COVID 19 Resources

Below is the algorithm I'm having my secretary use to schedule patients and more importantly identify those who may be suspect to having COVID so they aren't getting our other patients and staff sick.

COVID-19 Coronavirus Algorithm for Scheduling
1.Does the patient have symptoms of respiratory illness (e.g., fever in the last 48hrs, chills, sweats, cough and/or shortness of breath)? If YES proceed to question 2. If NO schedule patient in available slots and as appropriate.

2. Has the patient recently traveled outside the country OR been in an airplane OR boat in the past 2 weeks? If YES or NO proceed to question 3.

3. Has the patient been in close contact with anyone known OR suspected to have the COVID-19 coronavirus illness? Close contact is defined as within 6 feet for 3 minutes or more.

If patient answered yes to question 1 AND either question 2 OR 3:
Schedule patient today to be seen that day if slots available OR schedule for an appointment the next day AND have the patient self-quarantine, OR if patient feels the symptoms are life threatening direct them to the local ER or Urgent care and please advise the patient to call the emergency department or urgent care immediately so the staff there can provide them with arrival instructions.

Preparing Office for Suspected Coronavirus Patient:
Inform the patient by phone that they will need to apply a mask once they are in our office.
Notify nursing staff as soon as the patient arrives so that they may be placed in an exam room to wait for the provider (NO WAITING IN LOBBY FOR THESE PATIENTS).

If you have any questions or if the patient has any questions connect them immediately to RN or Provider.

Daily Prep: Clean desktop, keyboard, office phone and personal phone at minimum of twice daily and as needed with antiviral wipes.

COVID-19 Coronavirus Nursing Protocol

1. Suspected Coronavirus patients will be placed in a dedicated room, please notify provider that patient is a suspected COVID-19 patient.
Please have the patient continue wearing the mask while in the exam room, unless directed otherwise.

2. Does the patient have symptoms of respiratory illness (e.g., fever>100, cough and/or shortness of breath)?
If YES AND fever >100 in the office today please administer the flu swab. If NO, proceed to the next question.

3. Does the patient have any TWO of the following symptoms: shortness of breath, cough, wheeze, and/or has a history of COPD, asthma, current or past smoker; WITH one or more objection findings: SPO2 <90%, RR > or = 24, Fever > or = 100F (37.7C)?
If YES administer DuoNeb nebulizer treatment as long as patient consents and has no allergies to Albuterol or Ipratropium Bromide.

4. If there is any question about whether to carry out the nebulizer treatment contact the provider. If the patient has a temp > 102, HR >120, BP <90/60 or >180/110, RR >30, or SPO2 <88% or the patient looks unstable the provider should be contacted immediately (before any intervention).

5. After vitals signs are taken, please wipe down vital sign equipment with antiviral wipes.

6.After the patient leaves the exam room please wipe down the door handles (both sides), the chairs and exam table, and any other equipment used in the room. Please spray the room with antiviral spray.

Daily Prep: Clean desktop, keyboard, office phone and personal phone at minimum of twice daily and as needed with antiviral wipes.

Texas Dept of Health and Human Services Test Guide for Persons Under Investigation for COVID-19

https://www.dshs.texas.gov/coronavirus/docs/DSHSCriteriatoGuideTestingofPUI.pdf