1
ALERT THIS PLAYBOOK IS BEING UPDATED FREQUENTLY AS NEW INFORMATION BECOMES AVAILABLE
PLEASE CHECK BACK FOR THE LATEST INFORMATION
COVID-19 Infection Prevention Acute Care Playbook
Last update 6162020 452 AM
The 616202 Update includes
Updated Guidelines for PPE (pg 7)
2
Table of Contents
Chapter 1 Screening and Testing 4
Quick Screen IPDH Criteria to Evaluate Patients for COVID-19 5
Chapter 2 Personal Protective Equipment (PPE) 6
Guidelines for PPE 7 Personal Protective Equipment (PPE) Conservation 8 N95 RESPIRATOR PRODUCT UPDATE 10 Personal Protective Equipment (PPE) Validation Checklist During care of the patient with known or suspected COVID-19 12 Important Update Regarding Air Pressure in OrsProcedural Areas 13 Transporting of PUI or Confirmed COVID 19 patients Within a Health Care Facility 14
Chapter 3 Cleaning 15
Chapter 4 Clinical Protocols 25
COVID Awake RepositioningProning Protocol (CARP) 26 Instructions for patients with cough or trouble breathing 28 Respiratory support guideline for COVID-19 (PUI or confirmed) patients 29
Chapter 5 Pressure Injury Prevention 33
Protecting Facial Skin Under PPE N95 Face Masks 34 Guidelines for N95 Masks ndash Preventing Facial Pressure Injury 35 Pressure Injury Prevention PIP Tips for Prone Positioning 36
Chapter 6 Discharge Instructions 39
FAQs for Patients 40 Home Isolation Instructions for 42 People with Coronavirus-2019 (COVID-19) Infection and People Awaiting COVID-19 Test Results 42 CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19) 46 CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus (COVID-19) 47 Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients 49
Chapter 7 Removing Isolation Precautions on COVID-19 Patients 51
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients 52
Chapter 8 Mortuary Care 53
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients 54
Morgue Log - COVID-19 Log 56
Chapter 9 Contact Numbers 57
Appendix 64
COVID-19 Test Orders in Electronic Health Records (EHR) 65 IDPH COVID-19 Order 66 Meditech Changes 67 Cerner Changes 68 Athena Changes 69 Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation 70 Personal Protective (PPE) Validation Checklist for PPE Monitor 71 PUI ISOLATION SIGN INOUT SHEET 72 Infection PreventionLeader Rounding Checklist 73
3
Discharge Instructions for Patients with COVID-19 in Spanish 74
[Click on section titles to jump to relevant section]
4
Chapter 1 Screening and Testing
5
Quick Screen IPDH Criteria to Evaluate Patients for COVID-19
Target Population for Evaluation ALL patients who present at an AMITA Emergency Department
AMITA is following the guidance of the Centers for Disease Control and prevention (CDC) for ldquoCriteria to Guide Evaluation of PUI COVID-19rdquo at httpswwwcdcgovcoronavirus2019- nCoVhcpclinical-criteriahtml
Clinical Symptoms Epidemiologic Risks
Fever (ge1000) Cough Shortness of breath Loss of taste or smell
Sore throat
Myalgias (muscle pain) Headache
Chills
OR
Personal history of suspected or laboratory confirmed COVID-19 within the last 14 days
Close contact with a person with suspected or laboratory confirmed COVID-19 within the last 14 days
Lives in assistive living or recently discharged from a nursing homerehab facility known to have clusters of influenza or COVID-19-like illness
IF patient answers YES to ANY Clinical Symptoms or Risk Factors
Patient at risk for COVID-19 like illness Triage patient appropriately
Physicians and APCs should Refer to ldquoTesting Decision Matrixrdquo as outlined by CDC httpswwwcdcgovcoronavirus2019-ncovsymptoms-testingtestinghtml
COVID-19 screening performed NEGATIVE for COVID-like illness Proceed with appointment
Updated 5120 Signature
6
Chapter 2 Personal Protective Equipment (PPE)
7
Guidelines for PPE April 7 2020
Adjustments in these guidelines are subject to changes in standards of care andor supply chain availability
Tier Situation PPE for Patient Care
Activities
Tier 1
GreeterScreenerUniversal Masking
Non PUICOVID‐19 patient Standard precautions + universal masking
(follow isolation precautions if patients are on isolation for something other than COVID)
Tier 2 One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care
PUICOVID‐19 not receiving aerosol generating
procedure (AGP) OR when collecting NP swab
Tier 3 One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care
PUICOVID‐19 receiving aerosol generating
procedure (AGP) AGP = Positive pressure ventilation
(BiPAPCPAP) endotracheal intubation airway suctioning high frequency oscillatory
ventilation tracheostomy chest PT Nebulizer treatment sputum induction bronchoscopy
suctioning +
Centers for Disease Control and Prevention (CDC) httpswwwcdcgovcoronavirus2019‐ncovinfection‐controlcontrol‐recommendationshtml Advent Health (2020) Standard Operating Procedures (SOP) Personal Protective Equipment Guidance for Novel Respiratory Virus COVID‐19
Personal Protective Equipment (PPE) Conservation One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care Adjustments are subject to change with changes in standards of care andor supply chain availability
SUPPLY ITEM WHEN HOW TO RE US E
N95 MASKS
N95 must be covered by a FULL face shield when providing
direct patient care for
Tier 2 and Tier 3 patients
bull When removing the N95
bull Perform hand hygiene
bull Don clean pair of gloves
bull Grasp straps and remove mask without touching the front or inside
bull Place in clean breathable container such as a labeled paper bag
bull Doff gloves and perform hand hygiene
bull Don a face mask as per universal masking protocol
bull If the seal check is performed on the mask and integrity is maintained the mask can be worn multiple times otherwise the mask should be replaced immediately
bull If the N95 becomes damp damaged visibly soiled or hard to breathe through it must be discarded
NOTE N95 should be covered by a clean face mask for aerosolizing procedures and the face mask should be discarded upon exiting the room
FACE SHIELD
bull Must be disinfected inside and outside with hospital‐approved disinfectant wipe after doffing
bull If the hospital approved disinfectant wipe contains bleach bull Allow appropriate dwell time bull Rinse the shield or wipe with a wet paper towel taking care not to get the foam
headband wet bull Dry thoroughly
bull Label face shield and store in a clean location until damaged or unusable
bull Perform hand hygiene before and after contact 8
How To Perform a Particulate Respirator Seal Check Adapted from Epidemic and Pandemic Alert and Response | World Health Organization 2008
Step 1 minus Perform appropriate hand hygiene and don gloves minus Cup the respirator in your hand with the nosepiece at your fingertips allowing the headbands to hang
freely below your hand
Step 2
minus Position the respirator under your chin with the nosepiece up
Step 3
minus Pull the top strap over your head resting it high at the back of your head Pull the bottom strap over your
head and position it around the neck below the ears
Step 4
minus Place fingertips of both hands at the top of the metal nosepiece Mold the nosepiece (USING TWO FINGERS OF
EACH HAND) to the shape of your nose Pinching the nosepiece using one hand may result in less effective respirator performance
Step 5
minus Cover the front of the respirator with both hands being careful not to disturb the position of the respirator
Step 5a Positive seal check minus Exhale sharply A positive pressure inside the respirator = no leakage If leakage adjust the position andor
tension straps Retest the seal Repeat the steps until the respirator is secured properly Step 5b Negative seal check minus Inhale deeply If no leakage negative pressure will make respirator cling to your face minus Leakage will result in loss of negative pressure in the respirator due to air entering through gaps in the seal minus Doff gloves and perform appropriate hand hygiene
9
10
N95 RESPIRATOR PRODUCT UPDATE
In order to ensure protection and prevent a
disruption in product availability AMITA Health is
implementing the use of additional models of N95
respirators
In addition a full face shield must always be used
when wearing any N95 respirator per the AMITA
Health COVID-19 Infection Prevention ndash Acute Care
playbook
More information on COVID-19 playbooks and resources
can be found at
httpswwwamitahealthorgcovid-19-amita
11
AMITA Healthrsquos facilities have previously used the following models of N95s
Brand Model Photo
3M 1860
1860S
1870+
Halyard 46727
46827
AMITA Healthrsquos facilities will begin fit-testing and distributing the following models of N95s
Brand Model Photo
3M 8511
8210
Gerson 2140
For any questions please connect directly with your local Resource Group Operations Manager and
Critical Products Manager
12
Personal Protective Equipment (PPE) Validation Checklist During care of the patient with known or suspected COVID-19
Personal Protective Equipment (PPE) ValidationStaff Training Overview
Purpose
To create a consistent process of monitoring Donning and Doffing of PPE consistent
with CDC recommendations
Refer to Appendix C for the PPE Validation Self-Check Attestation
Refer to Appendix D for the PPE Validation Checklist for Monitor Observing
Expectations
bull Form Overview and Associate actions
Appendix C Personal Protective Equipment (PPE) Validation Self-Check Attestation
o Staff assigned to care for patient suspected or confirmed with COVID-19
o Reviews proper PPE donning and doffing expectations
o Attests that they will report any PPE needs for Ante Room
o Attests that they will report any PPE suspected of malfunctioning o Understands that they may be monitored for proper
donning and doffing
o Signs that they understand the importance of consistent
PPE compliance
o Files completed form in employee file
Appendix D Personal Protective Equipment (PPE) Validation Checklist (for Monitors observing)
Each individual entering patient room if suspected or confirmed COVID-19 will be
monitored for safe donning and doffing practices The assigned PPE Monitor will
OBSERVE and VALIDATE every time
o Proper PPE application
o Proper Date and Room number
o Consistent time entries for EACH time individual enters the room and exits o Assigned PPE Monitor and ALL Caregivers to enter Role Printed Name and
Signature
o Monitor to print name and relationship if visitor
o Forward to charge nurse Infection Control will pick up o Note multiple sheets may be required each day based on individuals entering the
room
o Note MUST remind individuals that doffing may require self-monitoring if Ante Room DOES NOT have a window Do NOT open doors for these doffing observations
o Both the HCP providing care and the monitor will document PPE use and
hand hygiene for both donning and doffing
bull Appendix E PUI Isolation Sign-InOut Sheet
bull Appendix F Infection PreventionLeader Rounding Checklist
13
Important Update Regarding Air Pressure in OrsProcedural Areas
1) All Operating Rooms and procedure rooms (including Cath Lab and IR) need to maintain
a positive pressure relationship to the adjacent areas Altering the airflow in these areas
compromises the sterile environment and puts healthcare workers at greater risk of
exposure
2) NEVER put an N95 mask on a patient Patients should be transported with a procedural
mask
3) Proper room cleaning should be as follows
Terminal clean of an ORprocedure space
a If an aerosol generating procedure was not performed
bull Procedure room may be cleaned immediately
bull Contact EVS and request a COVID-19 terminal clean
b If an aerosol generating procedure was performed
bull Close procedure room and do not allow anyone to enter the space
for 1 hour
bull After one hour has passed contact EVS and request a COVID-19
terminal clean
Reference
American Society of Healthcare Engineering (ASHE)American Hospital Association
(AHA) Facility Guidelines
From the ASHE Website
14
Transporting of PUI or Confirmed COVID 19 patients Within a Health Care Facility
What personal protective equipment (PPE) should be worn by individuals transporting
patients who are confirmed with or under investigation for COVID-19 within a healthcare
facility For example what PPE should be worn when transporting a patient to radiology
for imaging that cannot be performed in the patient room
In general transport and movement of the patient outside of their room should be limited to medically essential purposes If being transported outside of the room such as to radiology healthcare personnel (HCP) in the receiving area should be notified in advance of transporting the patient For transport the patient should wear a facemask to contain secretions and be covered with a clean sheet
If transport personnel must prepare the patient for transport (eg transfer them to the wheelchair or gurney) transport personnel should wear all recommended PPE (gloves a gown respiratory protection that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator or facemaskmdashif a respirator is not availablemdashand eye protection [ie goggles or disposable face shield that covers the front and sides of the face]) This recommendation is needed because these interactions typically involve close often face-to-face contact with the patient in an enclosed space (eg patient room) Once the patient has been transferred to the wheelchair or gurney (and prior to exiting the room) transporters should remove their gown gloves and eye protection and perform hand hygiene
If the patient is wearing a facemask no recommendation for PPE is made typically for HCP transporting patients with a respiratory infection from the patientrsquos room to the destination However given current limitations in knowledge regarding COVID-19 and following the currently cautious approach for risk stratification and monitoring of healthcare personnel caring for patients with COVID-19 use of a facemask by the transporter is recommended for anything more than brief encounters with COVID-19 patients Additional PPE should not be required unless there is an anticipated need to provide medical assistance during transport (eg helping the patient replace a dislodged facemask)
After arrival at their destination receiving personnel (eg in radiology) and the transporter (if assisting with transfer) should perform hand hygiene and wear all recommended PPE If still wearing their original respirator or facemask the transporter should take care to avoid self- contamination when donning the remainder of the recommended PPE This cautious approach will be refined and updated as more information becomes available and as response needs change in the United States
Interim guidance for EMS personnel transporting patients with confirmed or suspected COVID-19 is available here EMS personnel should wear all recommended PPE because they are providing direct medical care and in close contact with the patient for longer periods of time Reference httpswwwcdcgovcoronavirus2019-ncovinfection-controlinfection- prevention-control-faqhtml
15
Chapter 3 Cleaning
16
During this COVID-19 crisis please be aware that you may see a variety of disinfectantswipes for use against COVID-19 The below products are listed on the EPAs website for approved disinfectants against COVID-19 Please be mindful of reviewing the contact time (in minutes) recommended by each manufacturer as it varies per product Products noted for killing C diff spores are noted these products will also disinfectant against COVID-19 Please be mindful that spray disinfectant of any kind should not be sprayed directly on equipment or monitors Spray disinfectant will need to be sprayed on a wiperag before wiping down equipment of any kind to prevent damage andor malfunction
Image of the Product Product Name and number Company Name Contact Time (In Minutes)
Sani-Cloth XLarge 55 Alcohol Q86984
GRAINGER - 9JAJ1 (1) 172H69 (6pk)
Super Sani Large 55 Alcohol
Q55172
GRAINGER - 9RYJ7 (1)
Professional Disposables
International
2 minutes
Sani-Cloth Bleach Germicidal PDI P54072 P25784 P7007P P700RF H58195
U26595
GRAINGER - 16Z989
Professional Disposables
International
4 minutes
kills C Diff spores in 4
minutes
Sani-Cloth AF3 Large Canister P13872
Sani-Cloth AF3 Germicidal Wipes XL
81626514
Professional Disposables
International
Performance Health
3 minutes
SaniPrime (RTU-Wipes)
P25372 P24284 H06182 amp U13195
Professional Disposables
International
1 minute
17
Caviwipe1 XL 65 WipesCanister 13-5150
GRAINGER - 6TWF8 - 13-1150
Caviwipe1 Regular 160 WipesCanister 13-5100
Metrex For the coronavirus this
wipe does in fact need a 3-
minute kill time All other
pathogens require a 1
minute But only the
Coronavirus or in this case the
Adenovirus (most similar) is going to require
the use of 3-minute kill time
Caviwipe Bleach 6X10 90 WipesCanister 13-9100
Metrex 3 minutes
kills C Diff spores in 3
minutes
Cavicide (RTU)
GRAINGER - 3VDJ1 (24oz Bottle) 3VDJ2 (1gal Bottle) 3VDJ3 (25 Gal Bottle) 3VDJ7 (25 Gal
Easy Pour Jug)
Metrex 3 minutes
Clorox Healthcarereg Bleach Germicidal Wipes Office Depot 439675 1630225 265701
825962 8373413 764946 129202 8193323 8193614 8193080
Medline CLO30358H CLO35309 CLO31424Z
CLO31424 CLO30577H CLO30577
GRAINGER 1XEZ3 4XKR8 4XKR7 6VDE9
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
kills C diff spores
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
2
Table of Contents
Chapter 1 Screening and Testing 4
Quick Screen IPDH Criteria to Evaluate Patients for COVID-19 5
Chapter 2 Personal Protective Equipment (PPE) 6
Guidelines for PPE 7 Personal Protective Equipment (PPE) Conservation 8 N95 RESPIRATOR PRODUCT UPDATE 10 Personal Protective Equipment (PPE) Validation Checklist During care of the patient with known or suspected COVID-19 12 Important Update Regarding Air Pressure in OrsProcedural Areas 13 Transporting of PUI or Confirmed COVID 19 patients Within a Health Care Facility 14
Chapter 3 Cleaning 15
Chapter 4 Clinical Protocols 25
COVID Awake RepositioningProning Protocol (CARP) 26 Instructions for patients with cough or trouble breathing 28 Respiratory support guideline for COVID-19 (PUI or confirmed) patients 29
Chapter 5 Pressure Injury Prevention 33
Protecting Facial Skin Under PPE N95 Face Masks 34 Guidelines for N95 Masks ndash Preventing Facial Pressure Injury 35 Pressure Injury Prevention PIP Tips for Prone Positioning 36
Chapter 6 Discharge Instructions 39
FAQs for Patients 40 Home Isolation Instructions for 42 People with Coronavirus-2019 (COVID-19) Infection and People Awaiting COVID-19 Test Results 42 CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19) 46 CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus (COVID-19) 47 Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients 49
Chapter 7 Removing Isolation Precautions on COVID-19 Patients 51
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients 52
Chapter 8 Mortuary Care 53
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients 54
Morgue Log - COVID-19 Log 56
Chapter 9 Contact Numbers 57
Appendix 64
COVID-19 Test Orders in Electronic Health Records (EHR) 65 IDPH COVID-19 Order 66 Meditech Changes 67 Cerner Changes 68 Athena Changes 69 Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation 70 Personal Protective (PPE) Validation Checklist for PPE Monitor 71 PUI ISOLATION SIGN INOUT SHEET 72 Infection PreventionLeader Rounding Checklist 73
3
Discharge Instructions for Patients with COVID-19 in Spanish 74
[Click on section titles to jump to relevant section]
4
Chapter 1 Screening and Testing
5
Quick Screen IPDH Criteria to Evaluate Patients for COVID-19
Target Population for Evaluation ALL patients who present at an AMITA Emergency Department
AMITA is following the guidance of the Centers for Disease Control and prevention (CDC) for ldquoCriteria to Guide Evaluation of PUI COVID-19rdquo at httpswwwcdcgovcoronavirus2019- nCoVhcpclinical-criteriahtml
Clinical Symptoms Epidemiologic Risks
Fever (ge1000) Cough Shortness of breath Loss of taste or smell
Sore throat
Myalgias (muscle pain) Headache
Chills
OR
Personal history of suspected or laboratory confirmed COVID-19 within the last 14 days
Close contact with a person with suspected or laboratory confirmed COVID-19 within the last 14 days
Lives in assistive living or recently discharged from a nursing homerehab facility known to have clusters of influenza or COVID-19-like illness
IF patient answers YES to ANY Clinical Symptoms or Risk Factors
Patient at risk for COVID-19 like illness Triage patient appropriately
Physicians and APCs should Refer to ldquoTesting Decision Matrixrdquo as outlined by CDC httpswwwcdcgovcoronavirus2019-ncovsymptoms-testingtestinghtml
COVID-19 screening performed NEGATIVE for COVID-like illness Proceed with appointment
Updated 5120 Signature
6
Chapter 2 Personal Protective Equipment (PPE)
7
Guidelines for PPE April 7 2020
Adjustments in these guidelines are subject to changes in standards of care andor supply chain availability
Tier Situation PPE for Patient Care
Activities
Tier 1
GreeterScreenerUniversal Masking
Non PUICOVID‐19 patient Standard precautions + universal masking
(follow isolation precautions if patients are on isolation for something other than COVID)
Tier 2 One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care
PUICOVID‐19 not receiving aerosol generating
procedure (AGP) OR when collecting NP swab
Tier 3 One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care
PUICOVID‐19 receiving aerosol generating
procedure (AGP) AGP = Positive pressure ventilation
(BiPAPCPAP) endotracheal intubation airway suctioning high frequency oscillatory
ventilation tracheostomy chest PT Nebulizer treatment sputum induction bronchoscopy
suctioning +
Centers for Disease Control and Prevention (CDC) httpswwwcdcgovcoronavirus2019‐ncovinfection‐controlcontrol‐recommendationshtml Advent Health (2020) Standard Operating Procedures (SOP) Personal Protective Equipment Guidance for Novel Respiratory Virus COVID‐19
Personal Protective Equipment (PPE) Conservation One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care Adjustments are subject to change with changes in standards of care andor supply chain availability
SUPPLY ITEM WHEN HOW TO RE US E
N95 MASKS
N95 must be covered by a FULL face shield when providing
direct patient care for
Tier 2 and Tier 3 patients
bull When removing the N95
bull Perform hand hygiene
bull Don clean pair of gloves
bull Grasp straps and remove mask without touching the front or inside
bull Place in clean breathable container such as a labeled paper bag
bull Doff gloves and perform hand hygiene
bull Don a face mask as per universal masking protocol
bull If the seal check is performed on the mask and integrity is maintained the mask can be worn multiple times otherwise the mask should be replaced immediately
bull If the N95 becomes damp damaged visibly soiled or hard to breathe through it must be discarded
NOTE N95 should be covered by a clean face mask for aerosolizing procedures and the face mask should be discarded upon exiting the room
FACE SHIELD
bull Must be disinfected inside and outside with hospital‐approved disinfectant wipe after doffing
bull If the hospital approved disinfectant wipe contains bleach bull Allow appropriate dwell time bull Rinse the shield or wipe with a wet paper towel taking care not to get the foam
headband wet bull Dry thoroughly
bull Label face shield and store in a clean location until damaged or unusable
bull Perform hand hygiene before and after contact 8
How To Perform a Particulate Respirator Seal Check Adapted from Epidemic and Pandemic Alert and Response | World Health Organization 2008
Step 1 minus Perform appropriate hand hygiene and don gloves minus Cup the respirator in your hand with the nosepiece at your fingertips allowing the headbands to hang
freely below your hand
Step 2
minus Position the respirator under your chin with the nosepiece up
Step 3
minus Pull the top strap over your head resting it high at the back of your head Pull the bottom strap over your
head and position it around the neck below the ears
Step 4
minus Place fingertips of both hands at the top of the metal nosepiece Mold the nosepiece (USING TWO FINGERS OF
EACH HAND) to the shape of your nose Pinching the nosepiece using one hand may result in less effective respirator performance
Step 5
minus Cover the front of the respirator with both hands being careful not to disturb the position of the respirator
Step 5a Positive seal check minus Exhale sharply A positive pressure inside the respirator = no leakage If leakage adjust the position andor
tension straps Retest the seal Repeat the steps until the respirator is secured properly Step 5b Negative seal check minus Inhale deeply If no leakage negative pressure will make respirator cling to your face minus Leakage will result in loss of negative pressure in the respirator due to air entering through gaps in the seal minus Doff gloves and perform appropriate hand hygiene
9
10
N95 RESPIRATOR PRODUCT UPDATE
In order to ensure protection and prevent a
disruption in product availability AMITA Health is
implementing the use of additional models of N95
respirators
In addition a full face shield must always be used
when wearing any N95 respirator per the AMITA
Health COVID-19 Infection Prevention ndash Acute Care
playbook
More information on COVID-19 playbooks and resources
can be found at
httpswwwamitahealthorgcovid-19-amita
11
AMITA Healthrsquos facilities have previously used the following models of N95s
Brand Model Photo
3M 1860
1860S
1870+
Halyard 46727
46827
AMITA Healthrsquos facilities will begin fit-testing and distributing the following models of N95s
Brand Model Photo
3M 8511
8210
Gerson 2140
For any questions please connect directly with your local Resource Group Operations Manager and
Critical Products Manager
12
Personal Protective Equipment (PPE) Validation Checklist During care of the patient with known or suspected COVID-19
Personal Protective Equipment (PPE) ValidationStaff Training Overview
Purpose
To create a consistent process of monitoring Donning and Doffing of PPE consistent
with CDC recommendations
Refer to Appendix C for the PPE Validation Self-Check Attestation
Refer to Appendix D for the PPE Validation Checklist for Monitor Observing
Expectations
bull Form Overview and Associate actions
Appendix C Personal Protective Equipment (PPE) Validation Self-Check Attestation
o Staff assigned to care for patient suspected or confirmed with COVID-19
o Reviews proper PPE donning and doffing expectations
o Attests that they will report any PPE needs for Ante Room
o Attests that they will report any PPE suspected of malfunctioning o Understands that they may be monitored for proper
donning and doffing
o Signs that they understand the importance of consistent
PPE compliance
o Files completed form in employee file
Appendix D Personal Protective Equipment (PPE) Validation Checklist (for Monitors observing)
Each individual entering patient room if suspected or confirmed COVID-19 will be
monitored for safe donning and doffing practices The assigned PPE Monitor will
OBSERVE and VALIDATE every time
o Proper PPE application
o Proper Date and Room number
o Consistent time entries for EACH time individual enters the room and exits o Assigned PPE Monitor and ALL Caregivers to enter Role Printed Name and
Signature
o Monitor to print name and relationship if visitor
o Forward to charge nurse Infection Control will pick up o Note multiple sheets may be required each day based on individuals entering the
room
o Note MUST remind individuals that doffing may require self-monitoring if Ante Room DOES NOT have a window Do NOT open doors for these doffing observations
o Both the HCP providing care and the monitor will document PPE use and
hand hygiene for both donning and doffing
bull Appendix E PUI Isolation Sign-InOut Sheet
bull Appendix F Infection PreventionLeader Rounding Checklist
13
Important Update Regarding Air Pressure in OrsProcedural Areas
1) All Operating Rooms and procedure rooms (including Cath Lab and IR) need to maintain
a positive pressure relationship to the adjacent areas Altering the airflow in these areas
compromises the sterile environment and puts healthcare workers at greater risk of
exposure
2) NEVER put an N95 mask on a patient Patients should be transported with a procedural
mask
3) Proper room cleaning should be as follows
Terminal clean of an ORprocedure space
a If an aerosol generating procedure was not performed
bull Procedure room may be cleaned immediately
bull Contact EVS and request a COVID-19 terminal clean
b If an aerosol generating procedure was performed
bull Close procedure room and do not allow anyone to enter the space
for 1 hour
bull After one hour has passed contact EVS and request a COVID-19
terminal clean
Reference
American Society of Healthcare Engineering (ASHE)American Hospital Association
(AHA) Facility Guidelines
From the ASHE Website
14
Transporting of PUI or Confirmed COVID 19 patients Within a Health Care Facility
What personal protective equipment (PPE) should be worn by individuals transporting
patients who are confirmed with or under investigation for COVID-19 within a healthcare
facility For example what PPE should be worn when transporting a patient to radiology
for imaging that cannot be performed in the patient room
In general transport and movement of the patient outside of their room should be limited to medically essential purposes If being transported outside of the room such as to radiology healthcare personnel (HCP) in the receiving area should be notified in advance of transporting the patient For transport the patient should wear a facemask to contain secretions and be covered with a clean sheet
If transport personnel must prepare the patient for transport (eg transfer them to the wheelchair or gurney) transport personnel should wear all recommended PPE (gloves a gown respiratory protection that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator or facemaskmdashif a respirator is not availablemdashand eye protection [ie goggles or disposable face shield that covers the front and sides of the face]) This recommendation is needed because these interactions typically involve close often face-to-face contact with the patient in an enclosed space (eg patient room) Once the patient has been transferred to the wheelchair or gurney (and prior to exiting the room) transporters should remove their gown gloves and eye protection and perform hand hygiene
If the patient is wearing a facemask no recommendation for PPE is made typically for HCP transporting patients with a respiratory infection from the patientrsquos room to the destination However given current limitations in knowledge regarding COVID-19 and following the currently cautious approach for risk stratification and monitoring of healthcare personnel caring for patients with COVID-19 use of a facemask by the transporter is recommended for anything more than brief encounters with COVID-19 patients Additional PPE should not be required unless there is an anticipated need to provide medical assistance during transport (eg helping the patient replace a dislodged facemask)
After arrival at their destination receiving personnel (eg in radiology) and the transporter (if assisting with transfer) should perform hand hygiene and wear all recommended PPE If still wearing their original respirator or facemask the transporter should take care to avoid self- contamination when donning the remainder of the recommended PPE This cautious approach will be refined and updated as more information becomes available and as response needs change in the United States
Interim guidance for EMS personnel transporting patients with confirmed or suspected COVID-19 is available here EMS personnel should wear all recommended PPE because they are providing direct medical care and in close contact with the patient for longer periods of time Reference httpswwwcdcgovcoronavirus2019-ncovinfection-controlinfection- prevention-control-faqhtml
15
Chapter 3 Cleaning
16
During this COVID-19 crisis please be aware that you may see a variety of disinfectantswipes for use against COVID-19 The below products are listed on the EPAs website for approved disinfectants against COVID-19 Please be mindful of reviewing the contact time (in minutes) recommended by each manufacturer as it varies per product Products noted for killing C diff spores are noted these products will also disinfectant against COVID-19 Please be mindful that spray disinfectant of any kind should not be sprayed directly on equipment or monitors Spray disinfectant will need to be sprayed on a wiperag before wiping down equipment of any kind to prevent damage andor malfunction
Image of the Product Product Name and number Company Name Contact Time (In Minutes)
Sani-Cloth XLarge 55 Alcohol Q86984
GRAINGER - 9JAJ1 (1) 172H69 (6pk)
Super Sani Large 55 Alcohol
Q55172
GRAINGER - 9RYJ7 (1)
Professional Disposables
International
2 minutes
Sani-Cloth Bleach Germicidal PDI P54072 P25784 P7007P P700RF H58195
U26595
GRAINGER - 16Z989
Professional Disposables
International
4 minutes
kills C Diff spores in 4
minutes
Sani-Cloth AF3 Large Canister P13872
Sani-Cloth AF3 Germicidal Wipes XL
81626514
Professional Disposables
International
Performance Health
3 minutes
SaniPrime (RTU-Wipes)
P25372 P24284 H06182 amp U13195
Professional Disposables
International
1 minute
17
Caviwipe1 XL 65 WipesCanister 13-5150
GRAINGER - 6TWF8 - 13-1150
Caviwipe1 Regular 160 WipesCanister 13-5100
Metrex For the coronavirus this
wipe does in fact need a 3-
minute kill time All other
pathogens require a 1
minute But only the
Coronavirus or in this case the
Adenovirus (most similar) is going to require
the use of 3-minute kill time
Caviwipe Bleach 6X10 90 WipesCanister 13-9100
Metrex 3 minutes
kills C Diff spores in 3
minutes
Cavicide (RTU)
GRAINGER - 3VDJ1 (24oz Bottle) 3VDJ2 (1gal Bottle) 3VDJ3 (25 Gal Bottle) 3VDJ7 (25 Gal
Easy Pour Jug)
Metrex 3 minutes
Clorox Healthcarereg Bleach Germicidal Wipes Office Depot 439675 1630225 265701
825962 8373413 764946 129202 8193323 8193614 8193080
Medline CLO30358H CLO35309 CLO31424Z
CLO31424 CLO30577H CLO30577
GRAINGER 1XEZ3 4XKR8 4XKR7 6VDE9
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
kills C diff spores
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
3
Discharge Instructions for Patients with COVID-19 in Spanish 74
[Click on section titles to jump to relevant section]
4
Chapter 1 Screening and Testing
5
Quick Screen IPDH Criteria to Evaluate Patients for COVID-19
Target Population for Evaluation ALL patients who present at an AMITA Emergency Department
AMITA is following the guidance of the Centers for Disease Control and prevention (CDC) for ldquoCriteria to Guide Evaluation of PUI COVID-19rdquo at httpswwwcdcgovcoronavirus2019- nCoVhcpclinical-criteriahtml
Clinical Symptoms Epidemiologic Risks
Fever (ge1000) Cough Shortness of breath Loss of taste or smell
Sore throat
Myalgias (muscle pain) Headache
Chills
OR
Personal history of suspected or laboratory confirmed COVID-19 within the last 14 days
Close contact with a person with suspected or laboratory confirmed COVID-19 within the last 14 days
Lives in assistive living or recently discharged from a nursing homerehab facility known to have clusters of influenza or COVID-19-like illness
IF patient answers YES to ANY Clinical Symptoms or Risk Factors
Patient at risk for COVID-19 like illness Triage patient appropriately
Physicians and APCs should Refer to ldquoTesting Decision Matrixrdquo as outlined by CDC httpswwwcdcgovcoronavirus2019-ncovsymptoms-testingtestinghtml
COVID-19 screening performed NEGATIVE for COVID-like illness Proceed with appointment
Updated 5120 Signature
6
Chapter 2 Personal Protective Equipment (PPE)
7
Guidelines for PPE April 7 2020
Adjustments in these guidelines are subject to changes in standards of care andor supply chain availability
Tier Situation PPE for Patient Care
Activities
Tier 1
GreeterScreenerUniversal Masking
Non PUICOVID‐19 patient Standard precautions + universal masking
(follow isolation precautions if patients are on isolation for something other than COVID)
Tier 2 One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care
PUICOVID‐19 not receiving aerosol generating
procedure (AGP) OR when collecting NP swab
Tier 3 One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care
PUICOVID‐19 receiving aerosol generating
procedure (AGP) AGP = Positive pressure ventilation
(BiPAPCPAP) endotracheal intubation airway suctioning high frequency oscillatory
ventilation tracheostomy chest PT Nebulizer treatment sputum induction bronchoscopy
suctioning +
Centers for Disease Control and Prevention (CDC) httpswwwcdcgovcoronavirus2019‐ncovinfection‐controlcontrol‐recommendationshtml Advent Health (2020) Standard Operating Procedures (SOP) Personal Protective Equipment Guidance for Novel Respiratory Virus COVID‐19
Personal Protective Equipment (PPE) Conservation One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care Adjustments are subject to change with changes in standards of care andor supply chain availability
SUPPLY ITEM WHEN HOW TO RE US E
N95 MASKS
N95 must be covered by a FULL face shield when providing
direct patient care for
Tier 2 and Tier 3 patients
bull When removing the N95
bull Perform hand hygiene
bull Don clean pair of gloves
bull Grasp straps and remove mask without touching the front or inside
bull Place in clean breathable container such as a labeled paper bag
bull Doff gloves and perform hand hygiene
bull Don a face mask as per universal masking protocol
bull If the seal check is performed on the mask and integrity is maintained the mask can be worn multiple times otherwise the mask should be replaced immediately
bull If the N95 becomes damp damaged visibly soiled or hard to breathe through it must be discarded
NOTE N95 should be covered by a clean face mask for aerosolizing procedures and the face mask should be discarded upon exiting the room
FACE SHIELD
bull Must be disinfected inside and outside with hospital‐approved disinfectant wipe after doffing
bull If the hospital approved disinfectant wipe contains bleach bull Allow appropriate dwell time bull Rinse the shield or wipe with a wet paper towel taking care not to get the foam
headband wet bull Dry thoroughly
bull Label face shield and store in a clean location until damaged or unusable
bull Perform hand hygiene before and after contact 8
How To Perform a Particulate Respirator Seal Check Adapted from Epidemic and Pandemic Alert and Response | World Health Organization 2008
Step 1 minus Perform appropriate hand hygiene and don gloves minus Cup the respirator in your hand with the nosepiece at your fingertips allowing the headbands to hang
freely below your hand
Step 2
minus Position the respirator under your chin with the nosepiece up
Step 3
minus Pull the top strap over your head resting it high at the back of your head Pull the bottom strap over your
head and position it around the neck below the ears
Step 4
minus Place fingertips of both hands at the top of the metal nosepiece Mold the nosepiece (USING TWO FINGERS OF
EACH HAND) to the shape of your nose Pinching the nosepiece using one hand may result in less effective respirator performance
Step 5
minus Cover the front of the respirator with both hands being careful not to disturb the position of the respirator
Step 5a Positive seal check minus Exhale sharply A positive pressure inside the respirator = no leakage If leakage adjust the position andor
tension straps Retest the seal Repeat the steps until the respirator is secured properly Step 5b Negative seal check minus Inhale deeply If no leakage negative pressure will make respirator cling to your face minus Leakage will result in loss of negative pressure in the respirator due to air entering through gaps in the seal minus Doff gloves and perform appropriate hand hygiene
9
10
N95 RESPIRATOR PRODUCT UPDATE
In order to ensure protection and prevent a
disruption in product availability AMITA Health is
implementing the use of additional models of N95
respirators
In addition a full face shield must always be used
when wearing any N95 respirator per the AMITA
Health COVID-19 Infection Prevention ndash Acute Care
playbook
More information on COVID-19 playbooks and resources
can be found at
httpswwwamitahealthorgcovid-19-amita
11
AMITA Healthrsquos facilities have previously used the following models of N95s
Brand Model Photo
3M 1860
1860S
1870+
Halyard 46727
46827
AMITA Healthrsquos facilities will begin fit-testing and distributing the following models of N95s
Brand Model Photo
3M 8511
8210
Gerson 2140
For any questions please connect directly with your local Resource Group Operations Manager and
Critical Products Manager
12
Personal Protective Equipment (PPE) Validation Checklist During care of the patient with known or suspected COVID-19
Personal Protective Equipment (PPE) ValidationStaff Training Overview
Purpose
To create a consistent process of monitoring Donning and Doffing of PPE consistent
with CDC recommendations
Refer to Appendix C for the PPE Validation Self-Check Attestation
Refer to Appendix D for the PPE Validation Checklist for Monitor Observing
Expectations
bull Form Overview and Associate actions
Appendix C Personal Protective Equipment (PPE) Validation Self-Check Attestation
o Staff assigned to care for patient suspected or confirmed with COVID-19
o Reviews proper PPE donning and doffing expectations
o Attests that they will report any PPE needs for Ante Room
o Attests that they will report any PPE suspected of malfunctioning o Understands that they may be monitored for proper
donning and doffing
o Signs that they understand the importance of consistent
PPE compliance
o Files completed form in employee file
Appendix D Personal Protective Equipment (PPE) Validation Checklist (for Monitors observing)
Each individual entering patient room if suspected or confirmed COVID-19 will be
monitored for safe donning and doffing practices The assigned PPE Monitor will
OBSERVE and VALIDATE every time
o Proper PPE application
o Proper Date and Room number
o Consistent time entries for EACH time individual enters the room and exits o Assigned PPE Monitor and ALL Caregivers to enter Role Printed Name and
Signature
o Monitor to print name and relationship if visitor
o Forward to charge nurse Infection Control will pick up o Note multiple sheets may be required each day based on individuals entering the
room
o Note MUST remind individuals that doffing may require self-monitoring if Ante Room DOES NOT have a window Do NOT open doors for these doffing observations
o Both the HCP providing care and the monitor will document PPE use and
hand hygiene for both donning and doffing
bull Appendix E PUI Isolation Sign-InOut Sheet
bull Appendix F Infection PreventionLeader Rounding Checklist
13
Important Update Regarding Air Pressure in OrsProcedural Areas
1) All Operating Rooms and procedure rooms (including Cath Lab and IR) need to maintain
a positive pressure relationship to the adjacent areas Altering the airflow in these areas
compromises the sterile environment and puts healthcare workers at greater risk of
exposure
2) NEVER put an N95 mask on a patient Patients should be transported with a procedural
mask
3) Proper room cleaning should be as follows
Terminal clean of an ORprocedure space
a If an aerosol generating procedure was not performed
bull Procedure room may be cleaned immediately
bull Contact EVS and request a COVID-19 terminal clean
b If an aerosol generating procedure was performed
bull Close procedure room and do not allow anyone to enter the space
for 1 hour
bull After one hour has passed contact EVS and request a COVID-19
terminal clean
Reference
American Society of Healthcare Engineering (ASHE)American Hospital Association
(AHA) Facility Guidelines
From the ASHE Website
14
Transporting of PUI or Confirmed COVID 19 patients Within a Health Care Facility
What personal protective equipment (PPE) should be worn by individuals transporting
patients who are confirmed with or under investigation for COVID-19 within a healthcare
facility For example what PPE should be worn when transporting a patient to radiology
for imaging that cannot be performed in the patient room
In general transport and movement of the patient outside of their room should be limited to medically essential purposes If being transported outside of the room such as to radiology healthcare personnel (HCP) in the receiving area should be notified in advance of transporting the patient For transport the patient should wear a facemask to contain secretions and be covered with a clean sheet
If transport personnel must prepare the patient for transport (eg transfer them to the wheelchair or gurney) transport personnel should wear all recommended PPE (gloves a gown respiratory protection that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator or facemaskmdashif a respirator is not availablemdashand eye protection [ie goggles or disposable face shield that covers the front and sides of the face]) This recommendation is needed because these interactions typically involve close often face-to-face contact with the patient in an enclosed space (eg patient room) Once the patient has been transferred to the wheelchair or gurney (and prior to exiting the room) transporters should remove their gown gloves and eye protection and perform hand hygiene
If the patient is wearing a facemask no recommendation for PPE is made typically for HCP transporting patients with a respiratory infection from the patientrsquos room to the destination However given current limitations in knowledge regarding COVID-19 and following the currently cautious approach for risk stratification and monitoring of healthcare personnel caring for patients with COVID-19 use of a facemask by the transporter is recommended for anything more than brief encounters with COVID-19 patients Additional PPE should not be required unless there is an anticipated need to provide medical assistance during transport (eg helping the patient replace a dislodged facemask)
After arrival at their destination receiving personnel (eg in radiology) and the transporter (if assisting with transfer) should perform hand hygiene and wear all recommended PPE If still wearing their original respirator or facemask the transporter should take care to avoid self- contamination when donning the remainder of the recommended PPE This cautious approach will be refined and updated as more information becomes available and as response needs change in the United States
Interim guidance for EMS personnel transporting patients with confirmed or suspected COVID-19 is available here EMS personnel should wear all recommended PPE because they are providing direct medical care and in close contact with the patient for longer periods of time Reference httpswwwcdcgovcoronavirus2019-ncovinfection-controlinfection- prevention-control-faqhtml
15
Chapter 3 Cleaning
16
During this COVID-19 crisis please be aware that you may see a variety of disinfectantswipes for use against COVID-19 The below products are listed on the EPAs website for approved disinfectants against COVID-19 Please be mindful of reviewing the contact time (in minutes) recommended by each manufacturer as it varies per product Products noted for killing C diff spores are noted these products will also disinfectant against COVID-19 Please be mindful that spray disinfectant of any kind should not be sprayed directly on equipment or monitors Spray disinfectant will need to be sprayed on a wiperag before wiping down equipment of any kind to prevent damage andor malfunction
Image of the Product Product Name and number Company Name Contact Time (In Minutes)
Sani-Cloth XLarge 55 Alcohol Q86984
GRAINGER - 9JAJ1 (1) 172H69 (6pk)
Super Sani Large 55 Alcohol
Q55172
GRAINGER - 9RYJ7 (1)
Professional Disposables
International
2 minutes
Sani-Cloth Bleach Germicidal PDI P54072 P25784 P7007P P700RF H58195
U26595
GRAINGER - 16Z989
Professional Disposables
International
4 minutes
kills C Diff spores in 4
minutes
Sani-Cloth AF3 Large Canister P13872
Sani-Cloth AF3 Germicidal Wipes XL
81626514
Professional Disposables
International
Performance Health
3 minutes
SaniPrime (RTU-Wipes)
P25372 P24284 H06182 amp U13195
Professional Disposables
International
1 minute
17
Caviwipe1 XL 65 WipesCanister 13-5150
GRAINGER - 6TWF8 - 13-1150
Caviwipe1 Regular 160 WipesCanister 13-5100
Metrex For the coronavirus this
wipe does in fact need a 3-
minute kill time All other
pathogens require a 1
minute But only the
Coronavirus or in this case the
Adenovirus (most similar) is going to require
the use of 3-minute kill time
Caviwipe Bleach 6X10 90 WipesCanister 13-9100
Metrex 3 minutes
kills C Diff spores in 3
minutes
Cavicide (RTU)
GRAINGER - 3VDJ1 (24oz Bottle) 3VDJ2 (1gal Bottle) 3VDJ3 (25 Gal Bottle) 3VDJ7 (25 Gal
Easy Pour Jug)
Metrex 3 minutes
Clorox Healthcarereg Bleach Germicidal Wipes Office Depot 439675 1630225 265701
825962 8373413 764946 129202 8193323 8193614 8193080
Medline CLO30358H CLO35309 CLO31424Z
CLO31424 CLO30577H CLO30577
GRAINGER 1XEZ3 4XKR8 4XKR7 6VDE9
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
kills C diff spores
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
4
Chapter 1 Screening and Testing
5
Quick Screen IPDH Criteria to Evaluate Patients for COVID-19
Target Population for Evaluation ALL patients who present at an AMITA Emergency Department
AMITA is following the guidance of the Centers for Disease Control and prevention (CDC) for ldquoCriteria to Guide Evaluation of PUI COVID-19rdquo at httpswwwcdcgovcoronavirus2019- nCoVhcpclinical-criteriahtml
Clinical Symptoms Epidemiologic Risks
Fever (ge1000) Cough Shortness of breath Loss of taste or smell
Sore throat
Myalgias (muscle pain) Headache
Chills
OR
Personal history of suspected or laboratory confirmed COVID-19 within the last 14 days
Close contact with a person with suspected or laboratory confirmed COVID-19 within the last 14 days
Lives in assistive living or recently discharged from a nursing homerehab facility known to have clusters of influenza or COVID-19-like illness
IF patient answers YES to ANY Clinical Symptoms or Risk Factors
Patient at risk for COVID-19 like illness Triage patient appropriately
Physicians and APCs should Refer to ldquoTesting Decision Matrixrdquo as outlined by CDC httpswwwcdcgovcoronavirus2019-ncovsymptoms-testingtestinghtml
COVID-19 screening performed NEGATIVE for COVID-like illness Proceed with appointment
Updated 5120 Signature
6
Chapter 2 Personal Protective Equipment (PPE)
7
Guidelines for PPE April 7 2020
Adjustments in these guidelines are subject to changes in standards of care andor supply chain availability
Tier Situation PPE for Patient Care
Activities
Tier 1
GreeterScreenerUniversal Masking
Non PUICOVID‐19 patient Standard precautions + universal masking
(follow isolation precautions if patients are on isolation for something other than COVID)
Tier 2 One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care
PUICOVID‐19 not receiving aerosol generating
procedure (AGP) OR when collecting NP swab
Tier 3 One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care
PUICOVID‐19 receiving aerosol generating
procedure (AGP) AGP = Positive pressure ventilation
(BiPAPCPAP) endotracheal intubation airway suctioning high frequency oscillatory
ventilation tracheostomy chest PT Nebulizer treatment sputum induction bronchoscopy
suctioning +
Centers for Disease Control and Prevention (CDC) httpswwwcdcgovcoronavirus2019‐ncovinfection‐controlcontrol‐recommendationshtml Advent Health (2020) Standard Operating Procedures (SOP) Personal Protective Equipment Guidance for Novel Respiratory Virus COVID‐19
Personal Protective Equipment (PPE) Conservation One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care Adjustments are subject to change with changes in standards of care andor supply chain availability
SUPPLY ITEM WHEN HOW TO RE US E
N95 MASKS
N95 must be covered by a FULL face shield when providing
direct patient care for
Tier 2 and Tier 3 patients
bull When removing the N95
bull Perform hand hygiene
bull Don clean pair of gloves
bull Grasp straps and remove mask without touching the front or inside
bull Place in clean breathable container such as a labeled paper bag
bull Doff gloves and perform hand hygiene
bull Don a face mask as per universal masking protocol
bull If the seal check is performed on the mask and integrity is maintained the mask can be worn multiple times otherwise the mask should be replaced immediately
bull If the N95 becomes damp damaged visibly soiled or hard to breathe through it must be discarded
NOTE N95 should be covered by a clean face mask for aerosolizing procedures and the face mask should be discarded upon exiting the room
FACE SHIELD
bull Must be disinfected inside and outside with hospital‐approved disinfectant wipe after doffing
bull If the hospital approved disinfectant wipe contains bleach bull Allow appropriate dwell time bull Rinse the shield or wipe with a wet paper towel taking care not to get the foam
headband wet bull Dry thoroughly
bull Label face shield and store in a clean location until damaged or unusable
bull Perform hand hygiene before and after contact 8
How To Perform a Particulate Respirator Seal Check Adapted from Epidemic and Pandemic Alert and Response | World Health Organization 2008
Step 1 minus Perform appropriate hand hygiene and don gloves minus Cup the respirator in your hand with the nosepiece at your fingertips allowing the headbands to hang
freely below your hand
Step 2
minus Position the respirator under your chin with the nosepiece up
Step 3
minus Pull the top strap over your head resting it high at the back of your head Pull the bottom strap over your
head and position it around the neck below the ears
Step 4
minus Place fingertips of both hands at the top of the metal nosepiece Mold the nosepiece (USING TWO FINGERS OF
EACH HAND) to the shape of your nose Pinching the nosepiece using one hand may result in less effective respirator performance
Step 5
minus Cover the front of the respirator with both hands being careful not to disturb the position of the respirator
Step 5a Positive seal check minus Exhale sharply A positive pressure inside the respirator = no leakage If leakage adjust the position andor
tension straps Retest the seal Repeat the steps until the respirator is secured properly Step 5b Negative seal check minus Inhale deeply If no leakage negative pressure will make respirator cling to your face minus Leakage will result in loss of negative pressure in the respirator due to air entering through gaps in the seal minus Doff gloves and perform appropriate hand hygiene
9
10
N95 RESPIRATOR PRODUCT UPDATE
In order to ensure protection and prevent a
disruption in product availability AMITA Health is
implementing the use of additional models of N95
respirators
In addition a full face shield must always be used
when wearing any N95 respirator per the AMITA
Health COVID-19 Infection Prevention ndash Acute Care
playbook
More information on COVID-19 playbooks and resources
can be found at
httpswwwamitahealthorgcovid-19-amita
11
AMITA Healthrsquos facilities have previously used the following models of N95s
Brand Model Photo
3M 1860
1860S
1870+
Halyard 46727
46827
AMITA Healthrsquos facilities will begin fit-testing and distributing the following models of N95s
Brand Model Photo
3M 8511
8210
Gerson 2140
For any questions please connect directly with your local Resource Group Operations Manager and
Critical Products Manager
12
Personal Protective Equipment (PPE) Validation Checklist During care of the patient with known or suspected COVID-19
Personal Protective Equipment (PPE) ValidationStaff Training Overview
Purpose
To create a consistent process of monitoring Donning and Doffing of PPE consistent
with CDC recommendations
Refer to Appendix C for the PPE Validation Self-Check Attestation
Refer to Appendix D for the PPE Validation Checklist for Monitor Observing
Expectations
bull Form Overview and Associate actions
Appendix C Personal Protective Equipment (PPE) Validation Self-Check Attestation
o Staff assigned to care for patient suspected or confirmed with COVID-19
o Reviews proper PPE donning and doffing expectations
o Attests that they will report any PPE needs for Ante Room
o Attests that they will report any PPE suspected of malfunctioning o Understands that they may be monitored for proper
donning and doffing
o Signs that they understand the importance of consistent
PPE compliance
o Files completed form in employee file
Appendix D Personal Protective Equipment (PPE) Validation Checklist (for Monitors observing)
Each individual entering patient room if suspected or confirmed COVID-19 will be
monitored for safe donning and doffing practices The assigned PPE Monitor will
OBSERVE and VALIDATE every time
o Proper PPE application
o Proper Date and Room number
o Consistent time entries for EACH time individual enters the room and exits o Assigned PPE Monitor and ALL Caregivers to enter Role Printed Name and
Signature
o Monitor to print name and relationship if visitor
o Forward to charge nurse Infection Control will pick up o Note multiple sheets may be required each day based on individuals entering the
room
o Note MUST remind individuals that doffing may require self-monitoring if Ante Room DOES NOT have a window Do NOT open doors for these doffing observations
o Both the HCP providing care and the monitor will document PPE use and
hand hygiene for both donning and doffing
bull Appendix E PUI Isolation Sign-InOut Sheet
bull Appendix F Infection PreventionLeader Rounding Checklist
13
Important Update Regarding Air Pressure in OrsProcedural Areas
1) All Operating Rooms and procedure rooms (including Cath Lab and IR) need to maintain
a positive pressure relationship to the adjacent areas Altering the airflow in these areas
compromises the sterile environment and puts healthcare workers at greater risk of
exposure
2) NEVER put an N95 mask on a patient Patients should be transported with a procedural
mask
3) Proper room cleaning should be as follows
Terminal clean of an ORprocedure space
a If an aerosol generating procedure was not performed
bull Procedure room may be cleaned immediately
bull Contact EVS and request a COVID-19 terminal clean
b If an aerosol generating procedure was performed
bull Close procedure room and do not allow anyone to enter the space
for 1 hour
bull After one hour has passed contact EVS and request a COVID-19
terminal clean
Reference
American Society of Healthcare Engineering (ASHE)American Hospital Association
(AHA) Facility Guidelines
From the ASHE Website
14
Transporting of PUI or Confirmed COVID 19 patients Within a Health Care Facility
What personal protective equipment (PPE) should be worn by individuals transporting
patients who are confirmed with or under investigation for COVID-19 within a healthcare
facility For example what PPE should be worn when transporting a patient to radiology
for imaging that cannot be performed in the patient room
In general transport and movement of the patient outside of their room should be limited to medically essential purposes If being transported outside of the room such as to radiology healthcare personnel (HCP) in the receiving area should be notified in advance of transporting the patient For transport the patient should wear a facemask to contain secretions and be covered with a clean sheet
If transport personnel must prepare the patient for transport (eg transfer them to the wheelchair or gurney) transport personnel should wear all recommended PPE (gloves a gown respiratory protection that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator or facemaskmdashif a respirator is not availablemdashand eye protection [ie goggles or disposable face shield that covers the front and sides of the face]) This recommendation is needed because these interactions typically involve close often face-to-face contact with the patient in an enclosed space (eg patient room) Once the patient has been transferred to the wheelchair or gurney (and prior to exiting the room) transporters should remove their gown gloves and eye protection and perform hand hygiene
If the patient is wearing a facemask no recommendation for PPE is made typically for HCP transporting patients with a respiratory infection from the patientrsquos room to the destination However given current limitations in knowledge regarding COVID-19 and following the currently cautious approach for risk stratification and monitoring of healthcare personnel caring for patients with COVID-19 use of a facemask by the transporter is recommended for anything more than brief encounters with COVID-19 patients Additional PPE should not be required unless there is an anticipated need to provide medical assistance during transport (eg helping the patient replace a dislodged facemask)
After arrival at their destination receiving personnel (eg in radiology) and the transporter (if assisting with transfer) should perform hand hygiene and wear all recommended PPE If still wearing their original respirator or facemask the transporter should take care to avoid self- contamination when donning the remainder of the recommended PPE This cautious approach will be refined and updated as more information becomes available and as response needs change in the United States
Interim guidance for EMS personnel transporting patients with confirmed or suspected COVID-19 is available here EMS personnel should wear all recommended PPE because they are providing direct medical care and in close contact with the patient for longer periods of time Reference httpswwwcdcgovcoronavirus2019-ncovinfection-controlinfection- prevention-control-faqhtml
15
Chapter 3 Cleaning
16
During this COVID-19 crisis please be aware that you may see a variety of disinfectantswipes for use against COVID-19 The below products are listed on the EPAs website for approved disinfectants against COVID-19 Please be mindful of reviewing the contact time (in minutes) recommended by each manufacturer as it varies per product Products noted for killing C diff spores are noted these products will also disinfectant against COVID-19 Please be mindful that spray disinfectant of any kind should not be sprayed directly on equipment or monitors Spray disinfectant will need to be sprayed on a wiperag before wiping down equipment of any kind to prevent damage andor malfunction
Image of the Product Product Name and number Company Name Contact Time (In Minutes)
Sani-Cloth XLarge 55 Alcohol Q86984
GRAINGER - 9JAJ1 (1) 172H69 (6pk)
Super Sani Large 55 Alcohol
Q55172
GRAINGER - 9RYJ7 (1)
Professional Disposables
International
2 minutes
Sani-Cloth Bleach Germicidal PDI P54072 P25784 P7007P P700RF H58195
U26595
GRAINGER - 16Z989
Professional Disposables
International
4 minutes
kills C Diff spores in 4
minutes
Sani-Cloth AF3 Large Canister P13872
Sani-Cloth AF3 Germicidal Wipes XL
81626514
Professional Disposables
International
Performance Health
3 minutes
SaniPrime (RTU-Wipes)
P25372 P24284 H06182 amp U13195
Professional Disposables
International
1 minute
17
Caviwipe1 XL 65 WipesCanister 13-5150
GRAINGER - 6TWF8 - 13-1150
Caviwipe1 Regular 160 WipesCanister 13-5100
Metrex For the coronavirus this
wipe does in fact need a 3-
minute kill time All other
pathogens require a 1
minute But only the
Coronavirus or in this case the
Adenovirus (most similar) is going to require
the use of 3-minute kill time
Caviwipe Bleach 6X10 90 WipesCanister 13-9100
Metrex 3 minutes
kills C Diff spores in 3
minutes
Cavicide (RTU)
GRAINGER - 3VDJ1 (24oz Bottle) 3VDJ2 (1gal Bottle) 3VDJ3 (25 Gal Bottle) 3VDJ7 (25 Gal
Easy Pour Jug)
Metrex 3 minutes
Clorox Healthcarereg Bleach Germicidal Wipes Office Depot 439675 1630225 265701
825962 8373413 764946 129202 8193323 8193614 8193080
Medline CLO30358H CLO35309 CLO31424Z
CLO31424 CLO30577H CLO30577
GRAINGER 1XEZ3 4XKR8 4XKR7 6VDE9
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
kills C diff spores
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
5
Quick Screen IPDH Criteria to Evaluate Patients for COVID-19
Target Population for Evaluation ALL patients who present at an AMITA Emergency Department
AMITA is following the guidance of the Centers for Disease Control and prevention (CDC) for ldquoCriteria to Guide Evaluation of PUI COVID-19rdquo at httpswwwcdcgovcoronavirus2019- nCoVhcpclinical-criteriahtml
Clinical Symptoms Epidemiologic Risks
Fever (ge1000) Cough Shortness of breath Loss of taste or smell
Sore throat
Myalgias (muscle pain) Headache
Chills
OR
Personal history of suspected or laboratory confirmed COVID-19 within the last 14 days
Close contact with a person with suspected or laboratory confirmed COVID-19 within the last 14 days
Lives in assistive living or recently discharged from a nursing homerehab facility known to have clusters of influenza or COVID-19-like illness
IF patient answers YES to ANY Clinical Symptoms or Risk Factors
Patient at risk for COVID-19 like illness Triage patient appropriately
Physicians and APCs should Refer to ldquoTesting Decision Matrixrdquo as outlined by CDC httpswwwcdcgovcoronavirus2019-ncovsymptoms-testingtestinghtml
COVID-19 screening performed NEGATIVE for COVID-like illness Proceed with appointment
Updated 5120 Signature
6
Chapter 2 Personal Protective Equipment (PPE)
7
Guidelines for PPE April 7 2020
Adjustments in these guidelines are subject to changes in standards of care andor supply chain availability
Tier Situation PPE for Patient Care
Activities
Tier 1
GreeterScreenerUniversal Masking
Non PUICOVID‐19 patient Standard precautions + universal masking
(follow isolation precautions if patients are on isolation for something other than COVID)
Tier 2 One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care
PUICOVID‐19 not receiving aerosol generating
procedure (AGP) OR when collecting NP swab
Tier 3 One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care
PUICOVID‐19 receiving aerosol generating
procedure (AGP) AGP = Positive pressure ventilation
(BiPAPCPAP) endotracheal intubation airway suctioning high frequency oscillatory
ventilation tracheostomy chest PT Nebulizer treatment sputum induction bronchoscopy
suctioning +
Centers for Disease Control and Prevention (CDC) httpswwwcdcgovcoronavirus2019‐ncovinfection‐controlcontrol‐recommendationshtml Advent Health (2020) Standard Operating Procedures (SOP) Personal Protective Equipment Guidance for Novel Respiratory Virus COVID‐19
Personal Protective Equipment (PPE) Conservation One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care Adjustments are subject to change with changes in standards of care andor supply chain availability
SUPPLY ITEM WHEN HOW TO RE US E
N95 MASKS
N95 must be covered by a FULL face shield when providing
direct patient care for
Tier 2 and Tier 3 patients
bull When removing the N95
bull Perform hand hygiene
bull Don clean pair of gloves
bull Grasp straps and remove mask without touching the front or inside
bull Place in clean breathable container such as a labeled paper bag
bull Doff gloves and perform hand hygiene
bull Don a face mask as per universal masking protocol
bull If the seal check is performed on the mask and integrity is maintained the mask can be worn multiple times otherwise the mask should be replaced immediately
bull If the N95 becomes damp damaged visibly soiled or hard to breathe through it must be discarded
NOTE N95 should be covered by a clean face mask for aerosolizing procedures and the face mask should be discarded upon exiting the room
FACE SHIELD
bull Must be disinfected inside and outside with hospital‐approved disinfectant wipe after doffing
bull If the hospital approved disinfectant wipe contains bleach bull Allow appropriate dwell time bull Rinse the shield or wipe with a wet paper towel taking care not to get the foam
headband wet bull Dry thoroughly
bull Label face shield and store in a clean location until damaged or unusable
bull Perform hand hygiene before and after contact 8
How To Perform a Particulate Respirator Seal Check Adapted from Epidemic and Pandemic Alert and Response | World Health Organization 2008
Step 1 minus Perform appropriate hand hygiene and don gloves minus Cup the respirator in your hand with the nosepiece at your fingertips allowing the headbands to hang
freely below your hand
Step 2
minus Position the respirator under your chin with the nosepiece up
Step 3
minus Pull the top strap over your head resting it high at the back of your head Pull the bottom strap over your
head and position it around the neck below the ears
Step 4
minus Place fingertips of both hands at the top of the metal nosepiece Mold the nosepiece (USING TWO FINGERS OF
EACH HAND) to the shape of your nose Pinching the nosepiece using one hand may result in less effective respirator performance
Step 5
minus Cover the front of the respirator with both hands being careful not to disturb the position of the respirator
Step 5a Positive seal check minus Exhale sharply A positive pressure inside the respirator = no leakage If leakage adjust the position andor
tension straps Retest the seal Repeat the steps until the respirator is secured properly Step 5b Negative seal check minus Inhale deeply If no leakage negative pressure will make respirator cling to your face minus Leakage will result in loss of negative pressure in the respirator due to air entering through gaps in the seal minus Doff gloves and perform appropriate hand hygiene
9
10
N95 RESPIRATOR PRODUCT UPDATE
In order to ensure protection and prevent a
disruption in product availability AMITA Health is
implementing the use of additional models of N95
respirators
In addition a full face shield must always be used
when wearing any N95 respirator per the AMITA
Health COVID-19 Infection Prevention ndash Acute Care
playbook
More information on COVID-19 playbooks and resources
can be found at
httpswwwamitahealthorgcovid-19-amita
11
AMITA Healthrsquos facilities have previously used the following models of N95s
Brand Model Photo
3M 1860
1860S
1870+
Halyard 46727
46827
AMITA Healthrsquos facilities will begin fit-testing and distributing the following models of N95s
Brand Model Photo
3M 8511
8210
Gerson 2140
For any questions please connect directly with your local Resource Group Operations Manager and
Critical Products Manager
12
Personal Protective Equipment (PPE) Validation Checklist During care of the patient with known or suspected COVID-19
Personal Protective Equipment (PPE) ValidationStaff Training Overview
Purpose
To create a consistent process of monitoring Donning and Doffing of PPE consistent
with CDC recommendations
Refer to Appendix C for the PPE Validation Self-Check Attestation
Refer to Appendix D for the PPE Validation Checklist for Monitor Observing
Expectations
bull Form Overview and Associate actions
Appendix C Personal Protective Equipment (PPE) Validation Self-Check Attestation
o Staff assigned to care for patient suspected or confirmed with COVID-19
o Reviews proper PPE donning and doffing expectations
o Attests that they will report any PPE needs for Ante Room
o Attests that they will report any PPE suspected of malfunctioning o Understands that they may be monitored for proper
donning and doffing
o Signs that they understand the importance of consistent
PPE compliance
o Files completed form in employee file
Appendix D Personal Protective Equipment (PPE) Validation Checklist (for Monitors observing)
Each individual entering patient room if suspected or confirmed COVID-19 will be
monitored for safe donning and doffing practices The assigned PPE Monitor will
OBSERVE and VALIDATE every time
o Proper PPE application
o Proper Date and Room number
o Consistent time entries for EACH time individual enters the room and exits o Assigned PPE Monitor and ALL Caregivers to enter Role Printed Name and
Signature
o Monitor to print name and relationship if visitor
o Forward to charge nurse Infection Control will pick up o Note multiple sheets may be required each day based on individuals entering the
room
o Note MUST remind individuals that doffing may require self-monitoring if Ante Room DOES NOT have a window Do NOT open doors for these doffing observations
o Both the HCP providing care and the monitor will document PPE use and
hand hygiene for both donning and doffing
bull Appendix E PUI Isolation Sign-InOut Sheet
bull Appendix F Infection PreventionLeader Rounding Checklist
13
Important Update Regarding Air Pressure in OrsProcedural Areas
1) All Operating Rooms and procedure rooms (including Cath Lab and IR) need to maintain
a positive pressure relationship to the adjacent areas Altering the airflow in these areas
compromises the sterile environment and puts healthcare workers at greater risk of
exposure
2) NEVER put an N95 mask on a patient Patients should be transported with a procedural
mask
3) Proper room cleaning should be as follows
Terminal clean of an ORprocedure space
a If an aerosol generating procedure was not performed
bull Procedure room may be cleaned immediately
bull Contact EVS and request a COVID-19 terminal clean
b If an aerosol generating procedure was performed
bull Close procedure room and do not allow anyone to enter the space
for 1 hour
bull After one hour has passed contact EVS and request a COVID-19
terminal clean
Reference
American Society of Healthcare Engineering (ASHE)American Hospital Association
(AHA) Facility Guidelines
From the ASHE Website
14
Transporting of PUI or Confirmed COVID 19 patients Within a Health Care Facility
What personal protective equipment (PPE) should be worn by individuals transporting
patients who are confirmed with or under investigation for COVID-19 within a healthcare
facility For example what PPE should be worn when transporting a patient to radiology
for imaging that cannot be performed in the patient room
In general transport and movement of the patient outside of their room should be limited to medically essential purposes If being transported outside of the room such as to radiology healthcare personnel (HCP) in the receiving area should be notified in advance of transporting the patient For transport the patient should wear a facemask to contain secretions and be covered with a clean sheet
If transport personnel must prepare the patient for transport (eg transfer them to the wheelchair or gurney) transport personnel should wear all recommended PPE (gloves a gown respiratory protection that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator or facemaskmdashif a respirator is not availablemdashand eye protection [ie goggles or disposable face shield that covers the front and sides of the face]) This recommendation is needed because these interactions typically involve close often face-to-face contact with the patient in an enclosed space (eg patient room) Once the patient has been transferred to the wheelchair or gurney (and prior to exiting the room) transporters should remove their gown gloves and eye protection and perform hand hygiene
If the patient is wearing a facemask no recommendation for PPE is made typically for HCP transporting patients with a respiratory infection from the patientrsquos room to the destination However given current limitations in knowledge regarding COVID-19 and following the currently cautious approach for risk stratification and monitoring of healthcare personnel caring for patients with COVID-19 use of a facemask by the transporter is recommended for anything more than brief encounters with COVID-19 patients Additional PPE should not be required unless there is an anticipated need to provide medical assistance during transport (eg helping the patient replace a dislodged facemask)
After arrival at their destination receiving personnel (eg in radiology) and the transporter (if assisting with transfer) should perform hand hygiene and wear all recommended PPE If still wearing their original respirator or facemask the transporter should take care to avoid self- contamination when donning the remainder of the recommended PPE This cautious approach will be refined and updated as more information becomes available and as response needs change in the United States
Interim guidance for EMS personnel transporting patients with confirmed or suspected COVID-19 is available here EMS personnel should wear all recommended PPE because they are providing direct medical care and in close contact with the patient for longer periods of time Reference httpswwwcdcgovcoronavirus2019-ncovinfection-controlinfection- prevention-control-faqhtml
15
Chapter 3 Cleaning
16
During this COVID-19 crisis please be aware that you may see a variety of disinfectantswipes for use against COVID-19 The below products are listed on the EPAs website for approved disinfectants against COVID-19 Please be mindful of reviewing the contact time (in minutes) recommended by each manufacturer as it varies per product Products noted for killing C diff spores are noted these products will also disinfectant against COVID-19 Please be mindful that spray disinfectant of any kind should not be sprayed directly on equipment or monitors Spray disinfectant will need to be sprayed on a wiperag before wiping down equipment of any kind to prevent damage andor malfunction
Image of the Product Product Name and number Company Name Contact Time (In Minutes)
Sani-Cloth XLarge 55 Alcohol Q86984
GRAINGER - 9JAJ1 (1) 172H69 (6pk)
Super Sani Large 55 Alcohol
Q55172
GRAINGER - 9RYJ7 (1)
Professional Disposables
International
2 minutes
Sani-Cloth Bleach Germicidal PDI P54072 P25784 P7007P P700RF H58195
U26595
GRAINGER - 16Z989
Professional Disposables
International
4 minutes
kills C Diff spores in 4
minutes
Sani-Cloth AF3 Large Canister P13872
Sani-Cloth AF3 Germicidal Wipes XL
81626514
Professional Disposables
International
Performance Health
3 minutes
SaniPrime (RTU-Wipes)
P25372 P24284 H06182 amp U13195
Professional Disposables
International
1 minute
17
Caviwipe1 XL 65 WipesCanister 13-5150
GRAINGER - 6TWF8 - 13-1150
Caviwipe1 Regular 160 WipesCanister 13-5100
Metrex For the coronavirus this
wipe does in fact need a 3-
minute kill time All other
pathogens require a 1
minute But only the
Coronavirus or in this case the
Adenovirus (most similar) is going to require
the use of 3-minute kill time
Caviwipe Bleach 6X10 90 WipesCanister 13-9100
Metrex 3 minutes
kills C Diff spores in 3
minutes
Cavicide (RTU)
GRAINGER - 3VDJ1 (24oz Bottle) 3VDJ2 (1gal Bottle) 3VDJ3 (25 Gal Bottle) 3VDJ7 (25 Gal
Easy Pour Jug)
Metrex 3 minutes
Clorox Healthcarereg Bleach Germicidal Wipes Office Depot 439675 1630225 265701
825962 8373413 764946 129202 8193323 8193614 8193080
Medline CLO30358H CLO35309 CLO31424Z
CLO31424 CLO30577H CLO30577
GRAINGER 1XEZ3 4XKR8 4XKR7 6VDE9
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
kills C diff spores
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
6
Chapter 2 Personal Protective Equipment (PPE)
7
Guidelines for PPE April 7 2020
Adjustments in these guidelines are subject to changes in standards of care andor supply chain availability
Tier Situation PPE for Patient Care
Activities
Tier 1
GreeterScreenerUniversal Masking
Non PUICOVID‐19 patient Standard precautions + universal masking
(follow isolation precautions if patients are on isolation for something other than COVID)
Tier 2 One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care
PUICOVID‐19 not receiving aerosol generating
procedure (AGP) OR when collecting NP swab
Tier 3 One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care
PUICOVID‐19 receiving aerosol generating
procedure (AGP) AGP = Positive pressure ventilation
(BiPAPCPAP) endotracheal intubation airway suctioning high frequency oscillatory
ventilation tracheostomy chest PT Nebulizer treatment sputum induction bronchoscopy
suctioning +
Centers for Disease Control and Prevention (CDC) httpswwwcdcgovcoronavirus2019‐ncovinfection‐controlcontrol‐recommendationshtml Advent Health (2020) Standard Operating Procedures (SOP) Personal Protective Equipment Guidance for Novel Respiratory Virus COVID‐19
Personal Protective Equipment (PPE) Conservation One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care Adjustments are subject to change with changes in standards of care andor supply chain availability
SUPPLY ITEM WHEN HOW TO RE US E
N95 MASKS
N95 must be covered by a FULL face shield when providing
direct patient care for
Tier 2 and Tier 3 patients
bull When removing the N95
bull Perform hand hygiene
bull Don clean pair of gloves
bull Grasp straps and remove mask without touching the front or inside
bull Place in clean breathable container such as a labeled paper bag
bull Doff gloves and perform hand hygiene
bull Don a face mask as per universal masking protocol
bull If the seal check is performed on the mask and integrity is maintained the mask can be worn multiple times otherwise the mask should be replaced immediately
bull If the N95 becomes damp damaged visibly soiled or hard to breathe through it must be discarded
NOTE N95 should be covered by a clean face mask for aerosolizing procedures and the face mask should be discarded upon exiting the room
FACE SHIELD
bull Must be disinfected inside and outside with hospital‐approved disinfectant wipe after doffing
bull If the hospital approved disinfectant wipe contains bleach bull Allow appropriate dwell time bull Rinse the shield or wipe with a wet paper towel taking care not to get the foam
headband wet bull Dry thoroughly
bull Label face shield and store in a clean location until damaged or unusable
bull Perform hand hygiene before and after contact 8
How To Perform a Particulate Respirator Seal Check Adapted from Epidemic and Pandemic Alert and Response | World Health Organization 2008
Step 1 minus Perform appropriate hand hygiene and don gloves minus Cup the respirator in your hand with the nosepiece at your fingertips allowing the headbands to hang
freely below your hand
Step 2
minus Position the respirator under your chin with the nosepiece up
Step 3
minus Pull the top strap over your head resting it high at the back of your head Pull the bottom strap over your
head and position it around the neck below the ears
Step 4
minus Place fingertips of both hands at the top of the metal nosepiece Mold the nosepiece (USING TWO FINGERS OF
EACH HAND) to the shape of your nose Pinching the nosepiece using one hand may result in less effective respirator performance
Step 5
minus Cover the front of the respirator with both hands being careful not to disturb the position of the respirator
Step 5a Positive seal check minus Exhale sharply A positive pressure inside the respirator = no leakage If leakage adjust the position andor
tension straps Retest the seal Repeat the steps until the respirator is secured properly Step 5b Negative seal check minus Inhale deeply If no leakage negative pressure will make respirator cling to your face minus Leakage will result in loss of negative pressure in the respirator due to air entering through gaps in the seal minus Doff gloves and perform appropriate hand hygiene
9
10
N95 RESPIRATOR PRODUCT UPDATE
In order to ensure protection and prevent a
disruption in product availability AMITA Health is
implementing the use of additional models of N95
respirators
In addition a full face shield must always be used
when wearing any N95 respirator per the AMITA
Health COVID-19 Infection Prevention ndash Acute Care
playbook
More information on COVID-19 playbooks and resources
can be found at
httpswwwamitahealthorgcovid-19-amita
11
AMITA Healthrsquos facilities have previously used the following models of N95s
Brand Model Photo
3M 1860
1860S
1870+
Halyard 46727
46827
AMITA Healthrsquos facilities will begin fit-testing and distributing the following models of N95s
Brand Model Photo
3M 8511
8210
Gerson 2140
For any questions please connect directly with your local Resource Group Operations Manager and
Critical Products Manager
12
Personal Protective Equipment (PPE) Validation Checklist During care of the patient with known or suspected COVID-19
Personal Protective Equipment (PPE) ValidationStaff Training Overview
Purpose
To create a consistent process of monitoring Donning and Doffing of PPE consistent
with CDC recommendations
Refer to Appendix C for the PPE Validation Self-Check Attestation
Refer to Appendix D for the PPE Validation Checklist for Monitor Observing
Expectations
bull Form Overview and Associate actions
Appendix C Personal Protective Equipment (PPE) Validation Self-Check Attestation
o Staff assigned to care for patient suspected or confirmed with COVID-19
o Reviews proper PPE donning and doffing expectations
o Attests that they will report any PPE needs for Ante Room
o Attests that they will report any PPE suspected of malfunctioning o Understands that they may be monitored for proper
donning and doffing
o Signs that they understand the importance of consistent
PPE compliance
o Files completed form in employee file
Appendix D Personal Protective Equipment (PPE) Validation Checklist (for Monitors observing)
Each individual entering patient room if suspected or confirmed COVID-19 will be
monitored for safe donning and doffing practices The assigned PPE Monitor will
OBSERVE and VALIDATE every time
o Proper PPE application
o Proper Date and Room number
o Consistent time entries for EACH time individual enters the room and exits o Assigned PPE Monitor and ALL Caregivers to enter Role Printed Name and
Signature
o Monitor to print name and relationship if visitor
o Forward to charge nurse Infection Control will pick up o Note multiple sheets may be required each day based on individuals entering the
room
o Note MUST remind individuals that doffing may require self-monitoring if Ante Room DOES NOT have a window Do NOT open doors for these doffing observations
o Both the HCP providing care and the monitor will document PPE use and
hand hygiene for both donning and doffing
bull Appendix E PUI Isolation Sign-InOut Sheet
bull Appendix F Infection PreventionLeader Rounding Checklist
13
Important Update Regarding Air Pressure in OrsProcedural Areas
1) All Operating Rooms and procedure rooms (including Cath Lab and IR) need to maintain
a positive pressure relationship to the adjacent areas Altering the airflow in these areas
compromises the sterile environment and puts healthcare workers at greater risk of
exposure
2) NEVER put an N95 mask on a patient Patients should be transported with a procedural
mask
3) Proper room cleaning should be as follows
Terminal clean of an ORprocedure space
a If an aerosol generating procedure was not performed
bull Procedure room may be cleaned immediately
bull Contact EVS and request a COVID-19 terminal clean
b If an aerosol generating procedure was performed
bull Close procedure room and do not allow anyone to enter the space
for 1 hour
bull After one hour has passed contact EVS and request a COVID-19
terminal clean
Reference
American Society of Healthcare Engineering (ASHE)American Hospital Association
(AHA) Facility Guidelines
From the ASHE Website
14
Transporting of PUI or Confirmed COVID 19 patients Within a Health Care Facility
What personal protective equipment (PPE) should be worn by individuals transporting
patients who are confirmed with or under investigation for COVID-19 within a healthcare
facility For example what PPE should be worn when transporting a patient to radiology
for imaging that cannot be performed in the patient room
In general transport and movement of the patient outside of their room should be limited to medically essential purposes If being transported outside of the room such as to radiology healthcare personnel (HCP) in the receiving area should be notified in advance of transporting the patient For transport the patient should wear a facemask to contain secretions and be covered with a clean sheet
If transport personnel must prepare the patient for transport (eg transfer them to the wheelchair or gurney) transport personnel should wear all recommended PPE (gloves a gown respiratory protection that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator or facemaskmdashif a respirator is not availablemdashand eye protection [ie goggles or disposable face shield that covers the front and sides of the face]) This recommendation is needed because these interactions typically involve close often face-to-face contact with the patient in an enclosed space (eg patient room) Once the patient has been transferred to the wheelchair or gurney (and prior to exiting the room) transporters should remove their gown gloves and eye protection and perform hand hygiene
If the patient is wearing a facemask no recommendation for PPE is made typically for HCP transporting patients with a respiratory infection from the patientrsquos room to the destination However given current limitations in knowledge regarding COVID-19 and following the currently cautious approach for risk stratification and monitoring of healthcare personnel caring for patients with COVID-19 use of a facemask by the transporter is recommended for anything more than brief encounters with COVID-19 patients Additional PPE should not be required unless there is an anticipated need to provide medical assistance during transport (eg helping the patient replace a dislodged facemask)
After arrival at their destination receiving personnel (eg in radiology) and the transporter (if assisting with transfer) should perform hand hygiene and wear all recommended PPE If still wearing their original respirator or facemask the transporter should take care to avoid self- contamination when donning the remainder of the recommended PPE This cautious approach will be refined and updated as more information becomes available and as response needs change in the United States
Interim guidance for EMS personnel transporting patients with confirmed or suspected COVID-19 is available here EMS personnel should wear all recommended PPE because they are providing direct medical care and in close contact with the patient for longer periods of time Reference httpswwwcdcgovcoronavirus2019-ncovinfection-controlinfection- prevention-control-faqhtml
15
Chapter 3 Cleaning
16
During this COVID-19 crisis please be aware that you may see a variety of disinfectantswipes for use against COVID-19 The below products are listed on the EPAs website for approved disinfectants against COVID-19 Please be mindful of reviewing the contact time (in minutes) recommended by each manufacturer as it varies per product Products noted for killing C diff spores are noted these products will also disinfectant against COVID-19 Please be mindful that spray disinfectant of any kind should not be sprayed directly on equipment or monitors Spray disinfectant will need to be sprayed on a wiperag before wiping down equipment of any kind to prevent damage andor malfunction
Image of the Product Product Name and number Company Name Contact Time (In Minutes)
Sani-Cloth XLarge 55 Alcohol Q86984
GRAINGER - 9JAJ1 (1) 172H69 (6pk)
Super Sani Large 55 Alcohol
Q55172
GRAINGER - 9RYJ7 (1)
Professional Disposables
International
2 minutes
Sani-Cloth Bleach Germicidal PDI P54072 P25784 P7007P P700RF H58195
U26595
GRAINGER - 16Z989
Professional Disposables
International
4 minutes
kills C Diff spores in 4
minutes
Sani-Cloth AF3 Large Canister P13872
Sani-Cloth AF3 Germicidal Wipes XL
81626514
Professional Disposables
International
Performance Health
3 minutes
SaniPrime (RTU-Wipes)
P25372 P24284 H06182 amp U13195
Professional Disposables
International
1 minute
17
Caviwipe1 XL 65 WipesCanister 13-5150
GRAINGER - 6TWF8 - 13-1150
Caviwipe1 Regular 160 WipesCanister 13-5100
Metrex For the coronavirus this
wipe does in fact need a 3-
minute kill time All other
pathogens require a 1
minute But only the
Coronavirus or in this case the
Adenovirus (most similar) is going to require
the use of 3-minute kill time
Caviwipe Bleach 6X10 90 WipesCanister 13-9100
Metrex 3 minutes
kills C Diff spores in 3
minutes
Cavicide (RTU)
GRAINGER - 3VDJ1 (24oz Bottle) 3VDJ2 (1gal Bottle) 3VDJ3 (25 Gal Bottle) 3VDJ7 (25 Gal
Easy Pour Jug)
Metrex 3 minutes
Clorox Healthcarereg Bleach Germicidal Wipes Office Depot 439675 1630225 265701
825962 8373413 764946 129202 8193323 8193614 8193080
Medline CLO30358H CLO35309 CLO31424Z
CLO31424 CLO30577H CLO30577
GRAINGER 1XEZ3 4XKR8 4XKR7 6VDE9
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
kills C diff spores
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
7
Guidelines for PPE April 7 2020
Adjustments in these guidelines are subject to changes in standards of care andor supply chain availability
Tier Situation PPE for Patient Care
Activities
Tier 1
GreeterScreenerUniversal Masking
Non PUICOVID‐19 patient Standard precautions + universal masking
(follow isolation precautions if patients are on isolation for something other than COVID)
Tier 2 One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care
PUICOVID‐19 not receiving aerosol generating
procedure (AGP) OR when collecting NP swab
Tier 3 One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care
PUICOVID‐19 receiving aerosol generating
procedure (AGP) AGP = Positive pressure ventilation
(BiPAPCPAP) endotracheal intubation airway suctioning high frequency oscillatory
ventilation tracheostomy chest PT Nebulizer treatment sputum induction bronchoscopy
suctioning +
Centers for Disease Control and Prevention (CDC) httpswwwcdcgovcoronavirus2019‐ncovinfection‐controlcontrol‐recommendationshtml Advent Health (2020) Standard Operating Procedures (SOP) Personal Protective Equipment Guidance for Novel Respiratory Virus COVID‐19
Personal Protective Equipment (PPE) Conservation One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care Adjustments are subject to change with changes in standards of care andor supply chain availability
SUPPLY ITEM WHEN HOW TO RE US E
N95 MASKS
N95 must be covered by a FULL face shield when providing
direct patient care for
Tier 2 and Tier 3 patients
bull When removing the N95
bull Perform hand hygiene
bull Don clean pair of gloves
bull Grasp straps and remove mask without touching the front or inside
bull Place in clean breathable container such as a labeled paper bag
bull Doff gloves and perform hand hygiene
bull Don a face mask as per universal masking protocol
bull If the seal check is performed on the mask and integrity is maintained the mask can be worn multiple times otherwise the mask should be replaced immediately
bull If the N95 becomes damp damaged visibly soiled or hard to breathe through it must be discarded
NOTE N95 should be covered by a clean face mask for aerosolizing procedures and the face mask should be discarded upon exiting the room
FACE SHIELD
bull Must be disinfected inside and outside with hospital‐approved disinfectant wipe after doffing
bull If the hospital approved disinfectant wipe contains bleach bull Allow appropriate dwell time bull Rinse the shield or wipe with a wet paper towel taking care not to get the foam
headband wet bull Dry thoroughly
bull Label face shield and store in a clean location until damaged or unusable
bull Perform hand hygiene before and after contact 8
How To Perform a Particulate Respirator Seal Check Adapted from Epidemic and Pandemic Alert and Response | World Health Organization 2008
Step 1 minus Perform appropriate hand hygiene and don gloves minus Cup the respirator in your hand with the nosepiece at your fingertips allowing the headbands to hang
freely below your hand
Step 2
minus Position the respirator under your chin with the nosepiece up
Step 3
minus Pull the top strap over your head resting it high at the back of your head Pull the bottom strap over your
head and position it around the neck below the ears
Step 4
minus Place fingertips of both hands at the top of the metal nosepiece Mold the nosepiece (USING TWO FINGERS OF
EACH HAND) to the shape of your nose Pinching the nosepiece using one hand may result in less effective respirator performance
Step 5
minus Cover the front of the respirator with both hands being careful not to disturb the position of the respirator
Step 5a Positive seal check minus Exhale sharply A positive pressure inside the respirator = no leakage If leakage adjust the position andor
tension straps Retest the seal Repeat the steps until the respirator is secured properly Step 5b Negative seal check minus Inhale deeply If no leakage negative pressure will make respirator cling to your face minus Leakage will result in loss of negative pressure in the respirator due to air entering through gaps in the seal minus Doff gloves and perform appropriate hand hygiene
9
10
N95 RESPIRATOR PRODUCT UPDATE
In order to ensure protection and prevent a
disruption in product availability AMITA Health is
implementing the use of additional models of N95
respirators
In addition a full face shield must always be used
when wearing any N95 respirator per the AMITA
Health COVID-19 Infection Prevention ndash Acute Care
playbook
More information on COVID-19 playbooks and resources
can be found at
httpswwwamitahealthorgcovid-19-amita
11
AMITA Healthrsquos facilities have previously used the following models of N95s
Brand Model Photo
3M 1860
1860S
1870+
Halyard 46727
46827
AMITA Healthrsquos facilities will begin fit-testing and distributing the following models of N95s
Brand Model Photo
3M 8511
8210
Gerson 2140
For any questions please connect directly with your local Resource Group Operations Manager and
Critical Products Manager
12
Personal Protective Equipment (PPE) Validation Checklist During care of the patient with known or suspected COVID-19
Personal Protective Equipment (PPE) ValidationStaff Training Overview
Purpose
To create a consistent process of monitoring Donning and Doffing of PPE consistent
with CDC recommendations
Refer to Appendix C for the PPE Validation Self-Check Attestation
Refer to Appendix D for the PPE Validation Checklist for Monitor Observing
Expectations
bull Form Overview and Associate actions
Appendix C Personal Protective Equipment (PPE) Validation Self-Check Attestation
o Staff assigned to care for patient suspected or confirmed with COVID-19
o Reviews proper PPE donning and doffing expectations
o Attests that they will report any PPE needs for Ante Room
o Attests that they will report any PPE suspected of malfunctioning o Understands that they may be monitored for proper
donning and doffing
o Signs that they understand the importance of consistent
PPE compliance
o Files completed form in employee file
Appendix D Personal Protective Equipment (PPE) Validation Checklist (for Monitors observing)
Each individual entering patient room if suspected or confirmed COVID-19 will be
monitored for safe donning and doffing practices The assigned PPE Monitor will
OBSERVE and VALIDATE every time
o Proper PPE application
o Proper Date and Room number
o Consistent time entries for EACH time individual enters the room and exits o Assigned PPE Monitor and ALL Caregivers to enter Role Printed Name and
Signature
o Monitor to print name and relationship if visitor
o Forward to charge nurse Infection Control will pick up o Note multiple sheets may be required each day based on individuals entering the
room
o Note MUST remind individuals that doffing may require self-monitoring if Ante Room DOES NOT have a window Do NOT open doors for these doffing observations
o Both the HCP providing care and the monitor will document PPE use and
hand hygiene for both donning and doffing
bull Appendix E PUI Isolation Sign-InOut Sheet
bull Appendix F Infection PreventionLeader Rounding Checklist
13
Important Update Regarding Air Pressure in OrsProcedural Areas
1) All Operating Rooms and procedure rooms (including Cath Lab and IR) need to maintain
a positive pressure relationship to the adjacent areas Altering the airflow in these areas
compromises the sterile environment and puts healthcare workers at greater risk of
exposure
2) NEVER put an N95 mask on a patient Patients should be transported with a procedural
mask
3) Proper room cleaning should be as follows
Terminal clean of an ORprocedure space
a If an aerosol generating procedure was not performed
bull Procedure room may be cleaned immediately
bull Contact EVS and request a COVID-19 terminal clean
b If an aerosol generating procedure was performed
bull Close procedure room and do not allow anyone to enter the space
for 1 hour
bull After one hour has passed contact EVS and request a COVID-19
terminal clean
Reference
American Society of Healthcare Engineering (ASHE)American Hospital Association
(AHA) Facility Guidelines
From the ASHE Website
14
Transporting of PUI or Confirmed COVID 19 patients Within a Health Care Facility
What personal protective equipment (PPE) should be worn by individuals transporting
patients who are confirmed with or under investigation for COVID-19 within a healthcare
facility For example what PPE should be worn when transporting a patient to radiology
for imaging that cannot be performed in the patient room
In general transport and movement of the patient outside of their room should be limited to medically essential purposes If being transported outside of the room such as to radiology healthcare personnel (HCP) in the receiving area should be notified in advance of transporting the patient For transport the patient should wear a facemask to contain secretions and be covered with a clean sheet
If transport personnel must prepare the patient for transport (eg transfer them to the wheelchair or gurney) transport personnel should wear all recommended PPE (gloves a gown respiratory protection that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator or facemaskmdashif a respirator is not availablemdashand eye protection [ie goggles or disposable face shield that covers the front and sides of the face]) This recommendation is needed because these interactions typically involve close often face-to-face contact with the patient in an enclosed space (eg patient room) Once the patient has been transferred to the wheelchair or gurney (and prior to exiting the room) transporters should remove their gown gloves and eye protection and perform hand hygiene
If the patient is wearing a facemask no recommendation for PPE is made typically for HCP transporting patients with a respiratory infection from the patientrsquos room to the destination However given current limitations in knowledge regarding COVID-19 and following the currently cautious approach for risk stratification and monitoring of healthcare personnel caring for patients with COVID-19 use of a facemask by the transporter is recommended for anything more than brief encounters with COVID-19 patients Additional PPE should not be required unless there is an anticipated need to provide medical assistance during transport (eg helping the patient replace a dislodged facemask)
After arrival at their destination receiving personnel (eg in radiology) and the transporter (if assisting with transfer) should perform hand hygiene and wear all recommended PPE If still wearing their original respirator or facemask the transporter should take care to avoid self- contamination when donning the remainder of the recommended PPE This cautious approach will be refined and updated as more information becomes available and as response needs change in the United States
Interim guidance for EMS personnel transporting patients with confirmed or suspected COVID-19 is available here EMS personnel should wear all recommended PPE because they are providing direct medical care and in close contact with the patient for longer periods of time Reference httpswwwcdcgovcoronavirus2019-ncovinfection-controlinfection- prevention-control-faqhtml
15
Chapter 3 Cleaning
16
During this COVID-19 crisis please be aware that you may see a variety of disinfectantswipes for use against COVID-19 The below products are listed on the EPAs website for approved disinfectants against COVID-19 Please be mindful of reviewing the contact time (in minutes) recommended by each manufacturer as it varies per product Products noted for killing C diff spores are noted these products will also disinfectant against COVID-19 Please be mindful that spray disinfectant of any kind should not be sprayed directly on equipment or monitors Spray disinfectant will need to be sprayed on a wiperag before wiping down equipment of any kind to prevent damage andor malfunction
Image of the Product Product Name and number Company Name Contact Time (In Minutes)
Sani-Cloth XLarge 55 Alcohol Q86984
GRAINGER - 9JAJ1 (1) 172H69 (6pk)
Super Sani Large 55 Alcohol
Q55172
GRAINGER - 9RYJ7 (1)
Professional Disposables
International
2 minutes
Sani-Cloth Bleach Germicidal PDI P54072 P25784 P7007P P700RF H58195
U26595
GRAINGER - 16Z989
Professional Disposables
International
4 minutes
kills C Diff spores in 4
minutes
Sani-Cloth AF3 Large Canister P13872
Sani-Cloth AF3 Germicidal Wipes XL
81626514
Professional Disposables
International
Performance Health
3 minutes
SaniPrime (RTU-Wipes)
P25372 P24284 H06182 amp U13195
Professional Disposables
International
1 minute
17
Caviwipe1 XL 65 WipesCanister 13-5150
GRAINGER - 6TWF8 - 13-1150
Caviwipe1 Regular 160 WipesCanister 13-5100
Metrex For the coronavirus this
wipe does in fact need a 3-
minute kill time All other
pathogens require a 1
minute But only the
Coronavirus or in this case the
Adenovirus (most similar) is going to require
the use of 3-minute kill time
Caviwipe Bleach 6X10 90 WipesCanister 13-9100
Metrex 3 minutes
kills C Diff spores in 3
minutes
Cavicide (RTU)
GRAINGER - 3VDJ1 (24oz Bottle) 3VDJ2 (1gal Bottle) 3VDJ3 (25 Gal Bottle) 3VDJ7 (25 Gal
Easy Pour Jug)
Metrex 3 minutes
Clorox Healthcarereg Bleach Germicidal Wipes Office Depot 439675 1630225 265701
825962 8373413 764946 129202 8193323 8193614 8193080
Medline CLO30358H CLO35309 CLO31424Z
CLO31424 CLO30577H CLO30577
GRAINGER 1XEZ3 4XKR8 4XKR7 6VDE9
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
kills C diff spores
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
Personal Protective Equipment (PPE) Conservation One (1) N95 mask per day will be provided to each direct caregiver in High Risk Areas ED ICU COVID units and other areas where COVIDPUI patients
receive care Adjustments are subject to change with changes in standards of care andor supply chain availability
SUPPLY ITEM WHEN HOW TO RE US E
N95 MASKS
N95 must be covered by a FULL face shield when providing
direct patient care for
Tier 2 and Tier 3 patients
bull When removing the N95
bull Perform hand hygiene
bull Don clean pair of gloves
bull Grasp straps and remove mask without touching the front or inside
bull Place in clean breathable container such as a labeled paper bag
bull Doff gloves and perform hand hygiene
bull Don a face mask as per universal masking protocol
bull If the seal check is performed on the mask and integrity is maintained the mask can be worn multiple times otherwise the mask should be replaced immediately
bull If the N95 becomes damp damaged visibly soiled or hard to breathe through it must be discarded
NOTE N95 should be covered by a clean face mask for aerosolizing procedures and the face mask should be discarded upon exiting the room
FACE SHIELD
bull Must be disinfected inside and outside with hospital‐approved disinfectant wipe after doffing
bull If the hospital approved disinfectant wipe contains bleach bull Allow appropriate dwell time bull Rinse the shield or wipe with a wet paper towel taking care not to get the foam
headband wet bull Dry thoroughly
bull Label face shield and store in a clean location until damaged or unusable
bull Perform hand hygiene before and after contact 8
How To Perform a Particulate Respirator Seal Check Adapted from Epidemic and Pandemic Alert and Response | World Health Organization 2008
Step 1 minus Perform appropriate hand hygiene and don gloves minus Cup the respirator in your hand with the nosepiece at your fingertips allowing the headbands to hang
freely below your hand
Step 2
minus Position the respirator under your chin with the nosepiece up
Step 3
minus Pull the top strap over your head resting it high at the back of your head Pull the bottom strap over your
head and position it around the neck below the ears
Step 4
minus Place fingertips of both hands at the top of the metal nosepiece Mold the nosepiece (USING TWO FINGERS OF
EACH HAND) to the shape of your nose Pinching the nosepiece using one hand may result in less effective respirator performance
Step 5
minus Cover the front of the respirator with both hands being careful not to disturb the position of the respirator
Step 5a Positive seal check minus Exhale sharply A positive pressure inside the respirator = no leakage If leakage adjust the position andor
tension straps Retest the seal Repeat the steps until the respirator is secured properly Step 5b Negative seal check minus Inhale deeply If no leakage negative pressure will make respirator cling to your face minus Leakage will result in loss of negative pressure in the respirator due to air entering through gaps in the seal minus Doff gloves and perform appropriate hand hygiene
9
10
N95 RESPIRATOR PRODUCT UPDATE
In order to ensure protection and prevent a
disruption in product availability AMITA Health is
implementing the use of additional models of N95
respirators
In addition a full face shield must always be used
when wearing any N95 respirator per the AMITA
Health COVID-19 Infection Prevention ndash Acute Care
playbook
More information on COVID-19 playbooks and resources
can be found at
httpswwwamitahealthorgcovid-19-amita
11
AMITA Healthrsquos facilities have previously used the following models of N95s
Brand Model Photo
3M 1860
1860S
1870+
Halyard 46727
46827
AMITA Healthrsquos facilities will begin fit-testing and distributing the following models of N95s
Brand Model Photo
3M 8511
8210
Gerson 2140
For any questions please connect directly with your local Resource Group Operations Manager and
Critical Products Manager
12
Personal Protective Equipment (PPE) Validation Checklist During care of the patient with known or suspected COVID-19
Personal Protective Equipment (PPE) ValidationStaff Training Overview
Purpose
To create a consistent process of monitoring Donning and Doffing of PPE consistent
with CDC recommendations
Refer to Appendix C for the PPE Validation Self-Check Attestation
Refer to Appendix D for the PPE Validation Checklist for Monitor Observing
Expectations
bull Form Overview and Associate actions
Appendix C Personal Protective Equipment (PPE) Validation Self-Check Attestation
o Staff assigned to care for patient suspected or confirmed with COVID-19
o Reviews proper PPE donning and doffing expectations
o Attests that they will report any PPE needs for Ante Room
o Attests that they will report any PPE suspected of malfunctioning o Understands that they may be monitored for proper
donning and doffing
o Signs that they understand the importance of consistent
PPE compliance
o Files completed form in employee file
Appendix D Personal Protective Equipment (PPE) Validation Checklist (for Monitors observing)
Each individual entering patient room if suspected or confirmed COVID-19 will be
monitored for safe donning and doffing practices The assigned PPE Monitor will
OBSERVE and VALIDATE every time
o Proper PPE application
o Proper Date and Room number
o Consistent time entries for EACH time individual enters the room and exits o Assigned PPE Monitor and ALL Caregivers to enter Role Printed Name and
Signature
o Monitor to print name and relationship if visitor
o Forward to charge nurse Infection Control will pick up o Note multiple sheets may be required each day based on individuals entering the
room
o Note MUST remind individuals that doffing may require self-monitoring if Ante Room DOES NOT have a window Do NOT open doors for these doffing observations
o Both the HCP providing care and the monitor will document PPE use and
hand hygiene for both donning and doffing
bull Appendix E PUI Isolation Sign-InOut Sheet
bull Appendix F Infection PreventionLeader Rounding Checklist
13
Important Update Regarding Air Pressure in OrsProcedural Areas
1) All Operating Rooms and procedure rooms (including Cath Lab and IR) need to maintain
a positive pressure relationship to the adjacent areas Altering the airflow in these areas
compromises the sterile environment and puts healthcare workers at greater risk of
exposure
2) NEVER put an N95 mask on a patient Patients should be transported with a procedural
mask
3) Proper room cleaning should be as follows
Terminal clean of an ORprocedure space
a If an aerosol generating procedure was not performed
bull Procedure room may be cleaned immediately
bull Contact EVS and request a COVID-19 terminal clean
b If an aerosol generating procedure was performed
bull Close procedure room and do not allow anyone to enter the space
for 1 hour
bull After one hour has passed contact EVS and request a COVID-19
terminal clean
Reference
American Society of Healthcare Engineering (ASHE)American Hospital Association
(AHA) Facility Guidelines
From the ASHE Website
14
Transporting of PUI or Confirmed COVID 19 patients Within a Health Care Facility
What personal protective equipment (PPE) should be worn by individuals transporting
patients who are confirmed with or under investigation for COVID-19 within a healthcare
facility For example what PPE should be worn when transporting a patient to radiology
for imaging that cannot be performed in the patient room
In general transport and movement of the patient outside of their room should be limited to medically essential purposes If being transported outside of the room such as to radiology healthcare personnel (HCP) in the receiving area should be notified in advance of transporting the patient For transport the patient should wear a facemask to contain secretions and be covered with a clean sheet
If transport personnel must prepare the patient for transport (eg transfer them to the wheelchair or gurney) transport personnel should wear all recommended PPE (gloves a gown respiratory protection that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator or facemaskmdashif a respirator is not availablemdashand eye protection [ie goggles or disposable face shield that covers the front and sides of the face]) This recommendation is needed because these interactions typically involve close often face-to-face contact with the patient in an enclosed space (eg patient room) Once the patient has been transferred to the wheelchair or gurney (and prior to exiting the room) transporters should remove their gown gloves and eye protection and perform hand hygiene
If the patient is wearing a facemask no recommendation for PPE is made typically for HCP transporting patients with a respiratory infection from the patientrsquos room to the destination However given current limitations in knowledge regarding COVID-19 and following the currently cautious approach for risk stratification and monitoring of healthcare personnel caring for patients with COVID-19 use of a facemask by the transporter is recommended for anything more than brief encounters with COVID-19 patients Additional PPE should not be required unless there is an anticipated need to provide medical assistance during transport (eg helping the patient replace a dislodged facemask)
After arrival at their destination receiving personnel (eg in radiology) and the transporter (if assisting with transfer) should perform hand hygiene and wear all recommended PPE If still wearing their original respirator or facemask the transporter should take care to avoid self- contamination when donning the remainder of the recommended PPE This cautious approach will be refined and updated as more information becomes available and as response needs change in the United States
Interim guidance for EMS personnel transporting patients with confirmed or suspected COVID-19 is available here EMS personnel should wear all recommended PPE because they are providing direct medical care and in close contact with the patient for longer periods of time Reference httpswwwcdcgovcoronavirus2019-ncovinfection-controlinfection- prevention-control-faqhtml
15
Chapter 3 Cleaning
16
During this COVID-19 crisis please be aware that you may see a variety of disinfectantswipes for use against COVID-19 The below products are listed on the EPAs website for approved disinfectants against COVID-19 Please be mindful of reviewing the contact time (in minutes) recommended by each manufacturer as it varies per product Products noted for killing C diff spores are noted these products will also disinfectant against COVID-19 Please be mindful that spray disinfectant of any kind should not be sprayed directly on equipment or monitors Spray disinfectant will need to be sprayed on a wiperag before wiping down equipment of any kind to prevent damage andor malfunction
Image of the Product Product Name and number Company Name Contact Time (In Minutes)
Sani-Cloth XLarge 55 Alcohol Q86984
GRAINGER - 9JAJ1 (1) 172H69 (6pk)
Super Sani Large 55 Alcohol
Q55172
GRAINGER - 9RYJ7 (1)
Professional Disposables
International
2 minutes
Sani-Cloth Bleach Germicidal PDI P54072 P25784 P7007P P700RF H58195
U26595
GRAINGER - 16Z989
Professional Disposables
International
4 minutes
kills C Diff spores in 4
minutes
Sani-Cloth AF3 Large Canister P13872
Sani-Cloth AF3 Germicidal Wipes XL
81626514
Professional Disposables
International
Performance Health
3 minutes
SaniPrime (RTU-Wipes)
P25372 P24284 H06182 amp U13195
Professional Disposables
International
1 minute
17
Caviwipe1 XL 65 WipesCanister 13-5150
GRAINGER - 6TWF8 - 13-1150
Caviwipe1 Regular 160 WipesCanister 13-5100
Metrex For the coronavirus this
wipe does in fact need a 3-
minute kill time All other
pathogens require a 1
minute But only the
Coronavirus or in this case the
Adenovirus (most similar) is going to require
the use of 3-minute kill time
Caviwipe Bleach 6X10 90 WipesCanister 13-9100
Metrex 3 minutes
kills C Diff spores in 3
minutes
Cavicide (RTU)
GRAINGER - 3VDJ1 (24oz Bottle) 3VDJ2 (1gal Bottle) 3VDJ3 (25 Gal Bottle) 3VDJ7 (25 Gal
Easy Pour Jug)
Metrex 3 minutes
Clorox Healthcarereg Bleach Germicidal Wipes Office Depot 439675 1630225 265701
825962 8373413 764946 129202 8193323 8193614 8193080
Medline CLO30358H CLO35309 CLO31424Z
CLO31424 CLO30577H CLO30577
GRAINGER 1XEZ3 4XKR8 4XKR7 6VDE9
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
kills C diff spores
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
How To Perform a Particulate Respirator Seal Check Adapted from Epidemic and Pandemic Alert and Response | World Health Organization 2008
Step 1 minus Perform appropriate hand hygiene and don gloves minus Cup the respirator in your hand with the nosepiece at your fingertips allowing the headbands to hang
freely below your hand
Step 2
minus Position the respirator under your chin with the nosepiece up
Step 3
minus Pull the top strap over your head resting it high at the back of your head Pull the bottom strap over your
head and position it around the neck below the ears
Step 4
minus Place fingertips of both hands at the top of the metal nosepiece Mold the nosepiece (USING TWO FINGERS OF
EACH HAND) to the shape of your nose Pinching the nosepiece using one hand may result in less effective respirator performance
Step 5
minus Cover the front of the respirator with both hands being careful not to disturb the position of the respirator
Step 5a Positive seal check minus Exhale sharply A positive pressure inside the respirator = no leakage If leakage adjust the position andor
tension straps Retest the seal Repeat the steps until the respirator is secured properly Step 5b Negative seal check minus Inhale deeply If no leakage negative pressure will make respirator cling to your face minus Leakage will result in loss of negative pressure in the respirator due to air entering through gaps in the seal minus Doff gloves and perform appropriate hand hygiene
9
10
N95 RESPIRATOR PRODUCT UPDATE
In order to ensure protection and prevent a
disruption in product availability AMITA Health is
implementing the use of additional models of N95
respirators
In addition a full face shield must always be used
when wearing any N95 respirator per the AMITA
Health COVID-19 Infection Prevention ndash Acute Care
playbook
More information on COVID-19 playbooks and resources
can be found at
httpswwwamitahealthorgcovid-19-amita
11
AMITA Healthrsquos facilities have previously used the following models of N95s
Brand Model Photo
3M 1860
1860S
1870+
Halyard 46727
46827
AMITA Healthrsquos facilities will begin fit-testing and distributing the following models of N95s
Brand Model Photo
3M 8511
8210
Gerson 2140
For any questions please connect directly with your local Resource Group Operations Manager and
Critical Products Manager
12
Personal Protective Equipment (PPE) Validation Checklist During care of the patient with known or suspected COVID-19
Personal Protective Equipment (PPE) ValidationStaff Training Overview
Purpose
To create a consistent process of monitoring Donning and Doffing of PPE consistent
with CDC recommendations
Refer to Appendix C for the PPE Validation Self-Check Attestation
Refer to Appendix D for the PPE Validation Checklist for Monitor Observing
Expectations
bull Form Overview and Associate actions
Appendix C Personal Protective Equipment (PPE) Validation Self-Check Attestation
o Staff assigned to care for patient suspected or confirmed with COVID-19
o Reviews proper PPE donning and doffing expectations
o Attests that they will report any PPE needs for Ante Room
o Attests that they will report any PPE suspected of malfunctioning o Understands that they may be monitored for proper
donning and doffing
o Signs that they understand the importance of consistent
PPE compliance
o Files completed form in employee file
Appendix D Personal Protective Equipment (PPE) Validation Checklist (for Monitors observing)
Each individual entering patient room if suspected or confirmed COVID-19 will be
monitored for safe donning and doffing practices The assigned PPE Monitor will
OBSERVE and VALIDATE every time
o Proper PPE application
o Proper Date and Room number
o Consistent time entries for EACH time individual enters the room and exits o Assigned PPE Monitor and ALL Caregivers to enter Role Printed Name and
Signature
o Monitor to print name and relationship if visitor
o Forward to charge nurse Infection Control will pick up o Note multiple sheets may be required each day based on individuals entering the
room
o Note MUST remind individuals that doffing may require self-monitoring if Ante Room DOES NOT have a window Do NOT open doors for these doffing observations
o Both the HCP providing care and the monitor will document PPE use and
hand hygiene for both donning and doffing
bull Appendix E PUI Isolation Sign-InOut Sheet
bull Appendix F Infection PreventionLeader Rounding Checklist
13
Important Update Regarding Air Pressure in OrsProcedural Areas
1) All Operating Rooms and procedure rooms (including Cath Lab and IR) need to maintain
a positive pressure relationship to the adjacent areas Altering the airflow in these areas
compromises the sterile environment and puts healthcare workers at greater risk of
exposure
2) NEVER put an N95 mask on a patient Patients should be transported with a procedural
mask
3) Proper room cleaning should be as follows
Terminal clean of an ORprocedure space
a If an aerosol generating procedure was not performed
bull Procedure room may be cleaned immediately
bull Contact EVS and request a COVID-19 terminal clean
b If an aerosol generating procedure was performed
bull Close procedure room and do not allow anyone to enter the space
for 1 hour
bull After one hour has passed contact EVS and request a COVID-19
terminal clean
Reference
American Society of Healthcare Engineering (ASHE)American Hospital Association
(AHA) Facility Guidelines
From the ASHE Website
14
Transporting of PUI or Confirmed COVID 19 patients Within a Health Care Facility
What personal protective equipment (PPE) should be worn by individuals transporting
patients who are confirmed with or under investigation for COVID-19 within a healthcare
facility For example what PPE should be worn when transporting a patient to radiology
for imaging that cannot be performed in the patient room
In general transport and movement of the patient outside of their room should be limited to medically essential purposes If being transported outside of the room such as to radiology healthcare personnel (HCP) in the receiving area should be notified in advance of transporting the patient For transport the patient should wear a facemask to contain secretions and be covered with a clean sheet
If transport personnel must prepare the patient for transport (eg transfer them to the wheelchair or gurney) transport personnel should wear all recommended PPE (gloves a gown respiratory protection that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator or facemaskmdashif a respirator is not availablemdashand eye protection [ie goggles or disposable face shield that covers the front and sides of the face]) This recommendation is needed because these interactions typically involve close often face-to-face contact with the patient in an enclosed space (eg patient room) Once the patient has been transferred to the wheelchair or gurney (and prior to exiting the room) transporters should remove their gown gloves and eye protection and perform hand hygiene
If the patient is wearing a facemask no recommendation for PPE is made typically for HCP transporting patients with a respiratory infection from the patientrsquos room to the destination However given current limitations in knowledge regarding COVID-19 and following the currently cautious approach for risk stratification and monitoring of healthcare personnel caring for patients with COVID-19 use of a facemask by the transporter is recommended for anything more than brief encounters with COVID-19 patients Additional PPE should not be required unless there is an anticipated need to provide medical assistance during transport (eg helping the patient replace a dislodged facemask)
After arrival at their destination receiving personnel (eg in radiology) and the transporter (if assisting with transfer) should perform hand hygiene and wear all recommended PPE If still wearing their original respirator or facemask the transporter should take care to avoid self- contamination when donning the remainder of the recommended PPE This cautious approach will be refined and updated as more information becomes available and as response needs change in the United States
Interim guidance for EMS personnel transporting patients with confirmed or suspected COVID-19 is available here EMS personnel should wear all recommended PPE because they are providing direct medical care and in close contact with the patient for longer periods of time Reference httpswwwcdcgovcoronavirus2019-ncovinfection-controlinfection- prevention-control-faqhtml
15
Chapter 3 Cleaning
16
During this COVID-19 crisis please be aware that you may see a variety of disinfectantswipes for use against COVID-19 The below products are listed on the EPAs website for approved disinfectants against COVID-19 Please be mindful of reviewing the contact time (in minutes) recommended by each manufacturer as it varies per product Products noted for killing C diff spores are noted these products will also disinfectant against COVID-19 Please be mindful that spray disinfectant of any kind should not be sprayed directly on equipment or monitors Spray disinfectant will need to be sprayed on a wiperag before wiping down equipment of any kind to prevent damage andor malfunction
Image of the Product Product Name and number Company Name Contact Time (In Minutes)
Sani-Cloth XLarge 55 Alcohol Q86984
GRAINGER - 9JAJ1 (1) 172H69 (6pk)
Super Sani Large 55 Alcohol
Q55172
GRAINGER - 9RYJ7 (1)
Professional Disposables
International
2 minutes
Sani-Cloth Bleach Germicidal PDI P54072 P25784 P7007P P700RF H58195
U26595
GRAINGER - 16Z989
Professional Disposables
International
4 minutes
kills C Diff spores in 4
minutes
Sani-Cloth AF3 Large Canister P13872
Sani-Cloth AF3 Germicidal Wipes XL
81626514
Professional Disposables
International
Performance Health
3 minutes
SaniPrime (RTU-Wipes)
P25372 P24284 H06182 amp U13195
Professional Disposables
International
1 minute
17
Caviwipe1 XL 65 WipesCanister 13-5150
GRAINGER - 6TWF8 - 13-1150
Caviwipe1 Regular 160 WipesCanister 13-5100
Metrex For the coronavirus this
wipe does in fact need a 3-
minute kill time All other
pathogens require a 1
minute But only the
Coronavirus or in this case the
Adenovirus (most similar) is going to require
the use of 3-minute kill time
Caviwipe Bleach 6X10 90 WipesCanister 13-9100
Metrex 3 minutes
kills C Diff spores in 3
minutes
Cavicide (RTU)
GRAINGER - 3VDJ1 (24oz Bottle) 3VDJ2 (1gal Bottle) 3VDJ3 (25 Gal Bottle) 3VDJ7 (25 Gal
Easy Pour Jug)
Metrex 3 minutes
Clorox Healthcarereg Bleach Germicidal Wipes Office Depot 439675 1630225 265701
825962 8373413 764946 129202 8193323 8193614 8193080
Medline CLO30358H CLO35309 CLO31424Z
CLO31424 CLO30577H CLO30577
GRAINGER 1XEZ3 4XKR8 4XKR7 6VDE9
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
kills C diff spores
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
10
N95 RESPIRATOR PRODUCT UPDATE
In order to ensure protection and prevent a
disruption in product availability AMITA Health is
implementing the use of additional models of N95
respirators
In addition a full face shield must always be used
when wearing any N95 respirator per the AMITA
Health COVID-19 Infection Prevention ndash Acute Care
playbook
More information on COVID-19 playbooks and resources
can be found at
httpswwwamitahealthorgcovid-19-amita
11
AMITA Healthrsquos facilities have previously used the following models of N95s
Brand Model Photo
3M 1860
1860S
1870+
Halyard 46727
46827
AMITA Healthrsquos facilities will begin fit-testing and distributing the following models of N95s
Brand Model Photo
3M 8511
8210
Gerson 2140
For any questions please connect directly with your local Resource Group Operations Manager and
Critical Products Manager
12
Personal Protective Equipment (PPE) Validation Checklist During care of the patient with known or suspected COVID-19
Personal Protective Equipment (PPE) ValidationStaff Training Overview
Purpose
To create a consistent process of monitoring Donning and Doffing of PPE consistent
with CDC recommendations
Refer to Appendix C for the PPE Validation Self-Check Attestation
Refer to Appendix D for the PPE Validation Checklist for Monitor Observing
Expectations
bull Form Overview and Associate actions
Appendix C Personal Protective Equipment (PPE) Validation Self-Check Attestation
o Staff assigned to care for patient suspected or confirmed with COVID-19
o Reviews proper PPE donning and doffing expectations
o Attests that they will report any PPE needs for Ante Room
o Attests that they will report any PPE suspected of malfunctioning o Understands that they may be monitored for proper
donning and doffing
o Signs that they understand the importance of consistent
PPE compliance
o Files completed form in employee file
Appendix D Personal Protective Equipment (PPE) Validation Checklist (for Monitors observing)
Each individual entering patient room if suspected or confirmed COVID-19 will be
monitored for safe donning and doffing practices The assigned PPE Monitor will
OBSERVE and VALIDATE every time
o Proper PPE application
o Proper Date and Room number
o Consistent time entries for EACH time individual enters the room and exits o Assigned PPE Monitor and ALL Caregivers to enter Role Printed Name and
Signature
o Monitor to print name and relationship if visitor
o Forward to charge nurse Infection Control will pick up o Note multiple sheets may be required each day based on individuals entering the
room
o Note MUST remind individuals that doffing may require self-monitoring if Ante Room DOES NOT have a window Do NOT open doors for these doffing observations
o Both the HCP providing care and the monitor will document PPE use and
hand hygiene for both donning and doffing
bull Appendix E PUI Isolation Sign-InOut Sheet
bull Appendix F Infection PreventionLeader Rounding Checklist
13
Important Update Regarding Air Pressure in OrsProcedural Areas
1) All Operating Rooms and procedure rooms (including Cath Lab and IR) need to maintain
a positive pressure relationship to the adjacent areas Altering the airflow in these areas
compromises the sterile environment and puts healthcare workers at greater risk of
exposure
2) NEVER put an N95 mask on a patient Patients should be transported with a procedural
mask
3) Proper room cleaning should be as follows
Terminal clean of an ORprocedure space
a If an aerosol generating procedure was not performed
bull Procedure room may be cleaned immediately
bull Contact EVS and request a COVID-19 terminal clean
b If an aerosol generating procedure was performed
bull Close procedure room and do not allow anyone to enter the space
for 1 hour
bull After one hour has passed contact EVS and request a COVID-19
terminal clean
Reference
American Society of Healthcare Engineering (ASHE)American Hospital Association
(AHA) Facility Guidelines
From the ASHE Website
14
Transporting of PUI or Confirmed COVID 19 patients Within a Health Care Facility
What personal protective equipment (PPE) should be worn by individuals transporting
patients who are confirmed with or under investigation for COVID-19 within a healthcare
facility For example what PPE should be worn when transporting a patient to radiology
for imaging that cannot be performed in the patient room
In general transport and movement of the patient outside of their room should be limited to medically essential purposes If being transported outside of the room such as to radiology healthcare personnel (HCP) in the receiving area should be notified in advance of transporting the patient For transport the patient should wear a facemask to contain secretions and be covered with a clean sheet
If transport personnel must prepare the patient for transport (eg transfer them to the wheelchair or gurney) transport personnel should wear all recommended PPE (gloves a gown respiratory protection that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator or facemaskmdashif a respirator is not availablemdashand eye protection [ie goggles or disposable face shield that covers the front and sides of the face]) This recommendation is needed because these interactions typically involve close often face-to-face contact with the patient in an enclosed space (eg patient room) Once the patient has been transferred to the wheelchair or gurney (and prior to exiting the room) transporters should remove their gown gloves and eye protection and perform hand hygiene
If the patient is wearing a facemask no recommendation for PPE is made typically for HCP transporting patients with a respiratory infection from the patientrsquos room to the destination However given current limitations in knowledge regarding COVID-19 and following the currently cautious approach for risk stratification and monitoring of healthcare personnel caring for patients with COVID-19 use of a facemask by the transporter is recommended for anything more than brief encounters with COVID-19 patients Additional PPE should not be required unless there is an anticipated need to provide medical assistance during transport (eg helping the patient replace a dislodged facemask)
After arrival at their destination receiving personnel (eg in radiology) and the transporter (if assisting with transfer) should perform hand hygiene and wear all recommended PPE If still wearing their original respirator or facemask the transporter should take care to avoid self- contamination when donning the remainder of the recommended PPE This cautious approach will be refined and updated as more information becomes available and as response needs change in the United States
Interim guidance for EMS personnel transporting patients with confirmed or suspected COVID-19 is available here EMS personnel should wear all recommended PPE because they are providing direct medical care and in close contact with the patient for longer periods of time Reference httpswwwcdcgovcoronavirus2019-ncovinfection-controlinfection- prevention-control-faqhtml
15
Chapter 3 Cleaning
16
During this COVID-19 crisis please be aware that you may see a variety of disinfectantswipes for use against COVID-19 The below products are listed on the EPAs website for approved disinfectants against COVID-19 Please be mindful of reviewing the contact time (in minutes) recommended by each manufacturer as it varies per product Products noted for killing C diff spores are noted these products will also disinfectant against COVID-19 Please be mindful that spray disinfectant of any kind should not be sprayed directly on equipment or monitors Spray disinfectant will need to be sprayed on a wiperag before wiping down equipment of any kind to prevent damage andor malfunction
Image of the Product Product Name and number Company Name Contact Time (In Minutes)
Sani-Cloth XLarge 55 Alcohol Q86984
GRAINGER - 9JAJ1 (1) 172H69 (6pk)
Super Sani Large 55 Alcohol
Q55172
GRAINGER - 9RYJ7 (1)
Professional Disposables
International
2 minutes
Sani-Cloth Bleach Germicidal PDI P54072 P25784 P7007P P700RF H58195
U26595
GRAINGER - 16Z989
Professional Disposables
International
4 minutes
kills C Diff spores in 4
minutes
Sani-Cloth AF3 Large Canister P13872
Sani-Cloth AF3 Germicidal Wipes XL
81626514
Professional Disposables
International
Performance Health
3 minutes
SaniPrime (RTU-Wipes)
P25372 P24284 H06182 amp U13195
Professional Disposables
International
1 minute
17
Caviwipe1 XL 65 WipesCanister 13-5150
GRAINGER - 6TWF8 - 13-1150
Caviwipe1 Regular 160 WipesCanister 13-5100
Metrex For the coronavirus this
wipe does in fact need a 3-
minute kill time All other
pathogens require a 1
minute But only the
Coronavirus or in this case the
Adenovirus (most similar) is going to require
the use of 3-minute kill time
Caviwipe Bleach 6X10 90 WipesCanister 13-9100
Metrex 3 minutes
kills C Diff spores in 3
minutes
Cavicide (RTU)
GRAINGER - 3VDJ1 (24oz Bottle) 3VDJ2 (1gal Bottle) 3VDJ3 (25 Gal Bottle) 3VDJ7 (25 Gal
Easy Pour Jug)
Metrex 3 minutes
Clorox Healthcarereg Bleach Germicidal Wipes Office Depot 439675 1630225 265701
825962 8373413 764946 129202 8193323 8193614 8193080
Medline CLO30358H CLO35309 CLO31424Z
CLO31424 CLO30577H CLO30577
GRAINGER 1XEZ3 4XKR8 4XKR7 6VDE9
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
kills C diff spores
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
11
AMITA Healthrsquos facilities have previously used the following models of N95s
Brand Model Photo
3M 1860
1860S
1870+
Halyard 46727
46827
AMITA Healthrsquos facilities will begin fit-testing and distributing the following models of N95s
Brand Model Photo
3M 8511
8210
Gerson 2140
For any questions please connect directly with your local Resource Group Operations Manager and
Critical Products Manager
12
Personal Protective Equipment (PPE) Validation Checklist During care of the patient with known or suspected COVID-19
Personal Protective Equipment (PPE) ValidationStaff Training Overview
Purpose
To create a consistent process of monitoring Donning and Doffing of PPE consistent
with CDC recommendations
Refer to Appendix C for the PPE Validation Self-Check Attestation
Refer to Appendix D for the PPE Validation Checklist for Monitor Observing
Expectations
bull Form Overview and Associate actions
Appendix C Personal Protective Equipment (PPE) Validation Self-Check Attestation
o Staff assigned to care for patient suspected or confirmed with COVID-19
o Reviews proper PPE donning and doffing expectations
o Attests that they will report any PPE needs for Ante Room
o Attests that they will report any PPE suspected of malfunctioning o Understands that they may be monitored for proper
donning and doffing
o Signs that they understand the importance of consistent
PPE compliance
o Files completed form in employee file
Appendix D Personal Protective Equipment (PPE) Validation Checklist (for Monitors observing)
Each individual entering patient room if suspected or confirmed COVID-19 will be
monitored for safe donning and doffing practices The assigned PPE Monitor will
OBSERVE and VALIDATE every time
o Proper PPE application
o Proper Date and Room number
o Consistent time entries for EACH time individual enters the room and exits o Assigned PPE Monitor and ALL Caregivers to enter Role Printed Name and
Signature
o Monitor to print name and relationship if visitor
o Forward to charge nurse Infection Control will pick up o Note multiple sheets may be required each day based on individuals entering the
room
o Note MUST remind individuals that doffing may require self-monitoring if Ante Room DOES NOT have a window Do NOT open doors for these doffing observations
o Both the HCP providing care and the monitor will document PPE use and
hand hygiene for both donning and doffing
bull Appendix E PUI Isolation Sign-InOut Sheet
bull Appendix F Infection PreventionLeader Rounding Checklist
13
Important Update Regarding Air Pressure in OrsProcedural Areas
1) All Operating Rooms and procedure rooms (including Cath Lab and IR) need to maintain
a positive pressure relationship to the adjacent areas Altering the airflow in these areas
compromises the sterile environment and puts healthcare workers at greater risk of
exposure
2) NEVER put an N95 mask on a patient Patients should be transported with a procedural
mask
3) Proper room cleaning should be as follows
Terminal clean of an ORprocedure space
a If an aerosol generating procedure was not performed
bull Procedure room may be cleaned immediately
bull Contact EVS and request a COVID-19 terminal clean
b If an aerosol generating procedure was performed
bull Close procedure room and do not allow anyone to enter the space
for 1 hour
bull After one hour has passed contact EVS and request a COVID-19
terminal clean
Reference
American Society of Healthcare Engineering (ASHE)American Hospital Association
(AHA) Facility Guidelines
From the ASHE Website
14
Transporting of PUI or Confirmed COVID 19 patients Within a Health Care Facility
What personal protective equipment (PPE) should be worn by individuals transporting
patients who are confirmed with or under investigation for COVID-19 within a healthcare
facility For example what PPE should be worn when transporting a patient to radiology
for imaging that cannot be performed in the patient room
In general transport and movement of the patient outside of their room should be limited to medically essential purposes If being transported outside of the room such as to radiology healthcare personnel (HCP) in the receiving area should be notified in advance of transporting the patient For transport the patient should wear a facemask to contain secretions and be covered with a clean sheet
If transport personnel must prepare the patient for transport (eg transfer them to the wheelchair or gurney) transport personnel should wear all recommended PPE (gloves a gown respiratory protection that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator or facemaskmdashif a respirator is not availablemdashand eye protection [ie goggles or disposable face shield that covers the front and sides of the face]) This recommendation is needed because these interactions typically involve close often face-to-face contact with the patient in an enclosed space (eg patient room) Once the patient has been transferred to the wheelchair or gurney (and prior to exiting the room) transporters should remove their gown gloves and eye protection and perform hand hygiene
If the patient is wearing a facemask no recommendation for PPE is made typically for HCP transporting patients with a respiratory infection from the patientrsquos room to the destination However given current limitations in knowledge regarding COVID-19 and following the currently cautious approach for risk stratification and monitoring of healthcare personnel caring for patients with COVID-19 use of a facemask by the transporter is recommended for anything more than brief encounters with COVID-19 patients Additional PPE should not be required unless there is an anticipated need to provide medical assistance during transport (eg helping the patient replace a dislodged facemask)
After arrival at their destination receiving personnel (eg in radiology) and the transporter (if assisting with transfer) should perform hand hygiene and wear all recommended PPE If still wearing their original respirator or facemask the transporter should take care to avoid self- contamination when donning the remainder of the recommended PPE This cautious approach will be refined and updated as more information becomes available and as response needs change in the United States
Interim guidance for EMS personnel transporting patients with confirmed or suspected COVID-19 is available here EMS personnel should wear all recommended PPE because they are providing direct medical care and in close contact with the patient for longer periods of time Reference httpswwwcdcgovcoronavirus2019-ncovinfection-controlinfection- prevention-control-faqhtml
15
Chapter 3 Cleaning
16
During this COVID-19 crisis please be aware that you may see a variety of disinfectantswipes for use against COVID-19 The below products are listed on the EPAs website for approved disinfectants against COVID-19 Please be mindful of reviewing the contact time (in minutes) recommended by each manufacturer as it varies per product Products noted for killing C diff spores are noted these products will also disinfectant against COVID-19 Please be mindful that spray disinfectant of any kind should not be sprayed directly on equipment or monitors Spray disinfectant will need to be sprayed on a wiperag before wiping down equipment of any kind to prevent damage andor malfunction
Image of the Product Product Name and number Company Name Contact Time (In Minutes)
Sani-Cloth XLarge 55 Alcohol Q86984
GRAINGER - 9JAJ1 (1) 172H69 (6pk)
Super Sani Large 55 Alcohol
Q55172
GRAINGER - 9RYJ7 (1)
Professional Disposables
International
2 minutes
Sani-Cloth Bleach Germicidal PDI P54072 P25784 P7007P P700RF H58195
U26595
GRAINGER - 16Z989
Professional Disposables
International
4 minutes
kills C Diff spores in 4
minutes
Sani-Cloth AF3 Large Canister P13872
Sani-Cloth AF3 Germicidal Wipes XL
81626514
Professional Disposables
International
Performance Health
3 minutes
SaniPrime (RTU-Wipes)
P25372 P24284 H06182 amp U13195
Professional Disposables
International
1 minute
17
Caviwipe1 XL 65 WipesCanister 13-5150
GRAINGER - 6TWF8 - 13-1150
Caviwipe1 Regular 160 WipesCanister 13-5100
Metrex For the coronavirus this
wipe does in fact need a 3-
minute kill time All other
pathogens require a 1
minute But only the
Coronavirus or in this case the
Adenovirus (most similar) is going to require
the use of 3-minute kill time
Caviwipe Bleach 6X10 90 WipesCanister 13-9100
Metrex 3 minutes
kills C Diff spores in 3
minutes
Cavicide (RTU)
GRAINGER - 3VDJ1 (24oz Bottle) 3VDJ2 (1gal Bottle) 3VDJ3 (25 Gal Bottle) 3VDJ7 (25 Gal
Easy Pour Jug)
Metrex 3 minutes
Clorox Healthcarereg Bleach Germicidal Wipes Office Depot 439675 1630225 265701
825962 8373413 764946 129202 8193323 8193614 8193080
Medline CLO30358H CLO35309 CLO31424Z
CLO31424 CLO30577H CLO30577
GRAINGER 1XEZ3 4XKR8 4XKR7 6VDE9
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
kills C diff spores
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
12
Personal Protective Equipment (PPE) Validation Checklist During care of the patient with known or suspected COVID-19
Personal Protective Equipment (PPE) ValidationStaff Training Overview
Purpose
To create a consistent process of monitoring Donning and Doffing of PPE consistent
with CDC recommendations
Refer to Appendix C for the PPE Validation Self-Check Attestation
Refer to Appendix D for the PPE Validation Checklist for Monitor Observing
Expectations
bull Form Overview and Associate actions
Appendix C Personal Protective Equipment (PPE) Validation Self-Check Attestation
o Staff assigned to care for patient suspected or confirmed with COVID-19
o Reviews proper PPE donning and doffing expectations
o Attests that they will report any PPE needs for Ante Room
o Attests that they will report any PPE suspected of malfunctioning o Understands that they may be monitored for proper
donning and doffing
o Signs that they understand the importance of consistent
PPE compliance
o Files completed form in employee file
Appendix D Personal Protective Equipment (PPE) Validation Checklist (for Monitors observing)
Each individual entering patient room if suspected or confirmed COVID-19 will be
monitored for safe donning and doffing practices The assigned PPE Monitor will
OBSERVE and VALIDATE every time
o Proper PPE application
o Proper Date and Room number
o Consistent time entries for EACH time individual enters the room and exits o Assigned PPE Monitor and ALL Caregivers to enter Role Printed Name and
Signature
o Monitor to print name and relationship if visitor
o Forward to charge nurse Infection Control will pick up o Note multiple sheets may be required each day based on individuals entering the
room
o Note MUST remind individuals that doffing may require self-monitoring if Ante Room DOES NOT have a window Do NOT open doors for these doffing observations
o Both the HCP providing care and the monitor will document PPE use and
hand hygiene for both donning and doffing
bull Appendix E PUI Isolation Sign-InOut Sheet
bull Appendix F Infection PreventionLeader Rounding Checklist
13
Important Update Regarding Air Pressure in OrsProcedural Areas
1) All Operating Rooms and procedure rooms (including Cath Lab and IR) need to maintain
a positive pressure relationship to the adjacent areas Altering the airflow in these areas
compromises the sterile environment and puts healthcare workers at greater risk of
exposure
2) NEVER put an N95 mask on a patient Patients should be transported with a procedural
mask
3) Proper room cleaning should be as follows
Terminal clean of an ORprocedure space
a If an aerosol generating procedure was not performed
bull Procedure room may be cleaned immediately
bull Contact EVS and request a COVID-19 terminal clean
b If an aerosol generating procedure was performed
bull Close procedure room and do not allow anyone to enter the space
for 1 hour
bull After one hour has passed contact EVS and request a COVID-19
terminal clean
Reference
American Society of Healthcare Engineering (ASHE)American Hospital Association
(AHA) Facility Guidelines
From the ASHE Website
14
Transporting of PUI or Confirmed COVID 19 patients Within a Health Care Facility
What personal protective equipment (PPE) should be worn by individuals transporting
patients who are confirmed with or under investigation for COVID-19 within a healthcare
facility For example what PPE should be worn when transporting a patient to radiology
for imaging that cannot be performed in the patient room
In general transport and movement of the patient outside of their room should be limited to medically essential purposes If being transported outside of the room such as to radiology healthcare personnel (HCP) in the receiving area should be notified in advance of transporting the patient For transport the patient should wear a facemask to contain secretions and be covered with a clean sheet
If transport personnel must prepare the patient for transport (eg transfer them to the wheelchair or gurney) transport personnel should wear all recommended PPE (gloves a gown respiratory protection that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator or facemaskmdashif a respirator is not availablemdashand eye protection [ie goggles or disposable face shield that covers the front and sides of the face]) This recommendation is needed because these interactions typically involve close often face-to-face contact with the patient in an enclosed space (eg patient room) Once the patient has been transferred to the wheelchair or gurney (and prior to exiting the room) transporters should remove their gown gloves and eye protection and perform hand hygiene
If the patient is wearing a facemask no recommendation for PPE is made typically for HCP transporting patients with a respiratory infection from the patientrsquos room to the destination However given current limitations in knowledge regarding COVID-19 and following the currently cautious approach for risk stratification and monitoring of healthcare personnel caring for patients with COVID-19 use of a facemask by the transporter is recommended for anything more than brief encounters with COVID-19 patients Additional PPE should not be required unless there is an anticipated need to provide medical assistance during transport (eg helping the patient replace a dislodged facemask)
After arrival at their destination receiving personnel (eg in radiology) and the transporter (if assisting with transfer) should perform hand hygiene and wear all recommended PPE If still wearing their original respirator or facemask the transporter should take care to avoid self- contamination when donning the remainder of the recommended PPE This cautious approach will be refined and updated as more information becomes available and as response needs change in the United States
Interim guidance for EMS personnel transporting patients with confirmed or suspected COVID-19 is available here EMS personnel should wear all recommended PPE because they are providing direct medical care and in close contact with the patient for longer periods of time Reference httpswwwcdcgovcoronavirus2019-ncovinfection-controlinfection- prevention-control-faqhtml
15
Chapter 3 Cleaning
16
During this COVID-19 crisis please be aware that you may see a variety of disinfectantswipes for use against COVID-19 The below products are listed on the EPAs website for approved disinfectants against COVID-19 Please be mindful of reviewing the contact time (in minutes) recommended by each manufacturer as it varies per product Products noted for killing C diff spores are noted these products will also disinfectant against COVID-19 Please be mindful that spray disinfectant of any kind should not be sprayed directly on equipment or monitors Spray disinfectant will need to be sprayed on a wiperag before wiping down equipment of any kind to prevent damage andor malfunction
Image of the Product Product Name and number Company Name Contact Time (In Minutes)
Sani-Cloth XLarge 55 Alcohol Q86984
GRAINGER - 9JAJ1 (1) 172H69 (6pk)
Super Sani Large 55 Alcohol
Q55172
GRAINGER - 9RYJ7 (1)
Professional Disposables
International
2 minutes
Sani-Cloth Bleach Germicidal PDI P54072 P25784 P7007P P700RF H58195
U26595
GRAINGER - 16Z989
Professional Disposables
International
4 minutes
kills C Diff spores in 4
minutes
Sani-Cloth AF3 Large Canister P13872
Sani-Cloth AF3 Germicidal Wipes XL
81626514
Professional Disposables
International
Performance Health
3 minutes
SaniPrime (RTU-Wipes)
P25372 P24284 H06182 amp U13195
Professional Disposables
International
1 minute
17
Caviwipe1 XL 65 WipesCanister 13-5150
GRAINGER - 6TWF8 - 13-1150
Caviwipe1 Regular 160 WipesCanister 13-5100
Metrex For the coronavirus this
wipe does in fact need a 3-
minute kill time All other
pathogens require a 1
minute But only the
Coronavirus or in this case the
Adenovirus (most similar) is going to require
the use of 3-minute kill time
Caviwipe Bleach 6X10 90 WipesCanister 13-9100
Metrex 3 minutes
kills C Diff spores in 3
minutes
Cavicide (RTU)
GRAINGER - 3VDJ1 (24oz Bottle) 3VDJ2 (1gal Bottle) 3VDJ3 (25 Gal Bottle) 3VDJ7 (25 Gal
Easy Pour Jug)
Metrex 3 minutes
Clorox Healthcarereg Bleach Germicidal Wipes Office Depot 439675 1630225 265701
825962 8373413 764946 129202 8193323 8193614 8193080
Medline CLO30358H CLO35309 CLO31424Z
CLO31424 CLO30577H CLO30577
GRAINGER 1XEZ3 4XKR8 4XKR7 6VDE9
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
kills C diff spores
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
13
Important Update Regarding Air Pressure in OrsProcedural Areas
1) All Operating Rooms and procedure rooms (including Cath Lab and IR) need to maintain
a positive pressure relationship to the adjacent areas Altering the airflow in these areas
compromises the sterile environment and puts healthcare workers at greater risk of
exposure
2) NEVER put an N95 mask on a patient Patients should be transported with a procedural
mask
3) Proper room cleaning should be as follows
Terminal clean of an ORprocedure space
a If an aerosol generating procedure was not performed
bull Procedure room may be cleaned immediately
bull Contact EVS and request a COVID-19 terminal clean
b If an aerosol generating procedure was performed
bull Close procedure room and do not allow anyone to enter the space
for 1 hour
bull After one hour has passed contact EVS and request a COVID-19
terminal clean
Reference
American Society of Healthcare Engineering (ASHE)American Hospital Association
(AHA) Facility Guidelines
From the ASHE Website
14
Transporting of PUI or Confirmed COVID 19 patients Within a Health Care Facility
What personal protective equipment (PPE) should be worn by individuals transporting
patients who are confirmed with or under investigation for COVID-19 within a healthcare
facility For example what PPE should be worn when transporting a patient to radiology
for imaging that cannot be performed in the patient room
In general transport and movement of the patient outside of their room should be limited to medically essential purposes If being transported outside of the room such as to radiology healthcare personnel (HCP) in the receiving area should be notified in advance of transporting the patient For transport the patient should wear a facemask to contain secretions and be covered with a clean sheet
If transport personnel must prepare the patient for transport (eg transfer them to the wheelchair or gurney) transport personnel should wear all recommended PPE (gloves a gown respiratory protection that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator or facemaskmdashif a respirator is not availablemdashand eye protection [ie goggles or disposable face shield that covers the front and sides of the face]) This recommendation is needed because these interactions typically involve close often face-to-face contact with the patient in an enclosed space (eg patient room) Once the patient has been transferred to the wheelchair or gurney (and prior to exiting the room) transporters should remove their gown gloves and eye protection and perform hand hygiene
If the patient is wearing a facemask no recommendation for PPE is made typically for HCP transporting patients with a respiratory infection from the patientrsquos room to the destination However given current limitations in knowledge regarding COVID-19 and following the currently cautious approach for risk stratification and monitoring of healthcare personnel caring for patients with COVID-19 use of a facemask by the transporter is recommended for anything more than brief encounters with COVID-19 patients Additional PPE should not be required unless there is an anticipated need to provide medical assistance during transport (eg helping the patient replace a dislodged facemask)
After arrival at their destination receiving personnel (eg in radiology) and the transporter (if assisting with transfer) should perform hand hygiene and wear all recommended PPE If still wearing their original respirator or facemask the transporter should take care to avoid self- contamination when donning the remainder of the recommended PPE This cautious approach will be refined and updated as more information becomes available and as response needs change in the United States
Interim guidance for EMS personnel transporting patients with confirmed or suspected COVID-19 is available here EMS personnel should wear all recommended PPE because they are providing direct medical care and in close contact with the patient for longer periods of time Reference httpswwwcdcgovcoronavirus2019-ncovinfection-controlinfection- prevention-control-faqhtml
15
Chapter 3 Cleaning
16
During this COVID-19 crisis please be aware that you may see a variety of disinfectantswipes for use against COVID-19 The below products are listed on the EPAs website for approved disinfectants against COVID-19 Please be mindful of reviewing the contact time (in minutes) recommended by each manufacturer as it varies per product Products noted for killing C diff spores are noted these products will also disinfectant against COVID-19 Please be mindful that spray disinfectant of any kind should not be sprayed directly on equipment or monitors Spray disinfectant will need to be sprayed on a wiperag before wiping down equipment of any kind to prevent damage andor malfunction
Image of the Product Product Name and number Company Name Contact Time (In Minutes)
Sani-Cloth XLarge 55 Alcohol Q86984
GRAINGER - 9JAJ1 (1) 172H69 (6pk)
Super Sani Large 55 Alcohol
Q55172
GRAINGER - 9RYJ7 (1)
Professional Disposables
International
2 minutes
Sani-Cloth Bleach Germicidal PDI P54072 P25784 P7007P P700RF H58195
U26595
GRAINGER - 16Z989
Professional Disposables
International
4 minutes
kills C Diff spores in 4
minutes
Sani-Cloth AF3 Large Canister P13872
Sani-Cloth AF3 Germicidal Wipes XL
81626514
Professional Disposables
International
Performance Health
3 minutes
SaniPrime (RTU-Wipes)
P25372 P24284 H06182 amp U13195
Professional Disposables
International
1 minute
17
Caviwipe1 XL 65 WipesCanister 13-5150
GRAINGER - 6TWF8 - 13-1150
Caviwipe1 Regular 160 WipesCanister 13-5100
Metrex For the coronavirus this
wipe does in fact need a 3-
minute kill time All other
pathogens require a 1
minute But only the
Coronavirus or in this case the
Adenovirus (most similar) is going to require
the use of 3-minute kill time
Caviwipe Bleach 6X10 90 WipesCanister 13-9100
Metrex 3 minutes
kills C Diff spores in 3
minutes
Cavicide (RTU)
GRAINGER - 3VDJ1 (24oz Bottle) 3VDJ2 (1gal Bottle) 3VDJ3 (25 Gal Bottle) 3VDJ7 (25 Gal
Easy Pour Jug)
Metrex 3 minutes
Clorox Healthcarereg Bleach Germicidal Wipes Office Depot 439675 1630225 265701
825962 8373413 764946 129202 8193323 8193614 8193080
Medline CLO30358H CLO35309 CLO31424Z
CLO31424 CLO30577H CLO30577
GRAINGER 1XEZ3 4XKR8 4XKR7 6VDE9
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
kills C diff spores
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
14
Transporting of PUI or Confirmed COVID 19 patients Within a Health Care Facility
What personal protective equipment (PPE) should be worn by individuals transporting
patients who are confirmed with or under investigation for COVID-19 within a healthcare
facility For example what PPE should be worn when transporting a patient to radiology
for imaging that cannot be performed in the patient room
In general transport and movement of the patient outside of their room should be limited to medically essential purposes If being transported outside of the room such as to radiology healthcare personnel (HCP) in the receiving area should be notified in advance of transporting the patient For transport the patient should wear a facemask to contain secretions and be covered with a clean sheet
If transport personnel must prepare the patient for transport (eg transfer them to the wheelchair or gurney) transport personnel should wear all recommended PPE (gloves a gown respiratory protection that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator or facemaskmdashif a respirator is not availablemdashand eye protection [ie goggles or disposable face shield that covers the front and sides of the face]) This recommendation is needed because these interactions typically involve close often face-to-face contact with the patient in an enclosed space (eg patient room) Once the patient has been transferred to the wheelchair or gurney (and prior to exiting the room) transporters should remove their gown gloves and eye protection and perform hand hygiene
If the patient is wearing a facemask no recommendation for PPE is made typically for HCP transporting patients with a respiratory infection from the patientrsquos room to the destination However given current limitations in knowledge regarding COVID-19 and following the currently cautious approach for risk stratification and monitoring of healthcare personnel caring for patients with COVID-19 use of a facemask by the transporter is recommended for anything more than brief encounters with COVID-19 patients Additional PPE should not be required unless there is an anticipated need to provide medical assistance during transport (eg helping the patient replace a dislodged facemask)
After arrival at their destination receiving personnel (eg in radiology) and the transporter (if assisting with transfer) should perform hand hygiene and wear all recommended PPE If still wearing their original respirator or facemask the transporter should take care to avoid self- contamination when donning the remainder of the recommended PPE This cautious approach will be refined and updated as more information becomes available and as response needs change in the United States
Interim guidance for EMS personnel transporting patients with confirmed or suspected COVID-19 is available here EMS personnel should wear all recommended PPE because they are providing direct medical care and in close contact with the patient for longer periods of time Reference httpswwwcdcgovcoronavirus2019-ncovinfection-controlinfection- prevention-control-faqhtml
15
Chapter 3 Cleaning
16
During this COVID-19 crisis please be aware that you may see a variety of disinfectantswipes for use against COVID-19 The below products are listed on the EPAs website for approved disinfectants against COVID-19 Please be mindful of reviewing the contact time (in minutes) recommended by each manufacturer as it varies per product Products noted for killing C diff spores are noted these products will also disinfectant against COVID-19 Please be mindful that spray disinfectant of any kind should not be sprayed directly on equipment or monitors Spray disinfectant will need to be sprayed on a wiperag before wiping down equipment of any kind to prevent damage andor malfunction
Image of the Product Product Name and number Company Name Contact Time (In Minutes)
Sani-Cloth XLarge 55 Alcohol Q86984
GRAINGER - 9JAJ1 (1) 172H69 (6pk)
Super Sani Large 55 Alcohol
Q55172
GRAINGER - 9RYJ7 (1)
Professional Disposables
International
2 minutes
Sani-Cloth Bleach Germicidal PDI P54072 P25784 P7007P P700RF H58195
U26595
GRAINGER - 16Z989
Professional Disposables
International
4 minutes
kills C Diff spores in 4
minutes
Sani-Cloth AF3 Large Canister P13872
Sani-Cloth AF3 Germicidal Wipes XL
81626514
Professional Disposables
International
Performance Health
3 minutes
SaniPrime (RTU-Wipes)
P25372 P24284 H06182 amp U13195
Professional Disposables
International
1 minute
17
Caviwipe1 XL 65 WipesCanister 13-5150
GRAINGER - 6TWF8 - 13-1150
Caviwipe1 Regular 160 WipesCanister 13-5100
Metrex For the coronavirus this
wipe does in fact need a 3-
minute kill time All other
pathogens require a 1
minute But only the
Coronavirus or in this case the
Adenovirus (most similar) is going to require
the use of 3-minute kill time
Caviwipe Bleach 6X10 90 WipesCanister 13-9100
Metrex 3 minutes
kills C Diff spores in 3
minutes
Cavicide (RTU)
GRAINGER - 3VDJ1 (24oz Bottle) 3VDJ2 (1gal Bottle) 3VDJ3 (25 Gal Bottle) 3VDJ7 (25 Gal
Easy Pour Jug)
Metrex 3 minutes
Clorox Healthcarereg Bleach Germicidal Wipes Office Depot 439675 1630225 265701
825962 8373413 764946 129202 8193323 8193614 8193080
Medline CLO30358H CLO35309 CLO31424Z
CLO31424 CLO30577H CLO30577
GRAINGER 1XEZ3 4XKR8 4XKR7 6VDE9
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
kills C diff spores
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
15
Chapter 3 Cleaning
16
During this COVID-19 crisis please be aware that you may see a variety of disinfectantswipes for use against COVID-19 The below products are listed on the EPAs website for approved disinfectants against COVID-19 Please be mindful of reviewing the contact time (in minutes) recommended by each manufacturer as it varies per product Products noted for killing C diff spores are noted these products will also disinfectant against COVID-19 Please be mindful that spray disinfectant of any kind should not be sprayed directly on equipment or monitors Spray disinfectant will need to be sprayed on a wiperag before wiping down equipment of any kind to prevent damage andor malfunction
Image of the Product Product Name and number Company Name Contact Time (In Minutes)
Sani-Cloth XLarge 55 Alcohol Q86984
GRAINGER - 9JAJ1 (1) 172H69 (6pk)
Super Sani Large 55 Alcohol
Q55172
GRAINGER - 9RYJ7 (1)
Professional Disposables
International
2 minutes
Sani-Cloth Bleach Germicidal PDI P54072 P25784 P7007P P700RF H58195
U26595
GRAINGER - 16Z989
Professional Disposables
International
4 minutes
kills C Diff spores in 4
minutes
Sani-Cloth AF3 Large Canister P13872
Sani-Cloth AF3 Germicidal Wipes XL
81626514
Professional Disposables
International
Performance Health
3 minutes
SaniPrime (RTU-Wipes)
P25372 P24284 H06182 amp U13195
Professional Disposables
International
1 minute
17
Caviwipe1 XL 65 WipesCanister 13-5150
GRAINGER - 6TWF8 - 13-1150
Caviwipe1 Regular 160 WipesCanister 13-5100
Metrex For the coronavirus this
wipe does in fact need a 3-
minute kill time All other
pathogens require a 1
minute But only the
Coronavirus or in this case the
Adenovirus (most similar) is going to require
the use of 3-minute kill time
Caviwipe Bleach 6X10 90 WipesCanister 13-9100
Metrex 3 minutes
kills C Diff spores in 3
minutes
Cavicide (RTU)
GRAINGER - 3VDJ1 (24oz Bottle) 3VDJ2 (1gal Bottle) 3VDJ3 (25 Gal Bottle) 3VDJ7 (25 Gal
Easy Pour Jug)
Metrex 3 minutes
Clorox Healthcarereg Bleach Germicidal Wipes Office Depot 439675 1630225 265701
825962 8373413 764946 129202 8193323 8193614 8193080
Medline CLO30358H CLO35309 CLO31424Z
CLO31424 CLO30577H CLO30577
GRAINGER 1XEZ3 4XKR8 4XKR7 6VDE9
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
kills C diff spores
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
16
During this COVID-19 crisis please be aware that you may see a variety of disinfectantswipes for use against COVID-19 The below products are listed on the EPAs website for approved disinfectants against COVID-19 Please be mindful of reviewing the contact time (in minutes) recommended by each manufacturer as it varies per product Products noted for killing C diff spores are noted these products will also disinfectant against COVID-19 Please be mindful that spray disinfectant of any kind should not be sprayed directly on equipment or monitors Spray disinfectant will need to be sprayed on a wiperag before wiping down equipment of any kind to prevent damage andor malfunction
Image of the Product Product Name and number Company Name Contact Time (In Minutes)
Sani-Cloth XLarge 55 Alcohol Q86984
GRAINGER - 9JAJ1 (1) 172H69 (6pk)
Super Sani Large 55 Alcohol
Q55172
GRAINGER - 9RYJ7 (1)
Professional Disposables
International
2 minutes
Sani-Cloth Bleach Germicidal PDI P54072 P25784 P7007P P700RF H58195
U26595
GRAINGER - 16Z989
Professional Disposables
International
4 minutes
kills C Diff spores in 4
minutes
Sani-Cloth AF3 Large Canister P13872
Sani-Cloth AF3 Germicidal Wipes XL
81626514
Professional Disposables
International
Performance Health
3 minutes
SaniPrime (RTU-Wipes)
P25372 P24284 H06182 amp U13195
Professional Disposables
International
1 minute
17
Caviwipe1 XL 65 WipesCanister 13-5150
GRAINGER - 6TWF8 - 13-1150
Caviwipe1 Regular 160 WipesCanister 13-5100
Metrex For the coronavirus this
wipe does in fact need a 3-
minute kill time All other
pathogens require a 1
minute But only the
Coronavirus or in this case the
Adenovirus (most similar) is going to require
the use of 3-minute kill time
Caviwipe Bleach 6X10 90 WipesCanister 13-9100
Metrex 3 minutes
kills C Diff spores in 3
minutes
Cavicide (RTU)
GRAINGER - 3VDJ1 (24oz Bottle) 3VDJ2 (1gal Bottle) 3VDJ3 (25 Gal Bottle) 3VDJ7 (25 Gal
Easy Pour Jug)
Metrex 3 minutes
Clorox Healthcarereg Bleach Germicidal Wipes Office Depot 439675 1630225 265701
825962 8373413 764946 129202 8193323 8193614 8193080
Medline CLO30358H CLO35309 CLO31424Z
CLO31424 CLO30577H CLO30577
GRAINGER 1XEZ3 4XKR8 4XKR7 6VDE9
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
kills C diff spores
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
17
Caviwipe1 XL 65 WipesCanister 13-5150
GRAINGER - 6TWF8 - 13-1150
Caviwipe1 Regular 160 WipesCanister 13-5100
Metrex For the coronavirus this
wipe does in fact need a 3-
minute kill time All other
pathogens require a 1
minute But only the
Coronavirus or in this case the
Adenovirus (most similar) is going to require
the use of 3-minute kill time
Caviwipe Bleach 6X10 90 WipesCanister 13-9100
Metrex 3 minutes
kills C Diff spores in 3
minutes
Cavicide (RTU)
GRAINGER - 3VDJ1 (24oz Bottle) 3VDJ2 (1gal Bottle) 3VDJ3 (25 Gal Bottle) 3VDJ7 (25 Gal
Easy Pour Jug)
Metrex 3 minutes
Clorox Healthcarereg Bleach Germicidal Wipes Office Depot 439675 1630225 265701
825962 8373413 764946 129202 8193323 8193614 8193080
Medline CLO30358H CLO35309 CLO31424Z
CLO31424 CLO30577H CLO30577
GRAINGER 1XEZ3 4XKR8 4XKR7 6VDE9
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
kills C diff spores
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
18
Clorox Healthcarereg Hydrogen Peroxide Cleaner Disinfectant Wipes
Medline CLO30827 CLO30826Z CLO30826
CLO30825Z CLO30825 CLO30824H
GRAINGER 401Z41 401Z45 401Z42 401Z40
Clorox Professional Products Company
2 minutes
Healthcare Fuzion Cleaner (Spray)
GRAINGER 52LC52
Clorox Professional Products Company
1 minute
Oxivir Tb
GRAINGER 5KRJ0 (32oz Trigger Spray RTU 12PK) 48TJ10
(RTU 1 gal jug 4PK) 5KRJ1 (TB Wipes)
Diversey Inc 1 minute
Oxivir 1 (RTU-Wipe) GRAINGER
53JX16 (Wipes 6rdquox7rdquo) 53JX15 (Wipes 7rdquox8rdquo) 53JX17 (Wipes Bucket 11rdquox12rdquo) 45DW77
(Wipes Refill)
53JX14 (32oz Bottle RTU 12PK)
Diversey Inc 1minute
Oxivir Five 16 (Concentrate-Dip and use method)
GRAINGER 11Y608 (RTU 1 Gal Jug) 11Y610 (J-Fill Chem Dispenser) 15V142 (15 Gal Jug RTU
2pk) 11Y607 (RTD Chem Dispenser PK) 11Y609 (SmartDose Chem Dispenser)
Diversey Inc 5 minutes
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
19
Avert Sporicidal (RTU-wipe)
Diversey Inc 1 minute
kills C Diff spores in 4
minutes
Virex II 256 (Concentrate-Dip and use method)
GRAINGER 11W407 (1 Gal Jug) 10A336 (15 Gal Jug 2pk) 10C417 (J-Fill Chem Dispenser 2PK) 11Y654 (RTD Chem Dispenser) 6EFY2 (SmartDose Chem Dispenser) 11Y653 (32oz
Concentrated)
Diversey Inc 10 minutes
Virex Plus (Concentrate must be at 1128-Dip and Use
Method)
Diversey Inc 5 minutes
Noroxycdiff (electrostatic spray application)
Pervasive 7 minutes-15 minutes post
discharge clean process time
Dispatch 69150
GRAINGER 22D022
Clorox Professional Products Company
1 minute
Pericept (Concentrate-Dip and use method)
SSS 2 minutes
kills C Diff spores in 4 minutes-
contains no bleach or alcohol
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
20
Side Kick Disinfecting Wipes Standard Wipes Model Number 2060-000-001
Large Wipes Model Number 2060-000-002
Stryker 2 minutes
Maxim GSC Germicidal Spray Cleaner Product Number 042000
Midlab 2 minutes
Clorox Commercial Solutionsreg Cloroxreg Disinfecting Wipes Product 15949
Clorox Professional Products Company
4 minutes
Opti-Cide 3reg Wipes Item OCW06-100
Micro-Scientific LLC 3 minutes
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
21
Opti-Cide 3 Item OCS12-024
Micro-Scientific LLC 2 minutes
Opti-Cide 3 Item OCP04-128
Micro-Scientific LLC 2 minutes
Clorox Healthcarereg Bleach Germicidal Trigger
Spray Bottle Grainger Mfr Model 68970 Catalog Page
1512
Clorox Professional Products Company
3 minutes
kills C Diff spores in 3
minutes
Discide Ultra Disinfecting Towlettes Palmero Healthcare 2-30 second applications are required Please
wipe down surfaces allow a 30 second dwell
time for cleansing then
please wipe down surface again allow a
30 second dwell time for
disinfection
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
22
Discide Ultra Disinfecting Spray Palmero Healthcare 2-30 second applications are required Please spray surfaces
allow a 30 second dwell
time for cleansing then
please spray surface again
allow a 30 second dwell
time for disinfection
Ecolab Quaternary Disinfectant Wipes
12 x 85 XL Wipes 6000169 12x220 Wipes 6000166
Ecolab 2 minutes
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
23
These approved disinfectants are being utilized frequently during this time of COVID-19 However
please be aware that in the coming months we stay mindful of expiration dates regarding these
products Many of these approved disinfectants use a coding system of a Julian date code for their
expiration An example of this coding is listed below for reference
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
24
At AMITA Health Touchpoint is responsible for cleaning the rooms for PUIs and confirmed COVID 19 cases Any concerns related to cleaning of rooms or lack there of please contact Touchpoint services
Environmental Cleaning and Disinfection
Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings including those patient-care areas in which aerosol-generating procedures are performed Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2 Management of laundry food service utensils and medical waste should also be performed in accordance with routine procedures
Reference httpswwwcdcgovcoronavirus2019-ncovhcpcaring-for-patientshtml
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
25
Chapter 4 Clinical Protocols
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
26
COVID Awake RepositioningProning Protocol (CARP)
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
27
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
28
Instructions for patients with cough or trouble breathing
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
29
Respiratory support guideline for COVID-19 (PUI or confirmed) patients
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
30
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
31
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
32
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
33
Chapter 5 Pressure Injury Prevention
in COVID-19
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
34
Protecting Facial Skin Under PPE N95 Face Masks
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
35
Guidelines for N95 Masks ndash Preventing Facial Pressure Injury
Three factors we can influence to prevent these injuries
bull Intensity of pressure (and shear)
bull Duration of pressure (and shear)
bull Tissue tolerance of the individual
N95 Masks
bull Require a tight seal that should be seal-checked by the user each time it is
donned
bull Anything placed between the skin and mask should not interfere with the
function of the mask
bull There is currently no evidence to ensure the wearersrsquo safety from viral
penetration when a wound care dressing is placed under a respirator mask
Goal Present injury from friction moisture and pressure
bull Application of a liquid skin sealantprotectant on skin surfaces that will be in
contact with the mask may help prevent friction injuries and will not interfere
with the fit of the N95 mask
bull Do not use petroleum jelly mineral oil or any other compound that could
enhance slippage
bull Remove the mask from your face for 15 minutes every 2 hours outside of areas
of patient contact
bull Treat abrasions with topical moisturizers liquid skin protectantsealant thin
occlusive dressings may be used to protect open wounds if they do not interfere
with the mask seal Deep tissue injuries stage 3 or 4 and unstageable wounds
should be referred for professional wound care
(For further directioninformation contact your wound care nurse)
Reference NPIAP Position Statements on Preventing Injury with N95 Masks 2020
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
36
Pressure Injury Prevention PIP Tips for Prone Positioning
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
37
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
38
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
39
Chapter 6 Discharge Instructions
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
40
FAQs for Patients
Q What is 2019 Novel Coronavirus (COVID-19)
A There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses COVID-19 is a new disease caused by a novel (or new) coronavirus not previously seen in humans COVID-19 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan China that has spread around the world including the United States and all 50 states
Q What are the symptoms of COVID-2019
A People who are infected with COVID-19 have developed mild to severe respiratory illness with symptoms including fever cough shortness of breath and potentially respiratory distress 2-14 days after exposure Call your health care provider for medical advice if you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing
Q How does COVID-19 spread
A Coronaviruses are generally spread from person- to- person through respiratory droplets Someone who is actively sick with COVID-19 can spread the illness to others That is why CDC recommends that these patients be isolated from other family members Currently there is no evidence to support transmission of COVID ndash 19 associated with food It can be possible that a person can get COVID ndash 19 by touching a surface or object that has the virus on it and then touching their own mouth nose or possible their eyes
Q Who is at higher risk
People 65 years and older People at any age with Chronic lung disease or asthma Heart disease Diabetes Cancer patients or with weakened immune system
Q What are the treatments for COVID-19
A Currently there are no medicine to treat illnesses caused by COVID-19 Medical care is supportive to help relieve symptoms such as Tylenol for fever plenty of rest and fluids
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
41
Q How can I help protect myself
bull Stay home as much as possible Restrict activities outside your home except for getting medical care Avoid public transportation and public areas Avoid crowds Avoid non- essential travel
bull Take everyday precautions to keep space between yourself and others
bull To the extent possible avoid touching high-touch surfaces in public places ndash elevator buttons door handles handrails handshaking with people etc Use a tissue or your sleeve to cover your hand or finger if you must touch something
bull Wash your hands after touching surfaces in public places
bull Avoid touching your face nose eyes etc
bull Clean and disinfect your home to remove germs practice routine cleaning of frequently touched surfaces (for example tables doorknobs light switches handles desks toilets faucets sinks amp cell phones)
bull Perform hand hygiene frequently Wash your hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer
bull Make sure that shared spaces at home have good air flow such as by air conditioner or an opened window weather permitting
Q What steps should I take if I am sick A If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or
difficulty breathing call your healthcare provider for medical advice or call the COVID-19 hotline at Illinois Department of Public Health 1-800-889-3931
QHow long do I self-quarantine A If you have been diagnosed with COVID-19 you must quarantine yourself for 14 days after symptom onset If you have been in close contact with someone diagnosed with COVID-19 you must quarantine for 14 days since you first had contact with that person
For more information wwwcdcgovCOVID19
bull Pay attention for potential COVID-19 symptoms including fever cough and shortness of breath If you feel like you are developing symptoms call your doctor
bull If you develop emergency warning signs for COVID-19 get medical attention immediately In adults emergency warning signs
o Difficulty breathing or shortness of breath o Persistent pain or pressure in the chest o New confusion or inability to arouse
o Bluish lips or face
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
42
Home Isolation Instructions for People with Coronavirus-2019 (COVID-19) Infection and
People Awaiting COVID-19 Test Results
The following instructions are for people who are infected with COVID-19 or who are waiting to
find out the result of their test It also includes information for their families or caregivers
Instructions for People Who Have or Who May Have COVID-19
1 Stay home Do not leave your home except to get medical care Do not go to work school or public areas and do not use public transportation or taxis If someone delivers food or other necessities ask them to leave them at your door if possible If you need to meet someone at your door wear a mask
2 Separate yourself from other people in your home As much as possible stay in a different room from other people in your home Use a separate bathroom if possible If you must be in the same room as other people wear a facemask to prevent spreading germs to others
3 Before you visit your doctor let them know Call ahead before visiting your doctor so they can prepare for your visit and know that you have or may have COVID-19
4 Cover coughs and sneezes To prevent spreading germs to others when coughing or sneezing cover your mouth and nose with a tissue or your sleeve Throw used tissues in a lined trash can and immediately wash hands with soap and water
5 Keep hands clean Wash hands often and thoroughly especially after blowing your nose coughing or sneezing going to the bathroom and before eating or preparing food Use soap and water for at least 20 seconds Use hand sanitizer with at least 60 alcohol if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
6 Avoid sharing household items Do not share dishes drinking glasses cups eating utensils towels bedding or other items with other people in the home These items should be washed thoroughly after use with soap and warm water
7 Monitor illness If your illness gets worse seek medical care Call ahead and tell them that you have or may have COVID-19 If you have life-threatening symptoms (for example trouble breathing pain in chest) call 911 and tell them you have or may have COVID-19
Follow these recommendations
bull People with known COVID-19 infection until 14 days after symptom onset or 3 days
after fever resolution and significant symptom improvement whichever is longer
bull People waiting to learn if they are infected until you receive a negative COVID-19
test result
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
43
Information for Caregivers Intimate Partners and Household
Members of People Who Have or May Have COVID-19
People who live with are intimate partners or provide home care for the
patient at home should
1 Be informed Make sure that you understand and can help the patient follow their
healthcare providerrsquos instructions for medication(s) and care
2 Limit visitors to only people caring for the patient bull As much as possible anyone who is not caring for the patient should stay in another
home or stay in other rooms They should also use a separate bathroom if possible
bull Keep elderly people and those who have weak immune systems or chronic health conditions away from the person This includes people with diabetes chronic heart lung or kidney conditions
3 Make sure that shared spaces in the home have good air flow Open windows or
use an air conditioner if possible
4 Wash hands People in the home should wash their hands often and thoroughly with
soap and water for at least 20 seconds especially before eating or after using the bathroom Use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty Avoid touching your eyes nose and mouth with unclean hands
5 Wear disposable facemask and gloves when you touch or have contact with the
patientrsquos blood body fluids andor secretions (such as sweat saliva sputum nasal mucus vomit urine or diarrhea) When removing first remove and dispose of gloves Then immediately clean your hands with soap and water or alcohol-based hand sanitizer Next remove and dispose of facemask and immediately clean your hands again with soap and water or alcohol-based hand sanitizer Do not reuse
6 Avoid sharing household items Do not share dishes drinking glasses cups eating
utensils towels bedding or other items with the patient Follow the cleaning instructions below
7 Clean all ldquohigh-touchrdquo surfaces such as counters tabletops doorknobs bathroom
fixtures toilets phones keyboards tablets and bedside tables every day using household disinfectants Also clean any surfaces that may have blood body fluids andor secretions or excretions on them
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
44
Cleaning Instructions
bull Follow the recommendations provided on cleaning product labels including
precautions you should take when applying the product such as wearing gloves or
aprons and making sure you have good ventilation during use of the product
bull Use a diluted bleach solution or a household disinfectant with a label that says
ldquoEPA-approvedrdquo To find out if the product works against viruses read the product
label call the 1-800 number on the label or visit wwwepagov To make a bleach
solution at home add 1 tablespoon of bleach to 1 quart (4 cups) of water For a
larger supply add frac14 cup of bleach to 1 gallon (16 cups) of water
bull Wash laundry thoroughly
bull Immediately remove and wash clothes or bedding that have blood body fluids
andor secretions or excretions on them
bull Wear disposable gloves while handling soiled items Wash your hands immediately
after removing your gloves
bull Read and follow directions on labels of laundry or clothing items and detergent In
general wash and dry with the warmest temperatures recommended on the
clothing label
bull Place all used disposable gloves gowns facemasks and other contaminated items
in a lined container before disposing them with other household waste Wash your
hands immediately after handling these items
8 Monitor the patientrsquos illness If they are getting sicker call their medical provider
and tell the medical staff that the person has or is being evaluated for COVID-19 This
will help the healthcare providerrsquos office take steps to keep other people from getting
infected
It is important to note that caregivers household members and intimate partners
who do not follow these instructions when in close contact with the patient may
be considered to be ldquoclose contactsrdquo and should monitor their health Below is
information for close contacts
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
45
Information for Close Contacts of People Who Have or May Have COVID-19
If you have had close contact with someone who is confirmed to
have or being evaluated for COVID-19 you should
Monitor your health Start from the day you first had close contact
with the patient and continue for 14 days after you last had close
contact with the person Watch for these signs and symptoms
bull Fever Take your temperature twice a day
bull Coughing
bull Shortness of breath or trouble breathing
bull Other early symptoms to watch for are chills body aches sore
throat headache diarrhea nauseavomiting and runny nose
If you develop fever or any of these symptoms call your healthcare
provider right away and let them know about being a close contact to a
patient with confirmed or suspected COVID-19 Stay home from school
work and other public spaces until your symptoms improve Refer to home
care instructions for further information
For more information visit httpdphillinoisgovtopics-servicesdiseases-and- conditionsdiseases-a-z-listcoronavirus
Fever Cough Trouble breathing
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
46
CDC Guidelines What to do if you are sick with Coronavirus disease 2019 (COVID-19)
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
47
CDC Home Care Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus
(COVID-19)
This interim guidance is for staff at local and state health departments infection
prevention and control professionals healthcare providers and healthcare
workers who are coordinating the home care and isolation of people who are
confirmed to have or are being evaluated for 2019 novel coronavirus (COVID-
19) infection (see Criteria to Guide Evaluation of Patients Under Investigation
(PUI) for COVID-19) This document does not apply to patients in healthcare
settings
For interim healthcare infection prevention and control recommendations (see
Interim Healthcare Infection Prevention and Control Recommendations) CDC
will update this interim guidance as needed and as more information becomes
available
Preventing COVID-19 from Spreading in Homes and Communities Interim
guidance that may help prevent COVID-19from spreading among people in
homes and in communities
Based on public health and medical evaluation some people who are confirmed
to have or being evaluated for COVID-19 infection and do not require
hospitalization for medical reasons may be cared for at home Prior to a
healthcare facility releasing a person to home care the following steps should
be taken
Assess the Suitability of the Residential Setting for Home Care
In consultation with state or local health department staff a healthcare
professional should assess whether the residential setting is suitable and
appropriate for home care assess whether the patient is capable of adhering to
precautions that will be recommended as part of home care or isolation
(respiratory hygiene hand hygiene etc) and notify their local or state health
department that the residential setting has been determined to be suitable for
home care and that hospital discharge is planned
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
48
Provide Guidance for Precautions to Implement during Home Care
A healthcare professional should provide CDCrsquos interim guidance for Preventing
COVID-19 from Spreading to Others in Homes and Communities to the person
confirmed to have or being evaluated for COVID-19 infection and to the
caregiver and household members and
contact their state or local health department to discuss criteria for discontinuing
any such measures
Footnotes
Isolation is defined as the separation or restriction of activities of an ill person
with a contagious disease from those who are well
Additional Resources
Interim Healthcare Infection Prevention and Control Recommendations for
Patients Under Investigation for 2019 Novel Coronavirus
Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from
Spreading to Others in Homes and Communities
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
49
March 25 2020
Expectations for Superior Ambulance Personnel Transporting COVID‐19 Patients
Dear Customers
During this challenging event Superior Ambulance strives to make transportation of COVID‐19
patients as seamless as possible Superior will continue to transport COVID‐19 patients by air or
ground without restrictions We understand the supply constraints facing all healthcare
operations and have issued new PPE guidance to our crews to help preserve PPE Please expect
the following actions from our personnel
COVID‐19 PPE Standards for EMS
Standard Contact and Droplet Precautions (Gloves Gown Surgical Mask Eye Protection) Surgical mask also placed on the patient Used for most COVID‐19 patients
Add Airborne Precautions (N95 Mask) Used for high acuitycritically ill COVID‐19 patients o All ventedintubated patients o All patients on CPAP BIPAP or High Flow therapies o All patients undergoing nebulizer treatments o During other aerosol‐generating procedures such as
intubation open suctioning or manual bagging
AT THE PICKUP FACILITY
bull Our personnel will request limited PPE to include gloves gowns and surgical
masks Our personnel will remove or change most PPE prior to traveling through
the hospital to prevent cross‐contamination
bull Our personnel will supply their own eye protection and N95 masks if needed Our
personnel will reuse these items on a limited basis
bull Our personnel will request belongings to be placed in a new belongings bag Our
personnel will disinfect the outside of the bag Please attempt to limit belongings and
wait to bag them until our arrival
DURING TRANSPORT
bull Our personnel will follow COVID‐19 treatment protocols during transport to minimize risk of exposure
AT THE RECEIVING FACILITY
bull Our personnel will request 11 exchange of PPE supplies used during transport if
those items must be discarded (eg soiled gowns and masks or N95 masks
exceeding 5 uses)
bull Our personnel perform decontamination following every transport and will
perform an extensive decontamination after any COVID‐19 transport
This is a dynamic event We will continue to adapt our procedures as supply lines improve
and new guidance is issued from the CDC State and our EMS Medical Directors We will keep
you informed of significant changes and will continue to investigate and respond to all reports
of personnel not meeting these expectations
Thank you Mary Franco VP Superior Air‐Ground Ambulance Service
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
50
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
51
Chapter 7 Removing Isolation Precautions
on COVID-19 Patients
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
52
Recommendations for removing transmission-based isolation precautions on COVID-19 positive patients
Hospitalized
Hospitalized patients may have longer periods of SARS-CoV-2 detection compared to patients with mild or moderate disease Recommendations are as follows
bull Remain in transmission-based isolation precautions until discharge
bull Considerations will be made for those patients that are staying in the hospital for
reasons not related to COVID-19 using the test-based strategy Please coordinate
with Infection Control
Test-based strategy 1 Resolution of fever without the use of fever-reducing medications and 2 Improvement in respiratory symptoms (eg cough shortness of breath) and 3 Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 from at least two consecutive respiratory specimens collected ge24 hours apart (total of two negative specimens) Of note there have been reports of prolonged detection of RNA without direct correlation to viral culture
Outpatient (Please follow Re-Emergence Surgery Playbook for surgeries)
Symptomatic Utilize the Symptom based strategy recommended by CDC
1) At least 3 days (72 hours) have passed since recovery defined as resolution of fever
without the use of fever-reducing medications and improvement in respiratory
symptoms (eg cough shortness of breath) and
2) At least 10 days have passed since symptoms first appeared
Asymptomatic At least 10 days have passed since positive test result
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
53
I m po r
Chapter 8 Mortuary Care
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
54
Postmortem Checklist for Suspected or Confirmed COVID-19 Patients
INSTRUCTIONS Upon completion of the checklist below (where applicable) use the reverse side as a label
for the body bag Check the appropriate box and secure this label to the bag prior to transportation
Supplies Needed Body Bag (Request from Supply Department or as normally obtained) New sling (for transfer of body bag to gurney) Disposable nitrile gloves (wear when handling the body bag)
In the Patient Room 1048576 Don COVID-19 PPE to prepare the body for transport to the morgue
1048576 Remove invasive lines and devices from the patient (unless required for Medical Examiner or Coroner review) 1048576 Pack and bandage wounds and natural openings with absorbent material to contain body fluids
1048576 Place tag on the patientrsquos toe labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or DOA-no Covid-19 testing performed (Emergency Dept) 1048576 Place patient in the body bag and close (If patient body habitus will not allow
a standard sized bag to close completely request extra-large body bag) Double bag if using white bags Single bag for orange and black bags
1048576 Place tag on the body bag labeled ldquoCOVID-19 Positiverdquo ldquoCOVID-19 Negativerdquo ldquoCOVID-19 Test Pendingrdquo or ldquoDOA-no Covid-19 testing performedrdquo (Emergency Dept)
1048576 Place a sling under the body bag for transfer to the gurney 1048576 Move patient to gurney 1048576 Disinfect the outer surface of the body bag with an AMITA-approved disinfectant 1048576 Disinfect the handles of gurney for transportation with an AMITA-approved disinfectant 1048576 Doff Covid-19 PPE in accordance with doffing checklist 1048576 Perform hand hygiene 1048576 Follow discharge cleaning and room closure procedure
Transportation 1048576 Transportation will not enter the room gurney will be brought to hall for transport
Morgue 1048576 Using Standard Precautions move patient into cooler 1048576 Disinfect the gurney with AMITA-approved disinfectant 1048576 Perform Hand Hygiene 1048576 Decedents with Pending test results-hold the body in the morgue until Covid-19 test results are available Cook County ME does not require results and body can be released to them CommunicationRelease
1048576 Local market to assign responsible personnel to logrecord in a book or on a communication
board in the morgue all decedents with pending COVID-19 test results The assigned personnel
must provide the result and update the status in the morgue when the final results are received
1048576 Tag on body bag should be removed (if testing negative) or changed to COVID-19 positive
1048576 The assigned personnel must notify the coronermedical director or funeral home the decedent is
Covid-19 positive per local hospital notification policy Follow local hospital policy for
notificationrelease to the coronermedical examiner or funeral home that meets local county
state and federal regulatory requirements
1048576 The CoronerMedical ExaminerFuneral home will have their own policies and procedures for the
appropriate handling of a Covid-19 positive decedent once they pick up the body
COVID-19 PPE gloves gown mask (procedural maskN95PAPRCAPR) and eye protection httpswwwcdcgovcoronavirus2019-ncovhcpguidance-postmortem-specimenshtml
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
55
Covid-19 Positive
Covid-19 Negative
PUI (Results Pending)
DOA-no Covid -19
testing performed
(Emergency Department)
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
56
MORGUE LOG - COVID-19 LOG
Enter the DATE body was received with the know COVID-19 STATUS in corresponding box below For a decedent with unknown results enter the date received in the COVID-19 RESULTS PENDING box Once the results are provided the date of the result should be entered in
the COVID-19 POSITIVE or COVID-19 NEGATIVE BOX
PLEASE DO NOT REMOVE FULL SHEETS FROM MORGUE - JUST START A NEW SHEET
Cook County ME does not require results for PUI - you can release to Cook County ME if results are pending - communicate status to ME and if they approve to take you can release
DECEDENT NAME COVID-19 POSITIVE
COVID-19 RESULTS PENDING - DO NOT
RELEASE UNTIL RESULTS RECEIVED
COVID-19 NEGATIVE
Release DateOfficer
JOHN DOE [EXAMPLE] 412020 452020 462020204
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
57
Chapter 9 Contact Numbers
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
58
IDPH Chicago PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Regular Business Hours After-Hours
Cook 708-633-2000 708-906-0748
DuPage 630-682-7400 630-682-7207
Evanston 847-448-4311 847-448-4311
Grundy 815-941-3404 815-942-0336
Kane 630-208-3801 630-208-3801
Kankakee (Non CRI) 815-802-9400 815-937-8479
Kendall 630-553-9100 630-553-0911
Lake 847-377-8000 847-377-8000
McHenry 815-334-4510 815-344-7421
Oak Park 708-358-5480 708-771-9110
Will County 815-727-8480 815-727-8670
IDPH Edwardsville PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-hours number Method of contact After hours
Bond (618) 664-1442 618-664-5020 Health Dept
Calhoun (618)576-2428 618-576-2417 Sheriff
Clinton (618) 594-2723 618-594-4555 Sheriff
East Side Health District (618) 271-8722 618-409-7855 Cell
Fayette (618) 283-1044 618-463-2404 Sheriff
Greene (217) 942-6961 217-942-6961 Health Dept
Jersey (618) 498-9565 618-463-2921 answering service
Macoupin (217) 854-3223 217-854-3135 Sheriff
Madison (618) 692-8954 618-463-6957 answering service
Monroe (618) 939-3871 618-939-8651 Sheriff
Randolph (618) 826-5007 618-826-5484 Sheriff
St Clair (618) 233-7703 618-301-2907 Cell
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
59
IDPH Peoria PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
Bureau 815-872-5091 815-875-3344 Sheriff Dispatch
Fulton 309-647-1134 309-547-2277 Sheriff Dispatch
Henderson 309-627-2812 309-867-4291 Sheriff Dispatch
Henry 309-852-0197 309-852-0197 Answering Service
Knox 309-344-2224 309-343-9151 Sheriff Dispatch
LaSalle 815-433-3366 815-433-2161 Sheriff Dispatch
Livingston 815-844-7174 815-822-2178 Cell
Marshall 309-246-8074 309-246-2115 Sheriff Dispatch
McDonough 309-837-9951 309-837-9951 Answering Machine with Instructions
McLean 309-888-5450 888-865-9903 PATH211
Mercer 309-582-3759 309-582-5194 Sheriff Dispatch
Peoria 309-679-6000 309-679-6000 Answering Service
Putnam 815-872-5091 815-925-7015 Sheriff Dispatch
Rock Island 309-793-1955 309-794-1230 Sheriff Dispatch
Stark 309-852-0197 309-852-0197 Answering Service
Tazewell 309-925-5511 309-303-1375 On-Call Cell
Warren 309-734-1314 309-734-8505 Sheriff Dispatch
Woodford 309-467-3064 309-467-2375 Sheriff Dispatch
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
60
IDPH Springfield PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General Line After-Hours Method
ADAMS 217-222-8440 217-214-4000 Administrator - Jerrod Welch
BROWN 217-773-2714 217-242-9013 Mary Reich
CASS 217-452-3057 217-473-0070 Administrator- Teresa Armstrong
CHRISTIAN (217) 824-4113 (217) 820-1651 Administrator- Denise Larson
HANCOCK (217) 357-2171 309-255-2418 Administrator - Amy Mcalister
LOGAN 217-735-2317 217-671-2106 Salena Matteson
MASON 309-210-0110 309-222-0213 Administrator-Curt Giben
MENARD 217-535-3102 217-753-6666 other - Diana Wade
MONTGOMERY 217-532-2001 217-556-1455 Administrator -Hugh Satterlee
MORGAN 217-245-5111 217-245-5111 Other
PIKE 217-285-4407 800-377-8130217-370-6160 After hours Nurse
SANGAMON 217-535-3102 217-753-6666 other - Diana Wade
SCHYULER 217-322-6775 217-322-6775 Administrator - Lynnette
SCOTT 217-742-8203 217-742-3141 Administrator - Steve Shireman
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
61
IDPH Champaign PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours General After-Hours Method
Champaign-Urbana
Public Health District 217-352-7961 217-352-7961 Regular Business Phone-With After Hour
Options
Clark 217-382-4207 217-826-6393 Clark County Sheriffs Office
Coles 217-348-0530 217-345-0060 Coles Sheriffs Office Non Emergency
Crawford 618-544-8798 618-546-1515 Crawford County Sheriffs Office
Cumberland 217-849-3211 217-232-3211 Administrator
Dewitt-Piatt 217-935-3427 DeWitt or
217-762-7911 Piatt 217-519-3380 Administrator
Douglas 217-253-4137 217-253-2913 Douglas County Sheriff
Edgar 217-465-2212 217-251-5440 Administrator
Effingham 217-342-9237 217-342-2101 Effingham County Sheriffs Office
Ford 217-379-9281 217-766-4902 Administrator
Iroquois 815-432-2483 815-432-4918 Iroquois County 911 Dispatch (ICOM)
Jasper 618-783-4436 618-783-8477 Jasper County Sheriff
Lawrence 618-943-3302 618-943-5766 Lawrence County Dispatch
Macon 217-423-6988 217-875-8567 Decatur Memorial Hospital
Moultrie 217-728-4114 217-728-4386 Moultrie County Sheriffs Department
Shelby 217-774-9555 217-774-3941 Shelby County Sheriff Office
Vermilion 217-431-2662 217-304-3234 Administrator
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
62
IDPH Marion PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Department Business Hours After-Hours After-Hours Method
Clay 618-662-4406 618-662-4406 Connects to Answering Service
Egyptian 618-273-3326 618-518-0513 Cell Phone Number
Franklin-Williamson 618-993-8111 618-993-8111 Connects to Answering Service
Hamilton 618-643-3522 618-643-3522 Connects to Sheriffrsquos Office After
Jackson 618-684-3143 800-875-0162 Answering Service
Jefferson 618-244-7134 618-383-3025 Cell Phone Number
Marion 618-548-3878 618-322-3878 Cell Phone Number
Perry 618-357-5371 618-357-5371 Telephone System Allows Callers to Connect to Staff After Hours
Southern Seven 618-634-2297 800-358-7367 Answering Service
Wabash 618-263-3873 618-262-6715 Cell Phone Number
Washington 618-327-3644 618-327-3644 Answering Machine with After Hours Contact Information
Wayne 618-842-5166 618-842-5166 Connects to Answering Service
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
63
IDPH Rockford PHMSRR Local Health Department BusinessAfter-Hours Contact
County Health Business Hours After-Hours
Boone 815-544-2951 Amanda Mehl 815-262-2625
Carroll 815-244-8855 Craig Bantema 815-244-2635 - Sheriffrsquos Office
DeKalb 815-758-6673 Lisa Gonzalez 815-758-6673 - Option 6
Jo Daviess 815 777 0263 815-777-2141 Sandra Schleicher
Lee 815-284-3371 815-973-0830 - Cathy Ferguson-Allen
Ogle 815-562-6976 815-732-2136 Kyle Auman
Stephenson 815 235 8271 815-235-8252 ndash Craig Beintema
Whiteside (815) 626-2230 815-564-5610 ndash Cheryl Lee
Winnebago (815)720-4000 815-720-4000 ndash Theresa James
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
64
Appendix
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
65
April 7 2020
COVID-19 Test Orders in Electronic Health Records (EHR)
COVID-19 by PCR (Acute Care) and COVID-19 by PCR (Reference Lab) have been removed as order selections and two new test names for the COVID-19 PCR test performed at Alverno Laboratories has been created COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients COVID-19 RAPID Molecular on-site testing will continue to be performed at the hospitals and available to order in the EHRs This test is performed on-site with a turnaround time of 1 hour Testing though the Illinois Department of Public Health (IDPH) will continue to be available by contacting the hospital lab
Appendix A
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
66
Epic Changes
When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Will mark the patient as a COVID-19 Suspected on Storyboard except on Outpatients
bull Positive COVID-19 results will display on Storyboard for all patients
bull Does not trigger isolation BPA on Outpatients
bull Suspected and positive inpatients will display on the Infection Prevention worklist
bull Will be available unchecked in all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
67
Meditech Changes When COVID is entered in order entry COVID-19 Rapid Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op scrn appear COVID-19 Rapid Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op scrn is used for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull This order will be for COVID-19 screening of asymptomatic Pre-Operative and Pre-Procedural patients
bull Does not trigger alert for isolation precautions when ordered on outpatients
bull Will be available unchecked on all Pre-Operative and Pre-Procedural order sets
IDPH COVID-19 Order To send a specimen to IDPH the provider should use downtime orders and contact the hospital lab with the IDPH Authorization number and specimen source type (NP)
Appendix A
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
68
Cerner Changes When COVID is entered in order entry COVID-19 RAPID Molecular COVID-19 HiSensitivity PCR and COVID-19 PCR Pre-Op screening appear COVID-19 RAPID Molecular is for the rapid testing of acutely ill patients requiring admission or emergency procedures This test is performed on-site with a turnaround time of 1 hour COVID-19 HiSensitivity PCR is for testing of both inpatients and outpatients and is performed at Alverno Laboratories with a turnaround time of 12-24 hours COVID-19 PCR Pre-Op screening is for screening of asymptomatic Pre-Operative and Pre-Procedural Patients
bull Order displays as COVID-19 by PCR (Acute Care) (COVID-19 PCR Pre-Op screening)
bull This order will be for COVID-19 screening of Pre-Operative and Pre-Procedural patients
bull Will not mark the patient as a COVID PUI on the banner bar
bull Does not order isolation precautions when ordered or resulted
bull Positive COVID-19 results will display on the banner bar
bull Patient does not go to the Infection Prevention worklist
bull Will be pre-checked on all Pre-Operative order sets
IDPH COVID-19 Order If it is necessary to send a specimen to IDPH the IDPH COVID-19 order should be placed under ldquoMiscellaneous Lab Requestrdquo Add COVID-19 in the comment box select specimen type (nasopharyngeal specimen)
Dynamic DocumentationMPages
Appendix A
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
69
Athena Changes
When COVID is entered in order entry covid-19 by PCR is available to order
Appendix A
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
70
Personal Protective Equipment (PPE) Validation of DonningDoffing Guidelines Attestation
Appendix B
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
71
Personal Protective (PPE) Validation Checklist for PPE Monitor
Appendix C
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
COVID-19 Infection Prevention Acute Care Playbook v 482020
PUI ISOLATION SIGN INOUT SHEET
Appendix D
T E T L EL
72
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
Appendix E
Infection PreventionLeader Rounding Checklist
Rounding performed by (nametitle) DateTime
Personal Protective Equipment Y N Comments Gowns available
Gloves available
N95s available
Eye protection available
Trash emptynot overflowing
Hand Hygiene Y N Comments Hand sanitizer available
Hand soap available
Paper towels available
Transmission Based Precautions Y N Comments
AirborneContactEye protection signage posted outside of room
Appropriate documentation of isolation precautions in EMR
Airborne isolation room alarm on
Manual negative pressure checks documented
Cleaning and Disinfection Y N Comment
Cleaning and disinfection supplies available
Associates can speak to contact time of disinfectant used
Personnel Y N Comments
Assigned RN able to demonstrate appropriate donningdoffing practices
Associate contact log posted outside of door and filled out appropriately
Follow Up Items
T E T L EL
73
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
Discharge Instructions for Patients with COVID-19 in Spanish
ENFERMEDAD DEL CORONAVIRUS 2019 (COVID-19) Respuestas a las preguntas maacutes frecuentes
P iquestQueacute es el nuevo Coronavirus (COVID-19)
R Hay muchos tipos de coronavirus que afectan a los humanos incluyendo algunos que frecuentemente causan enfermedades leves del tracto respiratorio superior COVID-19 es una nueva enfermedad causada por un nuevo coronavirus no anteriormente visto en ser humanos El virus COVID-19 detectado por primera vez en Wuhan China donde fue identificado como la causa de un brote de enfermedades respiratorias y el virus se ha propagado al rededor del mundo incluyendo los Estados Unidos y todos los 50 estados Las actualizaciones maacutes recientes del resumen de la situacioacuten estaacuten disponibles en la paacutegina web de Los Centros para el Control y la Prevencioacuten de Enfermedades (CDC por sus siglas en ingleacutes) Enfermedad del coronavirus 2019 (COVID-19)
P iquestCuaacutel es la fuente del virus
R Los coronavirus son una familia grande de virus que son comuacuten en personas y en diferentes especies de animales incluyendo los camellos el ganado (vacas) los gatos y los murcieacutelagos Al principio muchos pacientes en el epicentro del brote de COVID-19 en China teniacutean una conexioacuten a un mercado grande de mariscos y animales vivos sugiriendo transmisioacuten de animal a persona Despueacutes un creciente nuacutemero de pacientes reportaron no tener contacto con mercados de animales indicando transmisioacuten de persona a persona Posteriormente la transmisioacuten de persona a persona fue reportada afuera de China incluyendo a los Estados Unidos
P iquestQueacute significa que COVID-19 es una pandemia global
R Una pandemia es un brote global de una enfermedad Las pandemias ocurren cuando aparece un virus nuevo que infecta a las personas y se puede transmitir de persona a persona Por queacute existe poquito a no inmunidad contra el nuevo virus se propaga mundial El virus que causa COVID-19 estaacute infectando a las personas y se estaacute propagando faacutecilmente de persona-a-persona Se han detectado casos en la mayoriacutea de los paiacuteses del mundo incluyendo los Estados Unidos el cual ha documentado casos en todos los 50 estados
P iquestCuaacuteles son los siacutentomas de COVID-19
R Las personas infectadas con COVID-19 han desarrollado enfermedad de nivel leve a grave con siacutentomas que incluyen fiebre tos dificultad para respirar y potencialmente agotamiento respiratorio 2-14 diacuteas despueacutes de la exposicioacuten Si usted piensa que fue expuesto al virus COVID-19 y desarrolla fiebre y siacutentomas como tos o dificultad para respirar llame a su doctor para recibir consejo meacutedico
P iquestCoacutemo se propaga el COVID-19
R El COVID-19 ha demostrado propagarse entre personas La persona que tiene la enfermedad activa (muestra siacutentomas) puede transmitir la enfermedad a otras personas Por eso los CDC recomiendan que estos pacientes sean aislados en el hospital o en casa (dependiendo de la gravedad de su enfermedad) hasta que esteacuten mejor y ya no representen un riesgo de infeccioacuten para los demaacutes
Appendix F
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
El coronavirus en ser humanos tiacutepicamente se propaga a traveacutes de las gotitas respiratorias que se producen cuando una persona infectada tose o estornuda El tiempo que uno tiene la enfermedad activa (muestra siacutentomas) puede variar asiacute que la decisioacuten de cuaacutendo se le puede permitir salir del aislamiento deberaacute tomarse seguacuten cada caso en particular y en consulta con meacutedicos expertos en la prevencioacuten y el control de infecciones y funcionarios de salud puacuteblica Esta decisioacuten implicaraacute tener en cuenta las caracteriacutesticas especiacuteficas de cada situacioacuten lo cual incluye la gravedad de la enfermedad sus sentildeales de enfermedad y siacutentomas y los resultados de las pruebas de laboratorio del paciente
La guiacutea actual de los CDC acerca de cuaacutendo estaacute bien permitirle a alguien salir del aislamiento es de evaluar caso por caso y cumplir todos los requisitos mencionados a continuacioacuten
bull El paciente no tiene fiebre sin el uso de medicamentos para bajar la fiebre bull El paciente ya no muestra siacutentomas incluida la tos bull El paciente obtuvo dos resultados negativos en dos pruebas respiratorias consecutivas recolectadas
con un miacutenimo de 24 horas entre ellas
Cuando la persona sale del aislamiento ya no representa un riesgo de infeccioacuten para los demaacutes
P iquestComo se diagnostica el COVID-19
R El diagnoacutestico ocurre haciendo pruebas de especiacutemenes respiratorios en un laboratorio Algunas cepas de coronavirus causan el resfriado comuacuten y los pacientes evaluados por su doctor pueden tener resultados positivos para estos tipos de cepas
P iquestPuede alguien transmitir el virus sin estar enfermo
R Se cree que personas son maacutes contagiosas cuando estaacuten sintomaacuteticas (lo maacutes enfermizo) La transmisioacuten tambieacuten es posible antes de demostrar siacutentomas Hay reportes de que esto ha ocurrido con COVID-19 pero no se cree que eacutesta sea la manera principal de transmisioacuten
P iquestEl tiempo caacutelido detendraacute el brote de COVID-19
R Auacuten se desconoce si el tiempo y la temperatura afectaraacuten la propagacioacuten del COVID-19 Algunos otros virus como los del resfriado comuacuten o de la influenza (gripe) se propagan maacutes durante los meses friacuteos pero eso no significa que es imposible enfermarse a causa de uno de esos virus durante otros meses En estos momentos no se sabe si la propagacioacuten del COVID-19 se reduciraacute cuando el tiempo se ponga maacutes caacutelido Hay mucho maacutes que aprender acerca de la transmisibilidad gravedad y otras caracteriacutesticas asociadas al COVID-19 y las investigaciones estaacuten en curso
P iquestQue es distanciamiento social
A Distanciamiento social es deliberadamente aumentar el espacio fiacutesico entre personas para evitar la transmisioacuten de enfermedad Mantener una distancia de por lo menos 6 pies reduce el riesgo de contraer el virus COVID-19 Otros ejemplos de distancia social con la meta de evitar grupos grandes de personas espacios concurridos y reuniones grandes Se recomienda trabajar desde su hogar en lugar de la oficina cerrar escuelas y cambiar a clases por internet visitar a seres queridos por medio de aparatos electroacutenicos en vez de en persona suspender servicios religiosos y cancelar o posponer reuniones grandes
P iquestQue estaacute recomendando el estado sobre la distancia social
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
R El Gobernador JB Pritzker ha prohibido reuniones puacuteblicas y privadas de 50 personas o maacutes hasta el 1 de mayo Esto incluye eventos comunitarios ciacutevicos ocio puacuteblico eventos religiosos eventos deportivos con espectadores conciertos convenciones y otros eventos similares o actividades que reuacutenen 50 o maacutes personas en un sitio o espacio al mismo tiempo (asesoramientos por los CDC recomiendan que las personas eviten grupos de maacutes de 10 personas)
P iquestPuedo salir al aire libre
R Si salga al aire libre para respirar aire fresco y hacer ejercicio Monte una bicicleta camine con su perro salga a correr La distancia social no significa quedarse en su casa significa evitar contacto cercano con otras personas Recuerde lavarse las manos al volver al hogar y antes de comer
P iquestPuedo ir al supermercado
R Si Compre lo necesario para reducir el nuacutemero de viajes y trate de ir de compras cuando la tienda tiene menos personas Algunos supermercados tienen horas especiales designadas para personas mayores de edad (60 antildeos o maacutes) mujeres embarazadas y personas con defensas deacutebiles para reducir su exposicioacuten a grupos grandes y la posibilidad de exposicioacuten a COVID-19
P iquestCoacutemo puedo protegerme
R Siga los siguientes consejos para prevenir COVID-19
bull Laacutevese las manos frecuentemente con agua y jaboacuten por un miacutenimo de 20 segundos especialmente despueacutes de soplarse la nariz toser o estornudar despueacutes de usar el bantildeo y antes de comer y preparar comida Si no tiene jaboacuten y agua disponible use un desinfectante que contenga por lo menos 60 de alcohol
bull No se toque los ojos nariz y boca sin lavarse las manos bull Evite el contacto cercano con personas enfermas con siacutentomas respiratorios bull Queacutedese en casa cuando esteacute enfermo bull Cuacutebrase con un pantildeuelo de papel al toser o estornudar y despueacutes tire el pantildeuelo a la basura bull Limpie y desinfecte los objetos y las superficies que se tocan con frecuencia bull Si no ha hablado con su meacutedico sobre la vacuna contra la influenza haacutegalo ahora para protegerse
contra la gripe estacional
P iquestDebo usar mascarilla
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida
o a recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud bull Siga manteniendo una distancia de 6 pies entre usted y otras personas La mascarilla de tela no
sustituye la distancia social
P iquestQueacute pasos deben tomar padres para proteger a sus hijos
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
R COVID-19 es un virus nuevo y auacuten estamos aprendiendo sobre eacutel Hasta el momento no hay muchos nintildeos afectados La mayoriacutea de los afectados incluyendo enfermedades graves han ocurrido en adultos en edad de trabajar y en ancianos Recomendamos que los nintildeos y joacutevenes no se reuacutenan cuando salgan de la escuela para modo de prevenir la transmisioacuten del virus en la comunidad Recueacuterdeles que se laven sus manos frecuentemente y tambieacuten sigan los otros consejos de prevencioacuten
P iquestQuieacuten son las personas en alto riesgo
R El virus COVID-19 es una nueva enfermedad y estamos aprendiendo maacutes sobre ella todos los diacuteas En los adultos mayores y personas con ciertas condiciones meacutedicas el riesgo es maacutes alto y estas condiciones meacutedicas pueden empeorar con el COVID-19 En acuerdo con la informacioacuten disponible hasta las fecha CDC dice que las siguientes condiciones son de maacutes alto riesgo
P iquestDebo de limpiar las superficies que se tocan con frecuencia
R Si Limpiar y desinfectar a menudo objetos que tocan con frecuencia como mesas manillas de puerta interruptor de luz encimeras manijas escritorios teleacutefonos teclados la taza del inodoro las llaves de agua y lavabos Si las superficies estaacuten sucias liacutempie con detergente o jaboacuten y agua antes de desinfectar Para desinfectar los productos desinfectantes maacutes comunes que estaacuten registrados en el EPA son eficaces
P iquestExiste una vacuna
R No En este momento no hay vacuna para COVID-19
P iquestQue tratamiento existe para el COVID-19
R En este momento no existe un tratamiento especiacutefico recomendado para enfermedades causadas por el COVID-19 La atencioacuten meacutedica ayuda a aliviar los siacutentomas
P iquestQue deben hacer los meacutedicos o proveedores de salud los
laboratorios y los departamentos de salud
bull Se puede propagar el COVID-19 a otras personas aun cuando no se siente enfermo bull Todos deben usar una mascarilla de tela cuando salen al puacuteblico por ejemplo a la tienda de comida o a
recoger otras necesidades o No se le debe poner cubrebocas a los nintildeos menores de 2 antildeos a quienes tengan dificultades
para respirar a los discapacitados a los inconscientes o cualquier persona quien no se pueda quitar la mascarilla sin ayuda
bull El propoacutesito de la mascarilla de tela es de proteger a otras personas en caso de que usted esteacute infectado
bull No use mascarillas disentildeadas para trabajadores de salud Siga manteniendo una distancia de 6 pies entre usted y otras personas
bull La mascarilla de tela no sustituye la distancia social o Personas mayores de 65 antildeos o Personas que viven en asilos y hogares de ancianos y vida asistida o Mujeres embarazadas o Cualquier persona sin importar la edad con las siguientes condiciones meacutedicas en particular si
no estaacuten siendo controladas con tratamientos Enfermedad croacutenica pulmonar o asma Insuficiencia cardiaca congestiva o enfermedad de la arteria coronaria
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
Diabetes Condiciones neuroloacutegicas que debilitan la habilidad de toser Sistema inmunoloacutegico deacutebil Anemia falciforme Enfermedad renal croacutenica que requiere diaacutelisis Cirrosis del hiacutegado Falta de bazo o un bazo que no funciona correctamente Sobrepeso extremo (el iacutendice de masa corporal equivalente a 40 o maacutes)
bull R Los meacutedicos o proveedores de salud y los laboratorios deben de reportar casos sospechosos de COVID-19 inmediatamente (dentro de 3 horas) al departamento de salud local quienes notifican a IDPH inmediatamente (dentro de 3 horas) tambieacuten Para recomendaciones y guiacuteas vea la paacutegina de IDPH Coronavirus o la paacutegina web del CDC 2019 Novel Coronavirus
P iquestQue estaacuten haciendo los departamentos de salud puacuteblica en Illinois al
respeto de esta situacioacuten
R IDPH y los departamentos locales de salud puacuteblica han implementado vigilancia intensificada para identificar y examinar pacientes maacutes probables a tener COVID-19 Los expertos de salud puacuteblica estaacuten comunicaacutendose y educando a los proveedores meacutedicos y otros socios de salud puacuteblica acerca de la situacioacuten corriente Se estaacuten desarrollando medidas para prevenir la propagacioacuten de la enfermedad en Illinois Comunicaciones dirigidas al puacuteblico se haraacuten disponibles por la paacutegina de IDPH Coronavirus
Informacioacuten para viajeros se encuentra en la paacutegina del CDC aquiacute httpswwwcdcgovcoronavirus2019-ncovtravelersindexhtml
Page Last Reviewed April 1 2020
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
Medidas para ayudar a prevenir la propagacioacuten del COVID-19 si
estaacute enfermo
Siga los pasos a continuacioacuten si estaacute enfermo con COVID-19 o cree que podriacutea tener esta enfermedad siga los pasos a continuacioacuten para cuidarse a siacute mismo y ayudar a proteger a otras personas de su hogar y comunidad
Queacutedese en casa excepto para conseguir atencioacuten meacutedica
bull Permanezca en el hogar La mayoriacutea de las personas con COVID-19 tienen una enfermedad leve y puedan recuperarse en casa sin atencioacuten meacutedica No salga de su casa excepto para buscar atencioacuten meacutedica No visite aacutereas puacuteblicas
bull Cuiacutedese Descanse y manteacutengase hidratado bull Manteacutengase en contacto con su meacutedico Llame antes de recibir atencioacuten meacutedica Aseguacuterese de
obtener atencioacuten meacutedica si tiene problemas para respirar o tiene alguacuten signo de advertencia de emergencia o si considera que se trata de una emergencia
bull Evite el transporte puacuteblico los vehiacuteculos compartidos y los taxis
Manteacutengase separado de las demaacutes personas y las mascotas de su casa
En la medida de lo posible permanezca en una misma habitacioacuten y alejado de otras personas y mascotas en su casa Tambieacuten deberiacutea usar otro bantildeo si tiene uno disponible Si necesita estar con otras personas o animales dentro o fuera de su casa use una cubierta de tela para cara
bull Vea COVID-19 y los animales si tiene preguntas sobre las mascotas
Maacutes detalles Si alguien en su casa estaacute enfermo
Appendix G
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
Vigile sus siacutentomas
bull Los siacutentomas comunes del COVID-19 incluyen fiebre y tos La dificultad para respirar es un siacutentoma maacutes grave que significa que debe recibir atencioacuten meacutedica
bull Siga las instrucciones de cuidado de su proveedor de atencioacuten meacutedica y departamento de salud local Las autoridades de salud locales le brindaraacuten indicaciones sobre coacutemo verificar sus siacutentomas y notificar la informacioacuten
iquestCuaacutendo buscar atencioacuten meacutedica
Si manifiesta alguno de estos signos de advertencia de emergencia de COVID-19 busque atencioacuten meacutedica de inmediato
bull Dificultad para respirar bull Dolor o presioacuten persistente en el pecho bull Confusioacuten o dificultad para estar alerta que no haya tenido antes bull Coloracioacuten azulada en los labios o el rostro
Esta lista no incluye todo Consulte a su proveedor de servicios meacutedicos por cualquier otro siacutentoma grave o que lo preocupe
Llame al 911 si tiene una emergencia meacutedica informe al operador que tiene o cree que podriacutea tener COVID-19 De ser posible coloacutequese una cubierta de tela para cara antes de que llegue el personal de servicios meacutedicos
Llame antes de ir al meacutedico
bull Llame antes Muchas visitas meacutedicas de rutina se estaacuten posponiendo o realizando por teleacutefono o telemedicina
bull Si tiene una cita meacutedica que no puede posponer llame al consultorio de su meacutedico e infoacutermeles que tiene o podriacutea tener COVID-19 Esto ayudaraacute al personal del consultorio a protegerse y proteger a otros pacientes
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
Si estaacute enfermo use una cubierta de tela para la cara sobre su nariz y boca
bull Deberiacutea usar una cubierta de tela para la cara que cubra la nariz y la boca si debe estar rodeado de otras personas o animales incluidas las mascotas (incluso en su casa)
bull No necesita usar la cubierta de tela para cara si estaacute solo Si no puede ponerse una cubierta de tela para la cara (por ejemplo porque tiene dificultad para respirar) cuacutebrase de alguna otra manera al toser y estornudar Procure mantenerse a al menos 6 pies de distancia de otras personas Esto ayudaraacute a proteger a las personas que lo rodean
Nota Durante la pandemia del COVID-19 las mascarillas de uso meacutedico estaacuten reservadas para los trabajadores de la salud y cierto personal de respuesta a emergencias Es posible que deba improvisar una cubierta de tela para la cara con una bufanda o un pantildeuelo
Maacutes detalles Cubiertas de tela para la cara
Cuacutebrase la nariz y la boca al toser y estornudar
bull Cuacutebrase la boca y la nariz con un pantildeuelo desechable al toser o estornudar bull Bote los pantildeuelos desechables usados en un cesto de basura con bolsa bull Laacutevese las manos inmediatamente con agua y jaboacuten por al menos 20 segundos Si no dispone de
agua y jaboacuten liacutempielas con un desinfectante de manos a base de alcohol que contenga al menos un 60 de alcohol
Liacutempiese las manos con frecuencia
bull Laacutevese las manos con frecuencia con agua y jaboacuten por al menos 20 segundos Esto es de suma importancia luego de sonarse la nariz toser o estornudar despueacutes de ir al bantildeo y antes de comer o preparar comidas
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
bull Use un desinfectante de manos si no tiene agua y jaboacuten Use un desinfectante de manos a base de alcohol con al menos un 60 de alcohol y cubra toda la superficie de sus manos frotaacutendolas entre siacute hasta sentirlas secas
bull El agua y el jaboacuten son la mejor opcioacuten en especial si las manos estaacuten visiblemente sucias bull Evite tocarse los ojos la nariz y la boca con las manos sin lavar
Maacutes detalles Consejos sobre el lavado de manos
Evite compartir artiacuteculos del hogar de uso personal
bull No comparta platos vasos tazas cubiertos toallas o ropa de cama con otras personas de su casa
bull Luego de usar estos artiacuteculos laacutevelos bien con agua y jaboacuten o coloacutequelos en el lavaplatos
Limpie todas las superficies de contacto frecuente todos los diacuteas
bull Limpie y desinfecte las superficies de contacto frecuente en la habitacioacuten del enfermo y el bantildeo Permita que otra persona limpie y desinfecte las superficies en las aacutereas comunes pero no su habitacioacuten y bantildeo
bull Si un cuidador u otra persona necesita limpiar y desinfectar la habitacioacuten o el bantildeo de una persona enferma debe hacerlo seguacuten sea necesario El cuidador u otra persona debe usar mascarilla y esperar tanto como sea posible luego de que la persona enferma haya usado el bantildeo
Las superficies de contacto frecuente incluyen teleacutefonos controles remotos mostradores mesones manijas de puertas griferiacutea del bantildeo inodoros teclados tabletas y mesas de noche
bull Limpie y desinfecte las aacutereas que puedan tener sangre heces o liacutequidos corporales en su superficie
bull Use limpiadores y desinfectantes de uso domeacutestico Limpie el aacuterea u objeto con agua y jaboacuten u otro detergente si estaacute sucio Luego use un desinfectante de uso domeacutestico
bull o Aseguacuterese de seguir las instrucciones que figuran en la etiqueta para garantizar un uso
seguro y eficaz del producto Muchos productos recomiendan mantener la superficie huacutemeda durante algunos minutos para asegurar la eliminacioacuten de los microbios Muchos tambieacuten
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
recomiendan tomar ciertas precauciones como usar guantes y asegurarse de tener buena ventilacioacuten mientras esteacute usando el producto
o La mayoriacutea de los desinfectantes de uso domeacutestico registrados en la EPA deberiacutean ser efectivos Podraacute encontrar una lista completa de desinfectantes aquiacuteiacutecono de sitio externo
Maacutes detalles Guiacutea completa para la desinfeccioacuten
Coacutemo discontinuar el aislamiento en el hogar
Las personas con COVID-19 que se han quedado en su casa (aislamiento en el hogar) pueden finalizar este aislamiento bajo las siguientes condiciones
bull Si no se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se cumplan estas tres condiciones
o No haber tenido fiebre durante al menos 72 horas (es decir tres diacuteas completos sin fiebre sin el uso de medicamentos para reducirla) Y
o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar hayan mejorado) Y
o que hayan pasado al menos 7 diacuteas desde la aparicioacuten de los siacutentomas bull Si se haraacute la prueba para determinar si auacuten es contagioso puede salir de su casa cuando se
cumplan estas tres condiciones o Que ya no tenga fiebre (sin el uso de medicamentos para reducirla)
Y o que los otros siacutentomas hayan mejorado (por ejemplo cuando su tos o dificultad para respirar
hayan mejorado) Y
o tener resultados negativos en dos pruebas seguidas con 24 horas de diferencia Su meacutedico seguiraacute las directrices de los CDC
En todos los casos siga las guiacuteas de su proveedor de atencioacuten meacutedica y departamento de salud local La decisioacuten de finalizar el aislamiento en el hogar deberiacutea tomarse con el asesoramiento de su proveedor de atencioacuten meacutedica y departamentos de salud estatal y local Las decisiones locales dependen de las circunstancias locales
Maacutes detalles Guiacutea para discontinuar el aislamiento
Appendix H
Appendix H