myProtocols

Telehealth Process Flow

 

Indicators the patient is stable enough for Telehealth

  • Appropriate mentation
  • SpO2 > 93%
  • HR < 100
  • Systolic BP >100
  • Not showing signs of severe dyspnea (dyspnea at rest, or inability to speak in complete sentences, Etc.)

 

Significant Findings

  • Shortness of breath
    • Decreased ability to speak
    • Pursed lip breathing
    • Use of accessory muscles
  • Lung Sounds
    • Wheezing
    • Ronchi
    • Absent all together
  • Waveform capnography indicative of constriction

 

Other differentials to consider

  • Asthma
  • Anaphylaxis
  • Aspiration
  • COPD (emphysema/bronchitis)
  • Pleural effusion
  • Pneumonia
  • PE/Pericardia; tamponade
  • Pneumothorax
  • Cardiac (MI/CHF)
  • Inhaled toxin (carbon Monoxide)

 

The patient is showing signs and symptoms of COVID-19 and is appropriate for Telehealth?

 

  • No
    • Initiate transport to appropriate facility

 

  • YES
    • Discuss option with the patient

 

Patient agrees to telehealth option

 

  • No
    • Initiate transport to appropriate facility

 

  • YES
    • Determine hospital preference Prisma Health or Bon Secours St. Francis (if no preference see PEARLS)

 

Patient remaining at home?

 

  • No
    • Initiate Transport to appropriate facility

 

  • YES
    • Review the providers instruction with the patient
    • Collect patients contact information
    • Send the patients contact and clinical information to the Community Paramedic via ESO

 

PEARLS:

  • Common symptoms of COVID-19:
    • Fever (100.4 F)
    • Cough
    • Shortness of breath
    • Nausea/Vomiting
    • Diarrhea
    • Recent contact with known or suspected COVID positive or PUI
  • If the patient has no hospital preference, then the following guidelines will be followed.
    • Even days telehealth calls to Bon Secours St. Francis
    • Odd days telehealth calls to Prisma Health
  • All patients that receive telehealth should have an order placed for drive-in COVID-19 testing
  • All COVID-19 Clinical Guidelines are only in effect for the duration of the COVID-19 emergency and are null and void once the COVID emergency is declared over.