RCU

General Measures

Follow facility based Infection Prevention and Control protocols

Refer to COVID−19 Regional Care Unit (RCU) Admission Orders Set

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

  • 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

May include:

  • 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

  • EKG

  • Portable chest X−ray

Consultations

MED LTC - Call QEII Locating at 1-902-473-2222

Medications

  • 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

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