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ACEP COVID-19 Field Guide

Table of Contents

Infection Prevention and Control Recommendations for Patient Arrival and Triage

Triage
  • If a patient is arriving via transport by EMS, EMS personnel should contact the receiving emergency department or health care facility and follow previously agreed upon local or regional transport protocols. 
  • Advise patients and visitors entering the facility, regardless of symptoms, to put on a cloth face covering or face mask before entering the building and await screening for fever and symptoms of COVID-19.
  • Post visual alerts (eg, signs or posters such as Figure 5.2) at the entrance and in strategic places (eg, waiting areas, elevators, cafeterias) to provide instructions (in appropriate languages) about hand hygiene, respiratory hygiene, and cough etiquette. 
    • Instructions should include wearing a cloth face covering or face mask for source control as well as how and when to perform hand hygiene.
    • Take steps to ensure that everyone adheres to hand hygiene, respiratory hygiene, and cough etiquette; all patients should follow triage procedures throughout the duration of their visit.
  • Provide supplies for respiratory hygiene and cough etiquette, including alcohol-based hand rub (ABHR) with 60% to 95% alcohol, tissues, and no-touch receptacles for disposal, at health care facility entrances, waiting rooms, and patient check-ins.
  • Install physical barriers (eg, glass or plastic windows) at reception areas. 
  • Consider establishing triage stations outside the facility to screen individuals before they enter.
  • Ensure rapid, safe triage and isolation of patients with symptoms of suspected COVID-19 or other respiratory infection (eg, fever, cough).
  • Ensure triage personnel who take vitals and assess patients wear a respirator (or face mask if respirators are unavailable), eye protection, and gloves for the primary evaluation of all patients presenting for care until COVID-19 is deemed unlikely.
    • Triage personnel should have a supply of face masks or cloth face coverings; these should be provided to all patients who are not wearing their own cloth face covering at check-in, assuming a sufficient supply exists.
  • Prioritize the triage of patients with symptoms of suspected COVID-19.
  • Isolate patients with symptoms of COVID-19 in an examination room with the door closed. If an examination room is not readily available, ensure the patient is not allowed to wait among other patients seeking care.
  • Identify a separate, well-ventilated space that allows waiting patients to be separated by 6 or more feet, with easy access to respiratory hygiene supplies.
    • In some settings, patients may opt to wait in a personal vehicle or outside the health care facility where they can be contacted by mobile phone when it is their turn to be evaluated.
  • Prioritize patients with suspected COVID-19 who require admission to a hospital or congregate care setting (eg, nursing home) for testing.

More information and additional strategies to minimize chances of exposure can be found in the “Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings.”

Figure 5.2 Sample poster that serves as a visual alert. Credit: CDC.

Sample poster that serves as a visual alert

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