covid-19 evaluate and release - acidremap.com
TRANSCRIPT
NO
COVID-19 Evaluate and Release
Special Consideration 6
This policy has been altered from the original NCCEP Policy by the local EMS Medical Director1/2022
Revised
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History:
Flu-like symptoms
Known COVID-19 Exposure
Travel to high risk international or domestic region
Signs and Symptoms:
Fever ≥ 100.4F
Cough
Dyspnea/SOB
Malaise
Chills
N/V/D
Rhinorrhea/Nasal Congestion
Differential:
COVID - 19
Influenza
Other Viral Infection
Pneumonia
UTI
Bacteremia
Sepsis
Hyperthyroidism
Medication reaction
Known COVID – 19 Positive
– OR –
High Suspicion of COVID – 19
GCS <15 or Other Concern for Altered Mental Status
Signs of Severe Respiratory Distress.
(Use of accessory muscles, retractions, grunting, noisy
breathing when at rest, unable to speak in complete sentences,
feeling of suffocation, etc)
Respiratory Exhaustion or
Apnea Reported
Age/Vital Signs (MUST FALL WITHIN THESE
PARAMETERS)
Age 18 – 60 year old
Heart Rate 50 – 110 BPM
Systolic BP 90 – 200 mmHg
Respiratory Rate 10 – 24 RPM
Pulse Ox ≥ 94%
Temp < 104°F
Blood Glucose 70 – 400 mg/dL
Signs of Dehydration:
Poor skin turgor
Sunken eyes
Sunken fontanelles
Does Patient Have Chronic Medical Conditions:
Respiratory (COPD, Asthma, Emphysema, ILD, etc)
Cardiac (CAD, CHF, Aortic Stenosis, Peripheral Arterial/
Vascular Disease, etc)
Renal (Chronic Kidney Disease, ESRD, Lupus, etc)
Metabolic (Diabetes, Severe Obesity, etc)
Immunosuppressed (Active Chemo, Cancer, Bone Marrow
Transplant, Organ Transplant, etc)
YES
NO
NO
YES
Consider Transport to Local
Hospital
Patients may refuse transport
at any time as long as they
retain capacity
If Transport is required, notify
receiving hospital ASAP
If you think the patient is
appropriate for home care but
falls outside these parameters,
contact online medical control,
preferably MD-1 or MD-2
If transport is not required,
provided prescribed care as
directed by medical control and
schedule follow up assessment
by EMS and/or Public Health.
Proceed to Self Monitor/Stay at
Home Instructions
Proceed to Self Monitor/Stay
at Home Instructions
PPE MUST BE WORN: N95,
GOWN, GOGGLES, GLOVES
Limit patient contact to 1 (one)
provider if at all possible
All providers should attempt to
maintain distance of 6+ feet from
the patient when possible and
when this does not interfere with
patient care
NO
NO
YES
YES
YES
YES
YES
EXIT TO
APPROPRIATE
PROTOCOL
NO
Contact Online Medical
Control To Discuss Case
NO
COVID-19 Evaluate and Release
Special Consideration 6
This policy has been altered from the original NCCEP Policy by the local EMS Medical Director
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Pearls
CREW SAFETY IS PARAMOUNT! UTILIZE PPE!
THIS PROTOCOL IS ONLY VALID FOR PATIENTS WITH SUSPECTED COVID-19 OR OTHER INFLUENZA LIKE
ILLNESS.
The intention with this protocol is to allow appropriate patients to self -isolate and monitor symptoms at home.
Patients must meet the criteria on page 1, be safe at home, and have appropriate resources:
Separate living space away from others in the home.
The patient is able to adhere to recommendations in the provided information
The patient is able to care for themselves (toileting, feeding, bathing, etc) or has a caregiver who can assist them.
The patient can call 911 or seek care at a medical facility if their condition worsens .
The patient is otherwise safe in their home.
At this time, patients can be evaluated and released if they meet the criteria on
page 1 AND Medical Direction agrees.
Disposition should be marked as “Patient Evaluated, No Treatment/Transport Required”. The patient
SHOULD NOT touch the tablet: this is to limit contamination and transmission of COVID-19. If a signature is
needed, please indicate that the reason they were unable to sign was due to “COVID-19".
Deviations from this protocol may be allowed ONLY AFTER DISCUSSION WITH ONLINE MEDICAL CONTROL .
Any questions about this protocol should be directed to online medical control, preferably to MD-1 or MD-2. If there
are any deviations from the protocol, they must be EXPLICITLY documented in the narrative section. This includes
documentation of discussions with medical control as well as explaining these deviations to the patient .
COVID Packet:
The COVID packet must be provided to all patients who are caring for themselves at home . This includes the
CDC Fact Sheets included in this protocol (English or Spanish) (https://www.cdc.gov/coronavirus/2019-ncov/
downloads/sick-with-2019-nCoV-fact-sheet.pdf; https://www.cdc.gov/coronavirus/2019-ncov/downloads/2019-ncov-
factsheet-sp.pdf) as well as the Durham County Emergency Medical Services information sheet included in this
protocol. Up to date QR codes for COVID information are provided below in English and Spanish.
Thoroughly document your discussions with the patient. Suggested documentation includes the
following:
“The patient was evaluated for the listed complaint. At this time, their illness is consistent with possible
COVID-19. They have the exam and vital signs as documented. Their medical history is listed in the
report. At this time, their symptoms can be managed at home. They have a separate living space for
isolation, can adhere to the recommendations in the provided packet, are able to care for themselves (or
have a caregiver who can care for them), can call 911 or seek further care if their condition worsens, and
they are otherwise safe. Medical Control was contacted [list physician name and/or MD number] and
agreed. The patient was provided with the language appropriate handouts associated with this protocol .”
1/2022Revised
English CDC COVID info Spanish CDC COVID info