March 1, 2020

COVID-19: Protecting Our Families and Patient Disposition

The Novel Coronavirus 2019, was first reported on in Wuhan, China in late December 2019.  The outbreak was declared a public health emergency of international concern in January 2020 and on March 11th, 2020, the outbreak was declared a global pandemic.  The spread of this virus is now global with lots of media attention.  The virus has been named SARS-CoV-2 and the disease it causes has become known as coronavirus disease 2019 (COVID-19).  This new outbreak has been producing lots of hysteria and false truths being spread, however the data surrounding the biology, epidemiology, and clinical characteristics are growing daily, making this a moving target.  This post will serve as a summary of protecting our families and patient disposition for COVID-19. 

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Protecting Our Families

While we all accept increased risks as part of our chosen profession, we all worry about family transmission.  Caring for infected patients represents substantial exposure for all healthcare providers.  Some conversations to start having with your hospital system and family:

  • Priority testing, vaccination and treatment when available for you and your family
  • Have discussions at home about separating living spaces and bathrooms to hopefully minimize risk
  • Having one entrance of arrival where clothing is removed immediately before entering the house
  • Leave work shoes outside of house (i.e. in garage)
  • Another option would be going to work in personal clothing and switching to scrubs at work and showering and changing back to personal clothing on the return home
  • Wipe down your cell phone before going home
  • Hospital housing provided when working a run of shifts

Patient Disposition

  • Not all persons under investigation require admission.
  • The decision to admit vs discharge home for home isolation should be made on a case-by-case basis with your local health department (This is a multifactorial decision depending first on the severity of the patients clinical presentation)
  • If mild symptoms a patient may qualify for home isolation depending on their ability to 1) comply with health department monitoring, and 2) remain home to minimize any risk of transmission to the general public 

COVID-19 Discharge Video via Sketchy EBM (Video Time: 8:36)

  • Two Discharge Algorithms (Both Non-Validated)
    • Brescia-COVID Respiratory Severity Scale (BCRSS) Algorithm – Italy [Link is HERE]

For More Thoughts on This Topic Checkout:

Post Peer Reviewed By: Anand Swaminathan, MD (Twitter: @EMSwami) and Mizuho Morrison, DO (Twitter: mizuhomorrison)

Cite this article as: Salim Rezaie, "COVID-19: Protecting Our Families and Patient Disposition", REBEL EM blog, March 1, 2020. Available at: https://rebelem.com/covid-19-protecting-our-families-and-patient-disposition/.
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Salim Rezaie

Emergency Physician at Greater San Antonio Emergency Physicians (GSEP)
Creator & Founder of REBEL EM
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