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.