Viral Syndrome
(COVID, Flu, RSV, etc)
Viral Syndrome
(COVID, Flu, RSV, etc)
Patient with a constellation of symptoms and signs consistent with a common viral syndrome. Examples include COVID-19, Influenza, Norovirus etc.
PCR / Swab testing while encouraged, is not required if the diagnosis is highly suspected
Requires a period of observation for symptom management and safe disposition (cannot be discharged directly from the ED)
Likely to be able to return to their home or baseline living situation within 24 hours
Low suspicion for bacterial cause
If patient meets sepsis criteria (they often will), then they do not meet any criteria for severe sepsis or septic shock.
Meets criteria for septic shock or severe sepsis
Lactate (if measured) is > 4
Persistent Hypotension after fluid resuscitation
End Organ Damage
Severe underlying immune compromise (AIDS with CD4 < 200, Neutropenia with ANC < 0.5)*
*Solid Organ Transplant not specifically excluded but caution advised.
Pulse oximetry and Cardiac monitoring as needed
IV fluids as needed
APAP, Ibuprofen scheduled while awake
Home O2 eval if needed
Nebs if wheezing
Symptom control with Anti-Emetics, Anti Diarrheal medications
Any disease specific treatments (E.g. Oseltamivir)
PT eval / CM eval for disposition safetey questions
Disposition
Stable Vitals
At Baseline Mobility, or accommodations made for home discharge if mobility impaired
If new O2 need, stability of O2 need established with stable O2 requirements over 12+ hours.
Rx for any symptomatic treatment arranged.
Unstable vital signs or worsening clinical condition
Significant lab or imaging abnormalities
Patient unable to take PO medications or able to safely care for self in home environment.
Alternative dangerous diagnosis suspected and further workup or monitoring needed
Development of Severe Sepsis or Septic Shock
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