the more recently emerged variants such as the Delta variant and the Omicron variant of concern.
View the COVID-19 in children and adolescents: vaccines, transmission at school and disease outcomes webinar from the Centre for Immunisation Research and Surveillance which provides a summary of COVID-19 in children as well as the benefits of vaccination.
The following resources are designed to support health services and healthcare providers in managing COVID-19 in children:
- COVID-19 Community Child Health Services Guidance for service provision (PDF 211 kB)
This document has been developed to support service adaptation by community child and youth health services in Queensland Hospital and Health Services (HHSs) during the COVID-19 Pandemic. - Paediatric emergency care during the COVID-19 pandemic
This Children’s Health Queensland site contains information specific to the emergency care of children during the COVID-19 outbreak including chest imaging guidelines, consensus statements on intubation and respiratory therapies and a paediatric airway checklist. - Protecting yourself and the community: mask-wearing video for adolescents
This video helps Queensland adolescents to understand why wearing a face mask is important. It provides tips for what kind of mask to wear and how to wear it properly. The video is designed for both health professionals and educators who work with high schoolers aged 12 years and above. For more information on COVID-19 and children, visit COVID-19 and your child’s health website.
COVID-19 services guidance and guidelines
- COVID-19 Cancer Guidelines (PDF 432 kB)
This document provides a guideline for treatment prioritisation when managing cancer patients during the COVID-19 pandemic. - COVID-19 Guidelines for Diabetes Services (PDF 442 kB)
This document provides general guidance for consideration by diabetes endocrine services to complement HHS planning and response activities. - Considerations for the delivery of palliative care during the COVID-19 pandemic (PDF 809 kB)
This guideline is for Queensland Health staff working across various settings to support and optimise the inclusion of planning for the delivery of palliative care services. - COVID-19 Persistent Pain Management Response Guidelines (PDF 313 kB)
This guideline is to provide Queensland Health Persistent Pain clinics with advice about key issues to consider when planning and preparing for the provision of services during the COVID-19 pandemic. - COVID-19 Preparedness for Renal Units (PDF 333 kB)
This guideline is to provide Queensland Health Renal Units with advice about key issues to consider when planning and preparing for the provision of services as we move into the next phase of living with COVID-19. - COVID-19 Response Plan Guideline – Sexual Health Services (PDF 234 kB)
The purpose of this document is to provide Queensland Health Sexual Health Services with a guideline to refer to regarding their response to COVID-19, and a generic COVID-19 response plan that may be tailored for their individual service’s use. - COVID-19 Guidance for Stroke Services Position Statement (PDF 347 kB)
This document is to highlight potential impacts the COVID-19 pandemic may have on access to timely assessment and treatment for both ischaemic and haemorrhagic stroke. - COVID-19 Trauma Services Escalation Plan (PDF 323 kB)
This document aims to provide guidance to Queensland Hospital and Health Services regarding the management of major trauma patients during the COVID-19 pandemic by outlining referral pathways, escalation trigger points and a communication strategy to assist with continuation of trauma services in the case of a community COVID-19 outbreak. - Guideline Statement for Management of Post-acute COVID-19 in General Medicine Services (PDF 464 kB)
The purpose of this document is to highlight the potential ongoing medical sequelae experienced by adult COVID-19 positive patients beyond the acute phase of the illness, and to summarise emerging evidence to guide management within general medicine services.
Intensive Care
- Clinical Guidelines - ICU inpatient clearance of COVID-19 infection
The Statewide Intensive Care Clinical Network in coordination with the Statewide Infectious Clinical Network have developed clinical guidelines to assist determining when an Intensive Care Unit (ICU) inpatient may be considered cleared of COVID-19 and can be moved from a designated COVID area to a non-COVID area to continue treatment. The clinical guidelines assist in a consistent approach across Queensland ICUs in determining COVID clearance, and the collection of uniform reporting for statewide and national reporting. - Queensland Adaptive Model for the Intensive Care Workforce during COVID-19 (PDF 865 kB)
This document aims to support HHSs to adapt workforce models in ICUs in response to the COVID-19 pandemic. - Queensland Intensive Care Support and Telehealth Program support guide (PDF 256 kB)
The Queensland Intensive Care Support and Telehealth Program (QICSTeP) was developed as a contingency to mitigate the potential impact of COVID-19 on statewide critical care provision. QICSTeP supports Queensland clinicians in accessing advice from intensive care specialists when managing either critically unwell adult patients or patients deteriorating and at risk of becoming critically unwell. QICSTeP is a phased service consisting of three phases, enabling the service to be escalated and de-escalated in response to the evolving Covid-19 pandemic.
Respiratory
- Interim COVID-19 Guidance for Respiratory Services (PDF 215 kB)
This document is to inform health care workers of the need to plan for the impact of COVID-19 epidemic on delivery of normal respiratory health services. - Aerosol generated respiratory therapies - High flow nasal prong oxygen (HFNP02) (PDF 194 kB)
This document provides guidance and support to clinicians in the use of high flow nasal prong oxygen (HFNP02). - Aerosol generated respiratory therapies - Nebulisers (PDF 243 kB)
This document provides guidance and support clinicians considering using nebulisers during the COVID-19 pandemic. - Aerosol generated respiratory therapies - Non-invasive ventilation (NIV) (PDF 175 kB)
This document provides guidance and support to clinicians that are required to perform non-invasive ventilation (NIV). - Aerosol generated respiratory therapies - Respiratory Physiotherapy (PDF 159 kB)
This document provides guidance and support to respiratory physiotherapists to deliver care during the COVID-19 pandemic.
