COVID-19: Hospital preparedness: Difference between revisions

Revision as of 23:28, 8 April 2020

All hospital dependant, please check with your hospital administration for existing protocols

Divide the ED into different sections based on risk of having/transmitting COVID-19
- Red/Dirty/Hot zone
- Yellow/Intermediate/cool zone (optional)
- Green/Clean/Cold zone
Set PPE levels for each section IPC for COVID
Control movement between sections by limiting ingress/egress routes.
Consider having all patients wear surgical masks and perform hand hygiene despite symptoms.

Preferably outside of the ER
Goal is to prevent them from being cohorted with non-COVID patients
Funnel into each of your zones
Screening Criteria - Any of the following positive, route to "red/dirty/hot/infected" side of the ED
- Symptoms - fever, respiratory symptoms, Chest pain, GI symptoms, malaise, fatigue
- Signs
  - toxic appearance, AMS
  - If performing vitals at screening - fever, hypoxia, tachypnea
All those without the above go to Yellow/Green

Mild illness
- Well appearing
- No hypoxia (SPO2 ≥94%)
- No tachypnea (RR≥22)
- No concerning GI or Other symptoms
Moderate/Severe illness
- Hypoxia
- Tachypnea
- Ill-appearing + COVID Risk Factors
- Other reasons needing admission

Mild illness
- Discharge as appropriate
- Consider Exertional O2Sat
  - 1 minute walking in place briskly.
  - Failure = 02Sat<90 OR inability to complete test
Moderate illness
- 02 via NC Sat>90%
- Attempt bronchodilator use
- Antipyretics
- CXR
- Evaluate for non-COVID causes of illness as indicated
  - Re-evaluate for discharge if improved
Severe illness - Admission

Consider creating standardized protocols for the following:

Authors:

@@ Line 51: / Line 51: @@
 ==Protocols==
+Consider creating standardized protocols for the following:
 *Labs/Imaging
 *Intubation