Clinical Algorithms for Admission and Discharge
Please see the BMC protocol on “COVID-19 Removal of Isolation Precautions PUI and COVID-19 patients” for access to updated and full guidance.
Admission criteria updated Dec 2nd 2020
Consider hospital admission for the following findings:
- Any patient with dyspnea or increase respiratory rate ( ≥ 30 breaths per min )
- Any patient with oxygen saturation ≤ 94% on RA or decrease in saturation to < 90% with ambulation
- Overall clinical concern by ED attending for risk of outpatient failure based on high risk for complications from severe COVID-19
Patients at high risk for complications from severe COVID-19
Age 65 years or older, serious cardiovascular disease (heart failure, coronary artery disease, cardiomyopathies), chronic obstructive pulmonary disease, diabetes, malignancy, obesity (BMI ≥30 kg/m 2 ), chronic kidney disease, immunocompromised state with solid organ transplantation, recipient of immunosuppressive therapy, pregnancy and sickle cell disease.
Asthma (moderate to severe), cerebrovascular disease
Criteria for safe discharge to home from the ED:
None of admission criteria listed above AND
- Reliable phone number where the patient could be reached for post-discharge follow-up
- Ability to understand and follow self-isolation recommendations
- Patient and family members with access to face covering at home
- Food security (enough for time in isolation, or ability to have someone procure it)
- Ability to care for own ADLS without assistance from someone outside their household
If the patient is being discharged and you would like the patient to be contacted by the COVID-infected follow up monitoring program, please select “COVID-19 Follow Up” under the “Nurse Follow Up” section of DISPO.
If the patient does not meet criteria for safe discharge home, please contact Social Work for help with disposition planning.
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