Assessment and Prioritized Care  of the patient diagnosed with COVID-19

Geriatric Fluid Volume Deficiency

Minni Frost is an 87-year old adult who is being transferred to the Emergency Department (ED) for assessment.  She currently lives in a retirement centre with her spouse.  She has experienced nausea and vomiting x 24 hours with associated decreased oral intake.  Minni is increasingly lethargic today and her spouse states she has been slightly confused for the past 12 hours.


Respiratory Deterioration

Robert Caron is a 57-year-old male who was admitted to the medical unit with shortness of breath, mild chest pain that increases with deep breaths, and a mild fever.  He had an ECG in the Emergency Department that shows sinus tachycardia.  Lab values: Creatine Kinase (MB) and cardiac troponin were within normal limits.  He had a nasopharyngeal swab for COVID-19, results pending.  He is currently receiving oxygen, 2L nasal prongs.


Care of the Ventilated Patient

Robert Caron is a 57-year-old male admitted to the medical unit this morning with shortness of breath, mild chest pain which increases with deep breaths, and mild fever.  Symptoms increased in severity requiring intubation.  His last set of vitals post-intubation were: T 38.2, HR 120, BP 110/60, and SPO2 95% FiO2 50%.  The RT will provide the vent settings.  He’s currently sedated with fentanyl and midazolam.  He also received rocuronium during induction.  He had a nasopharyngeal swab for COVID-19, results pending.  He is a full code.  Hist past medical history includes HTN, BPH, and type 2 diabetes.  His wife is at home and the physical is calling her right now to update her on the patient’s condition and transfer to the ICU.


Multiple Organ Dysfunction

Demetri Ivanivitch is a 23-year-old male (pronouns he/him) migrant worker from Belarus.  He was informed by Public Health that he tested positive for COVID-10 after screening by his employer.  He was put in self-isolation and followed by Public Health in the community. His only initial symptom was the loss of taste and smell.  Over the course of three days, the patient began experiencing increased shortness of breath (SOB).  He called 911 and was brought to the ER for assessment.   He was intubated and is now being transferred to the Intensive Care Unit (ICU).


Running a Code

A middle-aged (54 yrs) male, George Doulle arrived in the Emergency Department of a rural hospital for shortness of breath, non-productive cough, decreased appetite, and fever.  He has a past medical history of smoking (35 packs per year) and hypertension.  He is awaiting an assessment from the ER nurse and physician.