COVID-19: Hospital preparedness: Difference between revisions
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*All hospital dependant, please check with your hospital administration for existing protocols | |||
==Prehospital Care== | ==Prehospital Care== | ||
*ET-3 model | *ET-3 model | ||
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==Screening/Triage== | ==Screening/Triage== | ||
*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 [[Prevention of COVID-19 transmission in the healthcare setting|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) | |||
*Moderate/Severe illness | |||
**Ill appearing | |||
**Hypoxia | |||
**Tachypnea | |||
{{COVID Risk Factors}} | |||
* | ==Protocols== | ||
*Labs/Imaging | |||
*Intubation | |||
*CPR | |||
*Asthma | |||
*CV procedures | |||
*Disposition | |||
==Surge Capacity== | ==Surge Capacity== | ||
Revision as of 21:48, 8 April 2020
- All hospital dependant, please check with your hospital administration for existing protocols
Prehospital Care
- ET-3 model
- Treat Onsite
Screening/Triage
- 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)
- Moderate/Severe illness
- Ill appearing
- Hypoxia
- Tachypnea
COVID-19 Risk Factors for Severe Disease [1]
See VACO calculator
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
- ↑ 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.