Home » Duke COVID-19 Guide » VA COVID-19 Screening

Fellowship Program Leadership

Director-
Matthew A. Sparks, MD

Associate Director-
Harpreet Singh, MD

Associate Director-
Christina Wyatt, MD

Program Coordinator-
Marianne Drexler

Chief Fellow-
Rasha Raslan, MD

VA COVID-19 Screening

Bottom line for providers: dialysis staff will be instructed to ask for your assistance in evaluating patients with fever and resp symptoms on dialysis. (as they should even before COVID19). Use clinical judgment, screening questions,  call infection control for further advice. (17-6082). Infection control should be notified ASAP if also exposed to person of interest.

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For patients:

  1. All patients should wash their hands with alcohol or soap/water upon entering and exiting the dialysis unit. We have set up alcohol stations  in the HD unit for this purpose
  2. We are distributing information sheets to all our patients about practicing good hand washing and respiratory hygiene.
  3. We will educate patients  who have a fever and respiratory symptoms to call ahead of their appointment so we can manage them appropriately when they arrive. They should be instructed to wear a mask immediately on arrival and be placed in the isolation room to wait (instead of the waiting room) for further evaluation by one of the providers. All staff should use standard droplet precautions (regular mask) when dealing with patient.
  4. For all outpatients, we will ask them 2 screening questions on arrival:
    1. Do you have a fever+cough?
    2. Have you recently traveled out of town to an area where COVID19 is a concern, or have you been in close contact with someone you know has COVID19 (coronavirus)
  5. If the answer to BOTH questions is yes, then immediately place patient in resp isolation room for HD treatment and staff should use N95/PaPAR for protection. Notify Infection control (17-6082) for further guidance.   If patient is otherwise stable, can proceed with HD. Notify provider for further instruction—patient should be sent to ED for further eval after dialysis regardless.
  6. If patient just has symptoms,  but no known exposure to COVID19, place patient in resp isolation and use standard droplet precautions. Notify provider for evaluation.
  7. If patient just has exposure but no symptoms, ask patient to wear mask throughout treatment. Patient can be placed in the main unit, but we will try to coordinate their chair so that there are no patients within 6 feet of patient.
  8. For inpatients with concern for COVID 19 or confirmed COVID19, they will dialyze in our resp isolation or in the ICU and staff should use N95/ PaPAR. We are rapidly trying to increase our capacity to do off-unit HD.
  9. N95 masks should not be given to patients.

 

For staff:

  1. We recommend that you use discretion in  traveling out of town to any state or country that is under a state of emergency due to COVID19.
  2. Use standard droplet precautions (mask + eye protection) for any patient with fever and resp symptoms, and full N95-PaPAR if pt also has potential exposure to COVID19.
  3. If you have a fever symptoms, call your supervisor to discuss but do not come to work until you have been afebrile for more than 24 hours. We will consult with infection control regarding further testing and precautions.
  4. At this time, there is no quarantine recommendation for any dialysis staff member who has no symptoms who is exposed to someone with confirmed COVID19, but guidance from HR and infection control is evolving on this. If you have been exposed to someone who has COVID19, please contact your supervisor for further instruction.

 

What you can do now:

  • Stay Calm, but remain vigilant. While COVID19 is serious, the regular flu infects and kills far more people than COVID19 has. There is also no evidence of sustained person to person transmission here in North Carolina.  Worldwide experience so far has demonstrated that COVID19 can be contained with proper preparation and care.
  • Get your flu shot, if you haven’t already.
  • Make sure you know how to use and where to find PPE, including N95 mask and PaPR – Training can also be found online here

Personal Protective Equipment for COVID-19 video: https://www.youtube.com/watch?v=bG6zISnenPg

Additional Q&As regarding equipment can be found here.