Goals of Care
Complete within 24 hours
Provide care based on symptoms. Oxygen should only be used for symptomatic relief of dyspnea (i.e. not targeted to oxygen saturation). Avoid fluid resuscitation, VTE prophylaxis and dexamethasone. Do not monitor vital signs.
Would accept all interventions available in the RCU, including VTE prophylaxis and dexamethasone. Routine monitoring of temperature is not required. Vital signs monitoring to guide oxygen treatment and fluid resuscitation. Not for transfer to Acute COVID Unit. If there is acute deterioration, consider transition to comfort care only.
Would accept all interventions available in the RCU. Would accept transfer to an acute COVID unit, if indicated based on the need for high flow oxygen (i.e. oxygen levels less than 88 % despite maximum oxygen via nasal prongs). Would not accept escalation to IMCU / ICU level care, including no BiPAP, vasopressors or intubation.
Would accept BiPAP or vasopressors.
Would accept all interventions at the IMCU / ICU level of care, if indicated. This would include BiPAP, vasopressors and intubation.
FULL CODE Including CPR and Intubation
- Investigations are not required for RCU admission and should be ordered to guide management decisions within goals of care
- If comfort care only, investigations are not indicated
CBC, auto diff, INR, PTT
Creatinine, urea, electrolytes (Na, K), chloride, calcium, magnesium, phosphate, total CO2, random glucose
Confirmatory COVID−19 nasopharyngeal swab, if not done
Influenza nasopharyngeal swab, if not done
Portable chest X−ray
MED LTC - Call QEII Locating at 1-902-473-2222
Dexamethasone 6 mg po/ng/IV daily x 10 days or until discharge (whichever is sooner)
If less than 5 days since symptom onset, consider ID consult prior to initiating dexamethasone