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
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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?
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- Initiate transport to appropriate facility
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- Discuss option with the patient
Patient agrees to telehealth option
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- Initiate transport to appropriate facility
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- Determine hospital preference Prisma Health or Bon Secours St. Francis (if no preference see PEARLS)
Patient remaining at home?
-
- Initiate Transport to appropriate facility
-
- 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:
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- Fever (100.4 F)
- Cough
- Shortness of breath
- Nausea/Vomiting
- Diarrhea
- Recent contact with known or suspected COVID positive or PUI
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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.