and silver, to assist with the rollout of this protocol.
The SID Protocol. Dr Jackie Stone and Dr Martin Gill
SID stands for Silver, Ivermectin and Doxycycline
An “A-B-C-D-E-F” approach to treating Covid-19-positive patients with the SID protocol:
Initial assessment to determine if admission to the unit is needed (A,B,C,D,E)
A = ASSESSMENT (A-B-C-D-E)
A: Ambulant - If on a stretcher or too exhausted to walk they should be admitted to the unit, and not discharged until improving.
B: Breathing - If tachypnoeic with a respiratory rate over 22 per minute or worsening / slow respiratory rate due to exhaustion, (often associated with hypoxia with an O2 saturation below 70% )( watch the exhausted patient carefully).
C: Consciousness/confusion - Confusion or decreased or loss of consciousness is a bad prognostic factor. Keep in for observation under ICU level nursing care if possible, rather than home nursing.
D: Duration - If the patient has been symptomatic for longer than 10 days and is displaying the above-mentioned symptoms and/or has an elevated pulse rate, then the prognosis may be poor. This patient must remain in the unit for aggressive care including continuous nebulisation IV steroids and antibiotics, and subcutaneous enoxaparin if available.
E: Elevated pulse rate
Patients fulfilling any of the above criteria were flagged, as they were generally distressed, confused and often significantly hypoxic (Sp02<80%) and needed immediate and continuous care.
They were immediately put on continuous nebulisation using oxygen, cannulated, anticoagulated and bloods were taken for prognostic as well as treatment
reasons.
The following protocol was then followed:
Start patient on Ivermectin 0.6 mg/kg stat dose. Be prepared to titrate to effect up to 1-2mg/kg if saturations do not come up. Maintain on 0.3- 0.6mg per kg for up to 10 days. Rather err of the side of giving too much, than too little given the safety margins and therapeutic index of this drug. Warn the patient there is a 20% chance of visual side effects. Continue until symptom free for 48 hours.
Continuous nano particulate silver nebulisations - continue until saturations are above 90% then reduce to at least 3 times a day.
Doxycycline 200mg stat then 100 mg bd for a minimum of 5 days. 10 days of treatment was given in Delta. If patient unable to tolerate oral meds, IV Ceftriaxone 1-2g was given daily.
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