Symptoms: [checkbox name="Symptoms" value="Subjective fever|Chills|Congestion|Rhinorrhea|Sore Throat|Myalgias|Dry cough|Productive cough|Headache|Nausea|Vomiting|Diarrhea |Fatigue|SOB|Dysgeusia|Anosmia"] Therapies tried: [checkbox name="Therapies" value="Antipyretics|Cough meds|Nothing"] High Risk Conditions:[text name="Highriskconditions" default="see problem list"] Symptoms are [select name="variable_4" value="IMPROVING|WORSENING|STAYING THE SAME"] since onset STREP SCREENING: Is sore throat the main complaint without concurrent cold-like symptoms (nose/eyes/etc)? [select name="Centor" value="no|YES"][comment memo="Choose 'yes' to bring up Centor Criteria"][conditional field="Centor" condition="(Centor).is('YES')"] Denies: [checkbox name="variable_18" value="dyspnea on exertion|subjective fever|productive cough|myagl"] Modified Centor Score [select name="Q1Fever" value="No (0 points)=0|YES (1 point)=1"] <-- History of fever or measured temperature > 100.4 degrees F [select name="Q2Cough" value="Cough is present (0 points)=0|COUGH IS ABSENT (1 point)=1"] <-- Presence of coughing [select name="Q3Nodes" value="No (0 points)=0|YES (1 point)=1"] <-- Tender anterior cervical nodes [select name="Q4Tonsil" value="No (0 points)=0|YES (1 point)=1"] <-- Tonsillar swelling or exudates [select name="Q5Age" value="< 15 years (1 point)=1|15 to 45 years (0 points)=0|> 45 years (-1 point)=-1"] <-- Age Score --> [calc value="score=(Q1Fever)+(Q2Cough)+(Q3Nodes)+(Q4Tonsil)+(Q5Age)" memo="score"][/conditional] COVID-19 QUESTIONS: Documented fever: [select name="variable_1" value="NO|YES"] Close contact with person with confirmed or suspected COVID-19: [select name="variable_2" value="NO|YES"] Travel to high risk COVID-19 areas per current local guidance: [select name="variable_3" value="NO|YES"] PHYSICAL EXAM Appearance: well-appearing, alert, non-toxic, normal WOB, no acute distress Skin: no visible rashes Head/Face: normocephalic, symmetrical face Nose: reports being able to use both nostrils, reports no tenderness with applying pressure to sinus areas Throat: speaks in clear and unmuffled voice, reports pharynx w/o swelling or exudates Neck: no visible thyromegaly or other masses, able to move neck in all directions without pain Chest/Lungs: normal respiratory effort, no tachypnea apparent, speaking in full sentences, no audible wheezing CV: reports pulse to be regular and of normal rate, reports no LE edema, reports no calf tenderness Neuro: no tremor visible, normal concentration and attention, memory grossly intact Behavior: calm, pleasant, respectful, cooperative Speech/Vocalization: normal for age, clear & coherent Are you so breathless that you are unable to speak more than a few words? [checklist name="variable_1" value="NO|YES"] Are you breathing harder or faster than usual when doing nothing at all? [checklist name="variable_1" value="NO|YES"] Are you so ill that you’ve stopped doing all of your usual daily activities? [checklist name="variable_1" value="NO|YES"] UC course and MDM: Diagnostic Impression: Acute Viral Syndrome Testing Ordered: [checkbox name="Testing" value="Rapid flu|Rapid Strep|Covid-19 PCR|CBC|Radiography Chest| Chest CT| D-Dimer|LFT|None"] Patient is eligible and amenable to receive monoclonal antibody infusion. I have explained that I will send a task to the Covid-19 Care Team in case the PCR test is positive. However - and as a disclaimer- I have clarified that there is no guarantee of receiving the antibody since there is limited disponibility and schedule allocations. I have also exposed that after 10 days of symptoms; the antibody infusion is NOT recommended. Patient is not currently on respiratory distress/failure, multi-organ failure, rapid disease progression requiring escalating supportive care. There is no moderate acuity with extra risk factors (pneumonia, immunosuppressed, elderly, comorbidities), complicated social situation, worsening symptoms > 10 days out. Please go to the ED of your choice if you experience: Trouble breathing Persistent chest pain or pressure Inability to stay awake New confusion Blue lips or face
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