Triage Steps for Clinic Patients with Cough and Upper Respiratory Issues

Updated 5/20/2020

All patients will be screen for cough and fever by Clinic staff as they enter the back entrance before entering the Free Clinic. The door will remained locked and opened by clinic staff only. Their O2 sats and temp will be taken and assessed at that time. The patient will be asked if they have taken and Tylenol or ibuprofen before coming to the clinic. All patients and family members must wear a mask while in the clinic. All patients with a fever and or cough will be brought to our triage room #6 and #5. All volunteers have their temp taken as well before starting work. If greater than 100.4, they will not be able to volunteer.

The patient will be asked a series of questions regarding their cough. They will asked about possible contacts and have their temp and oxygen saturation taken. If they are without a fever with normal oxygen stats, they will be asked to finish their paperwork and told to sit in the waiting room. The waiting room has been reorganized so that patients can no longer sit together.

If the patient has a fever, they will be left in room 5 or 6 and seen by a provider and then discharged from that room. We are going to experiment with having most of the interaction and care done by the individual RN to limit potential exposure.  There is an isolation tote set up in room 5 that has all supplies that the volunteer will need to see the patient. If the patient is febrile, the volunteer will wear a surgical mask and face shield, gloves and disposable gown. They may use N95 masks and goggles. They will gown up outside room before entering and remove isolation wear before leaving the room. All caregivers will be instructed on the proper way to gown and remove the protective wear before and after caring for the patient in isolation.

It will be up to the individual provider to decide whether the patient needs additional evaluation by the Emergency Room at Peacehealth with possible testing for COVID-19. We currently have covid-19 test supplies at the clinic and can administer a test. We will call the ER prior to any patient leaving the clinic with instructions to go to the ER. The provider will decide whether the patient is stable enough the go by private vehicle or to call AMR.

The clinic has a “covid” bag to be given to patients that are not sick enough to go to the hospital. The bag will Tylenol for fever, Tussin syrup for cough and congestion, saline spray to assist breathing, and a handmade mask for the patient to wear when at home for self-isolation. There will be instructions on how to take the medication and a care sheet from the CDC web page on how to care for yourself at home and what to watch for.

The clinic can also triage and giver limited services to patients via phone. This would be for patients that might need med refills without vital signs taken and for patients with upper respiratory symptoms. If they qualify through this triage process, we will either be able to dispense the “covid” bag of essentials, or refill meds for patients without having them enter the clinic. We will either deliver the meds to them or have them drive up to the back and we could bring the meds out. The whole purpose is to keep the patient at home and still deliver services and keep our caregivers safe.  We will also provide other minor services via phone for patients.

Brian Dolan, Clinic Manager