Emergency Department Clinical Pathway for Screening/Evaluation of Children with Suspected 2019 Novel Coronavirus (COVID-19) Disease
Related Pathway
- COVID-19 Screening, Outpatient Specialty and Primary Care
- COVID-19 Screening, Inpatient
- COVID-19, Acute, All Settings
- Multisystem Inflammatory Syndrome in Children (MIS-C)
- End of Life Care
- Fever
- Fever in the Returned Traveler
- Influenza, Flu
- Pneumonia, Community Acquired
- Bronchiolitis, Emergent Evaluation
- Sepsis, ED, Inpatient, PICU
Current Screening for 2019 Novel Coronavirus Disease (COVID-19)
- Patient Arrival at Greeter Desk in Emergency Waiting
- Encounter created and exposure screen completed
- PAC Assessment, Sort ESI Level, Place Pt ID Band
- ED Visitation Guidance, Mask All Patients, Family Members
- Triage PPE
- Hand Hygiene
- Mask + Eye Protection
No Respiratory Symptoms
Cough, SOB with or without Fever
Main ED Waiting B,C
Main ED Waiting A
Escort Patients to Next Available Room
- AGP Existing/Likely
- Negative Pressure Rooms as available;
- Single room, door closed if not available
- BH Patients
- EDBH Rooms or
- ECBH Rooms if eligible
Mask + Eye Protection + HH + Gloves for All Patients (Gowns per symptoms)
Modified Expanded Precautions for COVID Symptoms, COVID Exposure, Known COVID Expanded Precautions for Aerosol-Generating Procedures, Precaution Video
Modified Expanded Precautions for COVID Symptoms, COVID Exposure, Known COVID Expanded Precautions for Aerosol-Generating Procedures, Precaution Video
Current Testing Recommendations for SARS-CoV-2
Patient Care Considerations
- Symptoms
- Symptoms concerning for COVID
- Non-specific Symptoms
- COVID Suspected Symptoms
- Exposure Definition, Examples
ED Asthma Pathway Changes in the setting of COVID-19
For patients requiring Asthma Treatment, MDI is preferred
For patients requiring Asthma Treatment, MDI is preferred
Therapeutic Considerations for Patients with Severe COVID-19
Pathway for Evaluation and Treatment of Patients with Active COVID-19 Infections
Pathway for Evaluation and Treatment of Patients with Active COVID-19 Infections
- Testing will not be done at Triage, but upon entry to room.
- Guidance on Re-testing/Reinfection:
- Do not repeat tests for patients with a positive PCR test in the preceding 90 days unless they have new infectious symptoms without alternate etiology and are ≥ 45 days from their initial positive test.
- Note:
Expected Acute Hospital Admission or Procedure (Peri-Operative Guidance) | |
---|---|
Assess Symptoms | Type of Test Recommended |
Symptoms Present |
|
No Symptoms |
|
Expected Discharge | |
---|---|
Assess Symptoms | Type of Test Recommended |
Symptoms Present |
|
No Symptoms; Regardless of Exposure status; Able to Mask |
No Testing |
No Symptoms and Exposed And Unable to Mask |
|
Guidance for Quarantine and Isolation for Healthy Children
CDC Guidelines COVID-19 Outlook: A Pandemic in Transition Requires Updated School Guidance, CHOP Policy Lab
- Note:
- Children with severe COVID infection or those with weakened immune systems may require longer periods of isolation of 10-20 days, parents and patients should discuss with their individual provider.
Exposed And NO Symptoms |
|
---|---|
COVID Positive Test or Clinical diagnosis of COVID |
|
Disposition
Discharge
Admission
- Use COVID-19 Discharge Smart Set if patient tested
- COVID Discharge Instructions
- COVID-19 Return to Sports Participation for General Pediatricians and Recommendations for Cardiology Consultation after COVID-19
- Frequently Asked Questions about Return to Sports PC,Cardiology Referral
- CHOP Outpatient Testing: Screening and
Scheduling a Test
- Admitting ED Patients: Consider Symptoms, Exposure, and AGP
- EDECU Eligible
- EDECU 13 may be used for appropriate COVID + patient
- Management of Parents and Caregivers with
Exposure to or Symptoms of COVID-19
- EDECU Eligible
- Transport of suspected/confirmed cases of COVID-19
Posted: January 2020
Revised: January 2023
Authors: K. Cohn, MD; L. Handy, MD; J. Sammons, MD; V. Kampalath MD; J. Lavelle MD; K. Chiotos, MD;
S. Myers, MD; MK. Abbadessa, ACCNS-P; S. Coffin, MD
Revised: January 2023
Authors: K. Cohn, MD; L. Handy, MD; J. Sammons, MD; V. Kampalath MD; J. Lavelle MD; K. Chiotos, MD;
S. Myers, MD; MK. Abbadessa, ACCNS-P; S. Coffin, MD
Evidence
- Coronavirus Disease Cases
- Clinical and CT features in pediatric patients with COVID‐19 infection: Different points from adults
- CDC: Coronavirus Disease, Information for HCP
- Clinical Features of Patients Infected with 2019 Novel Coronavirus in Wuhan, China.
- A Novel Coronavirus Outbreak of Global Health Concern
- Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19)
- World Health Organization: Novel Coronavirus
- Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
- High Temperature and High Humidity Reduce the Transmission of COVID-19
- Temperature, Humidity and Latitude Analysis to Predict Potential Spread and Seasonality for COVID-19
- Detection of SARS-CoV-2 in Different Types of Clinical Specimens
- Potential Anti-Viral Therapies
Educational Media