COVID-19: Hospital preparedness: Difference between revisions
| Line 6: | Line 6: | ||
*Treat Onsite | *Treat Onsite | ||
== | ==Evaluation Pathway== | ||
*Divide the ED into different sections based on risk of having/transmitting COVID-19 | *Divide the ED into different sections based on risk of having/transmitting COVID-19 | ||
**Red/Dirty/Hot zone | **Red/Dirty/Hot zone | ||
| Line 29: | Line 29: | ||
**No hypoxia (SPO2 ≥94%) | **No hypoxia (SPO2 ≥94%) | ||
**No tachypnea (RR≥22) | **No tachypnea (RR≥22) | ||
**No concerning GI or Other symptoms | |||
*Moderate/Severe illness | *Moderate/Severe illness | ||
**Hypoxia | **Hypoxia | ||
**Tachypnea | **Tachypnea | ||
**Ill-appearing + [[Template:COVID Risk Factors]] | **Ill-appearing + [[Template:COVID Risk Factors|COVID Risk Factors]] | ||
**Other reasons needing admission | **Other reasons needing admission | ||
===Evaluation for Disposition=== | |||
*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 | |||
==Protocols== | ==Protocols== | ||
Revision as of 22:57, 8 April 2020
- All hospital dependant, please check with your hospital administration for existing protocols
Prehospital Care
- ET-3 model
- Treat Onsite
Evaluation Pathway
- 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.
Screening
- 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
Triage/Risk Stratification
- 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
Evaluation for Disposition
- 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
Protocols
- Labs/Imaging
- Intubation
- CPR
- Asthma
- CV procedures
- Disposition
Surge Capacity
- Hospital Dependent
SARS-CoV2 Testing Strategies
Telehealth
- For information on telehealth, see Alternative Care Sites: COVID-19
Resource Allocation
- Ventilators
Personnel
- Return to work