UMHC General Care of Protected Patients SOP

• To provide adequate care, each nurse & primary provider team responsible for patient
BESIDE CLINICAL

should examine patient as per routine care (e.g., 1x/shift for RN, 1x/day for providers)
EVALUATIONS

• To minimize entry into room:

• Batch care responsibilities (e.g., meds, blood draws) as able – providers should
attempt to coordinate timing of ordered interventions as requested to facilitate
• Do not enter patient’s room under any circumstances (even in emergency) without first
appropriately donning PPE

• Minimize diagnostic testing as much as possible

• Bloodwork:
DIAGNOSTIC

• Goal to reduce # of needlesticks – batch tests if able

TESTING

• As possible, testing to be done at point-of-care

• Imaging:
• Use US to replace x-rays & portable x-rays to replace CT/MRI/etc whenever able
• All equipment in patient room needs decontamination after each use

• Minimize invasive procedures as much as possible

• Prior to entering room for procedure:
• Ensure all necessary equipment assembled
• Perform pre-procedure debrief with proceduralist & RN to ensure:
• All needed equipment is available (so only enter/exit room once)
• Determination of whether RN needs to be in room (in PPE)
• If not, RN stays outside room (not in PPE; PPE readily available)
• PPE for sterile procedures:
• Don standard PPE
• Enter room with all necessary equipment
INVASIVE PROCEDURES

• When starting procedure:

• Doff standard PPE outside patient room
• Don sterile PPE prior to re-entry into room to start procedure
• Vascular catheter insertion:
• Use ultrasound to maximize likelihood of 1st-attempt success
• Use ultrasound as preferred method to confirm IJ/SC venous catheter placement:
• Check lung sliding (rule out pneumothorax)–2 points on anterior chest
• Ensure low likelihood catheter is mal-positioned:
• Catheter not visible in 3 non-accessed IJ/SC sites
• Catheter tip not visible in RA/RV
• Instill 5ml agitated saline: goal = bubbles in RA in ≤2 secs (absent
or >2s = mal-positioned)
• Refer to separate SOPs for Intubation & CPR; for bronchoscopy, follow Intubation SOP
• Oxygenation/Ventilation: HFNC & NIPPV usable in negative pressure rooms (see SOPs)
• Body cavity drainage (e.g., thora/paracentesis)
• Use ultrasound to maximize likelihood of 1st-attempt success

reviewed Feb. 2021