COVID-19 Screening

If the patient has any of the following symptoms or recent possible exposures, they should be rescheduled for non-urgent medical or surgical services and consider testing. Communicate with your pathologist about testing information and with your infectious disease consultants about pertinent COVID-19 issues.

  1. Screening questions:
    1. Travel: Have you traveled within the US or internationally within the past 2 months, or had close contact with anyone who has traveled in the past 2 months?
    2. Close Proximity: Have you had close proximity > 5 minutes to a lab-proven COVID-19-positive or Person Under Investigation within the last 14 days?
    3. Family: Has anyone in your family or close work associates had confirmed, possible or suspected COVID-19 in the last 14 days?
    4. Occupation: Do you work in a higher-risk occupation, such as health care worker, first responder, front-line service worker, or grocery store/airline/airport/cruise-ship worker? (If yes, keep a higher index of suspicion.)
    5. Symptoms: Appear 2-14 days after exposure to the COVID-19 virus.
      1. Fever (100.0°F)
      2. Dyspnea, cough or other respiratory symptoms
      3. Shortness of breath
      4. Muscle aches/pain
      5. GI symptoms (nausea, vomiting, diarrhea)
      6. Loss of appetite
      7. Loss of taste or smell
      8. Conjunctivitis
      9. Chills / repeated shaking with chills
      10. Extreme fatigue
      11. Blue discoloration/ blisters of toes
      12. Age > 65 confused, dizzy, falls, mental status changes

      Seek immediate medical attention with the following warning signs:

      1. Trouble breathing
      2. Persistent pain or pressure in the chest
      3. New confusion or inability to arouse
      4. Bluish lips or face
  2. Face Masks: Advise the patient to wear a face mask (per CDC). If the patient does not have a mask, offer them an ear-loop mask. Hair bonnets and shoe covers are optional.
  3. Temperature Screening: Use an infrared thermometer. If this is not available, use a temporal scanning thermometer. If a patient is febrile, refer to their primary care physician for evaluation and reschedule their appointment. Screen any accompanying individuals.
  4. Gatekeeper-Greeter: Greet the patient with a gatekeeper donned with mask, gloves, and surgical scrubs. A protective isolation gown, shoe coverings, N95 respirator mask, hair covering, and gloves are necessary for an aerosolizing procedure such as testing. Staying six feet away, the gatekeeper can quickly remove their mask and smile at the patient. N95s should not be removed and replaced to smile at the approaching patient as that action breaks the fit “seal” and each time the face is touched risk of contamination increases. Do not shake hands, hug, or elbow bump.
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