My few pennies worth having done nearly three weeks of nights shifts, the majority running resus at @WhippsCrossHosp in @WhippsCrossED and seeing some of the sickest COVID-19 patient's. Thread tweets ordered by importance.

1) Patients are frightened. They don't tell you but you will see it in their face. They know their diagnosis. They have read the news. They have seen the number of people dying.

Telling them we WILL look after them is the best first line treatment for their respiratory rate.

2a) There is no family at the bedside. There is no family in the relatives room. There is no family in the ambulance. They are sitting at home, waiting, not knowing. Calling switchboard means they face a barrage of automated messages about COVID19 and often cannot get through.

2b) Call the family when it's safe to do so. Do not underestimate how important a very quick call is just to say they are being looked after. I've spoken to so many grateful families, no matter the hour of the night. Communication is important.

2c) If unwell ask the family what is important. It might be that the ambulance forgot their slippers & they get cold feet. The knowledge that someone had gone to the effort of popping some socks on them before they died offers some light in the darkness.

3) As resources become short, so do people's patience: frustration that they cannot give their best care in difficult circumstances. A few nights have been testing with multiple bluecalls in short periods of time. Take a breath. Remember to be kind -To patients, staff & yourself.

4) Names are important in a sea of blue gowns and facemasks. A sticky label with your name on means patients and staff recognise you & know who you are is good for comms and care. Don't be a mask with a voice, be Rob.