NO

COVID-19 Evaluate and Release

Special Consideration 6

This policy has been altered from the original NCCEP Policy by the local EMS Medical Director1/2022

Revised

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History:

Flu-like symptoms

Known COVID-19 Exposure

Travel to high risk international or domestic region

Signs and Symptoms:

Fever ≥ 100.4F

Cough

Dyspnea/SOB

Malaise

Chills

N/V/D

Rhinorrhea/Nasal Congestion

Differential:

COVID - 19

Influenza

Other Viral Infection

Pneumonia

UTI

Bacteremia

Sepsis

Hyperthyroidism

Medication reaction

Known COVID – 19 Positive

– OR –

High Suspicion of COVID – 19

GCS <15 or Other Concern for Altered Mental Status

Signs of Severe Respiratory Distress.

(Use of accessory muscles, retractions, grunting, noisy

breathing when at rest, unable to speak in complete sentences,

feeling of suffocation, etc)

Respiratory Exhaustion or

Apnea Reported

Age/Vital Signs (MUST FALL WITHIN THESE

PARAMETERS)

Age 18 – 60 year old

Heart Rate 50 – 110 BPM

Systolic BP 90 – 200 mmHg

Respiratory Rate 10 – 24 RPM

Pulse Ox ≥ 94%

Temp < 104°F

Blood Glucose 70 – 400 mg/dL

Signs of Dehydration:

Poor skin turgor

Sunken eyes

Sunken fontanelles

Does Patient Have Chronic Medical Conditions:

Respiratory (COPD, Asthma, Emphysema, ILD, etc)

Cardiac (CAD, CHF, Aortic Stenosis, Peripheral Arterial/

Vascular Disease, etc)

Renal (Chronic Kidney Disease, ESRD, Lupus, etc)

Metabolic (Diabetes, Severe Obesity, etc)

Immunosuppressed (Active Chemo, Cancer, Bone Marrow

Transplant, Organ Transplant, etc)

YES

NO

NO

YES

Consider Transport to Local

Hospital

Patients may refuse transport

at any time as long as they

retain capacity

If Transport is required, notify

receiving hospital ASAP

If you think the patient is

appropriate for home care but

falls outside these parameters,

contact online medical control,

preferably MD-1 or MD-2

If transport is not required,

provided prescribed care as

directed by medical control and

schedule follow up assessment

by EMS and/or Public Health.

Proceed to Self Monitor/Stay at

Home Instructions

Proceed to Self Monitor/Stay

at Home Instructions

PPE MUST BE WORN: N95,

GOWN, GOGGLES, GLOVES

Limit patient contact to 1 (one)

provider if at all possible

All providers should attempt to

maintain distance of 6+ feet from

the patient when possible and

when this does not interfere with

patient care

NO

NO

YES

YES

YES

YES

YES

EXIT TO

APPROPRIATE

PROTOCOL

NO

Contact Online Medical

Control To Discuss Case

NO

COVID-19 Evaluate and Release

Special Consideration 6

This policy has been altered from the original NCCEP Policy by the local EMS Medical Director

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Pearls

CREW SAFETY IS PARAMOUNT! UTILIZE PPE!

THIS PROTOCOL IS ONLY VALID FOR PATIENTS WITH SUSPECTED COVID-19 OR OTHER INFLUENZA LIKE

ILLNESS.

The intention with this protocol is to allow appropriate patients to self -isolate and monitor symptoms at home.

Patients must meet the criteria on page 1, be safe at home, and have appropriate resources:

Separate living space away from others in the home.

The patient is able to adhere to recommendations in the provided information

The patient is able to care for themselves (toileting, feeding, bathing, etc) or has a caregiver who can assist them.

The patient can call 911 or seek care at a medical facility if their condition worsens .

The patient is otherwise safe in their home.

At this time, patients can be evaluated and released if they meet the criteria on

page 1 AND Medical Direction agrees.

Disposition should be marked as “Patient Evaluated, No Treatment/Transport Required”. The patient

SHOULD NOT touch the tablet: this is to limit contamination and transmission of COVID-19. If a signature is

needed, please indicate that the reason they were unable to sign was due to “COVID-19".

Deviations from this protocol may be allowed ONLY AFTER DISCUSSION WITH ONLINE MEDICAL CONTROL .

Any questions about this protocol should be directed to online medical control, preferably to MD-1 or MD-2. If there

are any deviations from the protocol, they must be EXPLICITLY documented in the narrative section. This includes

documentation of discussions with medical control as well as explaining these deviations to the patient .

COVID Packet:

The COVID packet must be provided to all patients who are caring for themselves at home . This includes the

CDC Fact Sheets included in this protocol (English or Spanish) (https://www.cdc.gov/coronavirus/2019-ncov/

downloads/sick-with-2019-nCoV-fact-sheet.pdf; https://www.cdc.gov/coronavirus/2019-ncov/downloads/2019-ncov-

factsheet-sp.pdf) as well as the Durham County Emergency Medical Services information sheet included in this

protocol. Up to date QR codes for COVID information are provided below in English and Spanish.

Thoroughly document your discussions with the patient. Suggested documentation includes the

following:

“The patient was evaluated for the listed complaint. At this time, their illness is consistent with possible

COVID-19. They have the exam and vital signs as documented. Their medical history is listed in the

report. At this time, their symptoms can be managed at home. They have a separate living space for

isolation, can adhere to the recommendations in the provided packet, are able to care for themselves (or

have a caregiver who can care for them), can call 911 or seek further care if their condition worsens, and

they are otherwise safe. Medical Control was contacted [list physician name and/or MD number] and

agreed. The patient was provided with the language appropriate handouts associated with this protocol .”

1/2022Revised

English CDC COVID info Spanish CDC COVID info