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COVID MDM – TEST/NO TEST (3/20)

This patient presents with symptoms concerning for viral syndrome including flu and SARS-nCoV-2019.



WELL-APPEARING/DISCHARGE



YES: Patient meets criteria to test for COVID-19. Doubt PNA, sepsis, other serious bacterial infection or acute emergent condition. Is otherwise well-appearing with acceptable vitals, a reassuring physical exam, and is safe to discharge home following NP swab. Will add to follow-up list to call with results after. Will provide strict return precautions and instructions on self-isolation/quarantine and anticipatory guidance.



NO: Patient does NOT meet our current criteria to test for COVID-19, although coronavirus infection is certainly on the differential. Doubt PNA, sepsis, other serious bacterial infection or acute emergent condition. Is otherwise well-appearing with acceptable vitals, a reassuring physical exam, and lacks serious medical comorbidities that would require admission. Patient is nontoxic-appearing and although symptomatic, otherwise safe to go home. Will provide strict return precautions and instructions on self-isolation/quarantine and anticipatory guidance.



ADMITTING (testing)



Patient presentation suspicious for COVID-19 infection. Patient requires admission for their symptoms given . Differential diagnosis includes other viral causes of LRTI, pneumonia, less likely PE, PTX, primary cardiovascular causes, bacterial sepsis, or other severe metabolic/ischemic derangements. Will swab for SARS-nCoV-19, place in enhanced precautions, admit to medicine.



from natedotphrase.com



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