Emergency Department Surveillance
Physicians should be aware that there is ongoing active surveillance for COVID 19 in Nova Scotia. All patients seen in the Emergency Departments and/or admitted to hospital with acute respiratory illness will be automatically tested for COVID 19 regardless of travel or exposure history. To facilitate this surveillance the following should occur on all patients seen in the Emergency Department:
- All patient with respiratory symptoms should be placed on contact and droplet precautions
- All patients with ILI (cough or fever) should have an NPS for influenza testing
- All patients being tested for influenza will be automatically tested for COVID regardless of history of travel or contact with a known or suspect case.
- Patients who are discharged home from the Emergency Department will be told to self-isolate until contacted by Public Health with their results
- For patients requiring admission ONLY those who meet the COVID case definition (history of travel outside Nova Scotia within 14 days and/or contact with known or suspected COVID case (symptomatic person within the past 14 days, including a symptomatic person who has travelled outside Canada in the past 14 days)) are eligible for COVID unit admission.
- All other acute respiratory symptom patients requiring admission should be admitted to an appropriate non-COVID ward with contact and droplet precautions.
*Updated* Order Set for Admitting COVID-19 Patients
A new pre-printed order set for admitting COVID-19 patients is available
here. These documents are changing regularly, please check
www.cdha.nshealth.ca/coronavirus for the most up to date clinical support documents daily.
COVID-19 Inpatient Unit Guideline
Click to download the draft Guideline for taking admitting history and physical. The appropriately formatted form will be uploaded tomorrow.
Clinical and Medical Advisory Team
Huge shout out to the Medical and Clinical Advisory Team who worked 15 hours straight today to update and provide new clinical support documents!
With the changes to screening criteria and needed clarification on naming criteria, our teams are working to review and revise clinical instructions, practice guidelines, order sets, and care pathways to reflect new provincial screening protocols and guidelines. Updates will be posted on our
COVID-19 website as soon as they are available.
Provincial Status Update
Seven new cases were identified on Saturday, March 21. All are travel-related or connected to an earlier case. To date, Nova Scotia has 28 positive test results and 2088 negative cases. The 28 individuals affected range in age from late-teens to mid-70's. Two cases are hospitalized. The QEII Health Sciences Centre's Microbiology Lab is now certified to report positive and negative tests for COVID-19. Tests no longer have to be sent to the National Microbiology Lab in Winnipeg.
Clarification for Health Care Workers on State of Emergency Provisions
Today (Sunday, March 22), Nova Scotia declared a provincial state of emergency to help contain the spread of COVID-19. Nova Scotians are being directed to observe social distancing of two metres (six feet). Nova Scotia borders will tighten to travellers and all entry points (land, sea, air) will be closely managed starting on Monday, March 23, at 6 a.m. Nova Scotians should only leave if essential. Anyone entering the province will be stopped, questioned and told to self-isolate for 14 days.
Healthy health care workers including physicians are exempt from the cross border travel restriction, as are Nova Scotians entering or exiting the province for specialized medical treatment.
Health care providers are exempt from the social distancing requirement of two metres and the gathering limit of no more than five people when in the workplace. This includes:
- Nova Scotia Health Authority & IWK employees
- Physicians and nurse practitioners
- DHW-funded home support agencies and VON
- Nursing homes
- Residential care facilities
- There are exemptions for other essential industries as well.
Privacy of Patients During COVID-19
The privacy of our patients remains a top priority for NSHA. Any information gained from your work within the health system is only to be used in the course of performing your duties.
You may not share any information about a community member attending a facility outside of NSHA. Even sharing within NSHA outside of the course of your daily duties would be considered a privacy breach.
Any reports of information being shared inappropriately will be investigated by the Privacy Officer in your zone. Breach of patient confidentiality is a serious matter and may result in disciplinary action, up to and including termination of employment if it is determined that the breach was committed with intent to gossip or another malicious purpose. If you have questions about what may or may not be shared during the COVID-19 Pandemic please reach out to the Privacy Office at
Privacy@nshealth.ca.
COVID-19 Testing
The QEII Health Sciences Centre’s Microbiology Lab is now certified to report positive and negative tests for COVID-19. Tests no longer have to be sent to the National Microbiology Lab in Winnipeg.
Delivery for testing to the regional laboratory should occur within four hours from time of collection. If transportation is delayed beyond four hours, the specimens should be refrigerated and transported to the laboratory using a cooler with ice packs. Transport logistics needs to be maximized to ensure that specimens are received by the QEII laboratory within 24 hours.
Reminder: swab caps must be tightened to prevent leakage and requisitions placed in outside pocket of sample bag.
Traveling Airway Management Road Show Comes Just in Time for Truro
Emergency Departments across the province are benefitting from a traveling road show delivering training in Airway Management. A local emergency department leader credits this training, and Lorri Beatty, for providing support to their colleagues in Northern Zone where, not long after, the first COVID-19 patient required intubation.
Dr. Kirk Magee a Central Zone emergency physician, directed AFP funding towards airway/simulation/education and provided train the trainer sessions with each zone. These sessions are informed by the world renowned work of
George Kovacs and Adam Law, in conjunction with many of their contacts in some of the worst hit centers of this pandemic.
This work is ongoing, important, and life-saving (both for patients, and for health care providers who must effectively manage airways in the safest manner possible). It could not happen without the close relationship between the Dalhousie Dept of Emergency Medicine, and the NSHA Emergency Program of Care.
Credit also goes to the Colchester East Hante Hospital’s emergency department team who fully invested in the training to intubate for COVID-19. They spent Friday from 4:30pm-6:00pm in simulation training. Not long after, the same individuals were required to intubate a COVID-19 positive patient. They are now sharing their process and encouraging other health teams across the province to practice in the room with the team members they intend to use for intubations.
The roadshow is hitting Cape Breton tomorrow
