UNCONTROLLED WHEN PRINTED

The purpose of these COVID-19 Interim Guidelines is to provide short-term advice to manage the risks associated with COVID-19 in the community and to protect patients and St John WA staff from potential exposure whilst maintaining the highest possible standards of clinical care to the community of Western Australia.

FRONT LINE STAFF SAFETY IS OUR PRIMARY CONCERN.

All Clinical Practice Guidelines not addressed in this document remain unchanged and still apply in full. Staff should ensure that they stay up to date with the latest information regarding COVID-19 on Connect.

This update is provided in the setting of very low penetration of COVID disease in Western Australia and zero or close to zero community transmission.

Scope:

  • Adult ‘PnT’ pathway for COVID-19 / ILI patients

Definitions:

  • PnT: Patient not Transported
  • ILI: Influenza-like Illness

Instruction:

Please note: Registered Paramedic or most senior clinician to perform PnT assessment.

Does the patient have symptoms consistent with COVID-19?
Any combination of the following may trigger clinical suspicion:

  • Fever > 37.5 or recent history without a known cause
  • Sore throat
  • Shortness of breath
  • Wheezing / cough
  • Acute loss of taste and smell

If yes to the above, the patient and crew who will have close contact with patient to don appropriate PPE – see PPE requirements.

  • Only crew with appropriate PPE to approach patient.

Assess patient

  • If any high-risk features are present, transport is advised
    • Age:                                         > 60
    • Respiratory rate:                      > 22
    • Oxygen saturation:                  < 95
    • Heart rate:                                > 100
    • Systolic blood pressure:          < 110
    • Altered mental state
    • Patient looks unwell
    • Chest pain or features indicative of heart failure
    • Clinical concern exists even without any of the above features.
  • Document your findings and rationale in ePCR.

Exclusions:

High risk patients must be transported, regardless of the above

  • Diabetes
  • Pregnant
  • Known cardiovascular disease or pulmonary disease (e.g. previous pneumonia / asthma / COPD)
    • Have had an organ transplant and are on immune suppressive therapy
    • Have had a bone marrow transplant in the last 24 months
    • Are on immune suppressive therapy for graft versus host disease
    • Have blood cancer eg leukaemia, lymphoma or myelodysplastic syndrome (diagnosed within the last 5 years)
    • Are having chemotherapy or radiotherapy

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