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| *All hospital dependant, please check with your hospital administration for existing protocols
| | #REDIRECT[[COVID-19]] |
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| ==Prehospital Care==
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| *ET-3 model
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| *Treat Onsite
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| ==Evaluation Pathway<ref>https://asprtracie.hhs.gov/technical-resources/119/covid-19-hospital-triage-screening-resources/99</ref>==
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| *Divide the ED into different sections based on risk of having/transmitting COVID-19
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| **Red/Dirty/Hot zone
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| **Yellow/Intermediate/cool zone (optional)
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| **Green/Clean/Cold zone
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| *Set PPE levels for each section [[Prevention of COVID-19 transmission in the healthcare setting|IPC for COVID]]
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| *Control movement between sections by limiting ingress/egress routes.
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| *Consider having all patients wear surgical masks and perform hand hygiene despite symptoms.
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| ===Screening===
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| *Preferably outside of the ER
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| *Goal is to prevent them from being cohorted with non-COVID patients
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| *Funnel into each of your zones
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| *Screening Criteria - Any of the following positive, route to "red/dirty/hot/infected" side of the ED
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| **Symptoms - fever, respiratory symptoms, Chest pain, GI symptoms, malaise, fatigue
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| **Signs
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| ***toxic appearance, AMS
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| ***If performing vitals at screening - fever, hypoxia, tachypnea
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| *All those without the above go to Yellow/Green
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| ===Triage/Risk Stratification===
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| *Mild illness
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| **Well appearing
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| **No hypoxia (SPO2 ≥94%)
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| **No tachypnea (RR≥22)
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| **No concerning GI or Other symptoms
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| *Moderate/Severe illness
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| **Hypoxia
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| **Tachypnea
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| **Ill-appearing + [[Template:COVID Risk Factors|COVID Risk Factors]]
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| **Other reasons needing admission
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| ===Evaluation for Disposition===
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| *Mild illness
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| **Discharge as appropriate
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| **Consider Exertional O2Sat
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| ***1 minute walking in place briskly.
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| ***Failure = 02Sat<90 OR inability to complete test
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| *Moderate illness
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| **02 via NC Sat>90%
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| **Attempt bronchodilator use
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| **Antipyretics
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| **CXR
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| **Evaluate for non-COVID causes of illness as indicated
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| ***Re-evaluate for discharge if improved
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| *Severe illness - Admission
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| ==Protocols==
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| Consider creating standardized protocols for the following:
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| *Labs/Imaging
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| *Intubation
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| *CPR
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| *Asthma
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| *CV procedures
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| *Disposition
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| ==Surge Capacity==
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| *Hospital Dependent
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| ==SARS-CoV2 Testing Strategies==
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| [[Testing+Surveillance: COVID]]
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| ==Telehealth==
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| * For information on telehealth, see [[Alternative Care Sites: COVID-19]]
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| ==Resource Allocation==
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| *Ventilators
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| ==Personnel==
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| *Return to work
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| ==Resources==
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| ===Examples===
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| *Topic Collection: COVID-19 Hospital Triage/Screening Resources <ref>https://asprtracie.hhs.gov/technical-resources/119/covid-19-hospital-triage-screening-resources/99</ref>
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| *Brigham & Women's Hospital Protocols- <ref>COVID-19 Protocols. Brigham and Women’s Hospital COVID-19 Clinical Guidelines. https://covidprotocols.org/protocols/02-ed-inpatient-floor-management-triage-transfers. Published 2020. Accessed April 8, 2020.</ref>
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| *Massachusets General Hospital - <ref>Massachusetts General Hospital COVID-19 Treatment Guide Version 1.36 04/05/2020. https://www.massgeneral.org/assets/MGH/pdf/news/coronavirus/mass-general-COVID-19-treatment-guidance.pdf. Published 2020. Accessed April 8, 2020.</ref>
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| *Mount Sinai -
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| [[File:MSH covid Management|thumb]]
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| *Department of Defense Practice Managment - <ref>https://www.health.mil/Reference-Center/Technical-Documents/2020/03/24/DoD-COVID-19-Practice-Management-Guide</ref>
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| [[Category:COVID-19]]
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