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COVID-19 resources for health care professionals

COVID-19 is an emerging, rapidly evolving situation. We are committed to doing our best to keep our partnering health care professionals informed about the latest efforts being put into place at Dayton Children's. Below you will find resources that you can print and use in your offices, as well as links to reputable local and national resources.

 

COVID-19 hotline 1-888-746-KIDS (5437)

Please give families our hotline number for any questions they may have about COVID-19. It is staffed by nurses at Dayton Children's from 8:00 am to 8:00 pm, everyday, including weekends

back to school guidance

As some schools prepare to welcome students to the classroom, we know that many families are turning to you for guidance. Dayton Children's wants to support you in offering consistent, evidence-based recommendations, so we created a "back to school" task force that is working with the Ohio Department of Health, county health departments, Ohio Children's Hospital Association, and area school districts to create a resource hub for information and materials.

One of the issues many of you are facing right now is parents asking for letters that will exempt their child from wearing a mask at school. As of August 4, Governor DeWine's order states that everyone in an Ohio school should wear a mask. While we certainly understand the mixed feelings regarding masks, evidence continues to show that universal masking is one of the best ways to prevent the spread of infectious disease and lessen the severity of the illness. Therefore, we are providing the guidance that there should be very few medical exceptions for school-age children.

Those include:

  1. Children under the age of 2 years
  2. Any child unable to remove the face covering without assistance
  3. A child with a significant behavioral/psychological issue undergoing treatment that is exacerbated specifically by the use of a facial covering (e.g. severe anxiety or a tactile aversion)
  4. A child living with severe autism or with extreme developmental delay who may become agitated or anxious wearing a mask
  5. A child with a facial deformity that causes airway obstruction

Chronic conditions such as asthma or diabetes would NOT be considered as an exemption for wearing a mask. In fact, we know these children will be the ones who benefit the most from the safety a mask provides!

clinical resources for primary care

The purpose of this hub is to compile resources into one location to support the easy access of information that pediatric health care providers in our area may need during the novel coronavirus (COVID-19) pandemic.

The Dayton Children's command center has made evidence-based decisions in creating these documents based on guidance from the Centers of Disease Control and Prevention (CDC), the Ohio Department of Health, and other nationally-recognized and established health care experts.

Guidance from those agencies continues to change rapidly so information on the CDC and our state and local departments of public health websites will supersede the information in the documents below.

If you have any questions, you can always reach out to Dayton Children's COVID-19 hotline 1-888-746-KIDS (5437)

 

virtual visit resources

Dayton Children's is aware of the ongoing cybersecurity concerns regarding the use of Zoom video meetings, from "Zoom-bombing" to eavesdropping. Most of these concerns were related to the free version of Zoom (public meetings without passwords). We do not use that version. Nonetheless, we want to assure you we are taking every precaution to maintain the integrity and confidentiality of patients' and employees' personal information in video visits. Here are a few ways we are doing so.

  1. Each video visit meeting is private, and given a randomly generated unique meeting ID and password. This information only goes to participants on the appointment invite.
  2. After patients join their secure visit, they are placed in a virtual waiting room. The Dayton Children's team reviews those individuals before admitting them to the call. In the very unlikely event that there are people in the waiting room who should not be included, they would not be admitted.
  3. Dayton Children's caregivers that have access to video visits have been granted proper access levels for the Zoom meetings. We do not allow unauthorized or staff who are not members of the care team into video visits.
  4. Video visits with Dayton Children's team members are not recorded, allowing the patient and their family to speak with their care team in a confidential and private environment.

These security settings apply to video visits initiated through MyKidsChart and visits started through Zoom.

Our cybersecurity team will continue to carefully monitor any further Zoom security issues, and will adjust our security policies as required to continue providing our providers, staff and patients a secure video visit environment.

For our partnering providers who may not be using Zoom for video visits, we have provided additional resources.

frequently asked questions

COVID-19

where can we send our patients to get tested?

First determine if a test is necessary. A positive result will not routinely change treatment. Given the short supply of tests and testing sample supplies, it is normally better to instruct the child to recover at home and the parents to monitor for worsening symptoms. However, if you feel a test is necessary, given the circumstances of the patient, there are several options.

  • For offices with LabLink employees, the LabLink employee can take the sample with supplies in the office and send it to Dayton Children's for processing with the appropriate lab.
  • For offices without LabLink, your staff can take the sample and call for a Dayton Children's courier to pick it up for testing. You may need to take the sample out to the courier, so that person does not need to come into the office.
  • For all offices, sending patients to the University of Dayton screening site is also always an option.

when should I test patients for COVID-19?

If you have a patient who has a fever above 100.4 degrees Fahrenheit, a cough and shortness of breath or difficulty breathing, you should test first for flu, then consider a RIDP before moving on to a COVID-19 test.

As you know testing is limited, but even more importantly testing supplies are extremely limited. Dayton Children's policy is to only test for children with COVID-19 symptoms who need to be hospitalized because of the severity of symptoms or who have significant underlying medical conditions.

how do I test patients for COVID-19?

A nasopharyngeal (NP) swab placed in viral transport media is the standard for COVID-19 testing.

what tips should I give my patients and families to prevent the spread of novel coronavirus?

The best way to prevent illness is to avoid being exposed to the virus. However, we have a tip sheet that outlines the 6 ways to stay healthy.

  • Wash your hands with soap and water for at least 20 seconds. You can also use hand sanitizer with 65% alcohol when hands are not visibly dirty.
  • Avoid touching your eyes, nose and mouth.
  • Stay home when you are sick.
  • Avoid close contact with people who are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

how do I establish effective staff safety protocols?

You should review CDC and ODH guidelines. Dayton Children's has moved to a universal masking policy, in which everyone in the building will wear a mask. Health care workers will wear one mask per shift, removing if it becomes soiled or hard to breathe through, taking  care to never touch the front of the mask.

how do I treat patients with confirmed COVID-19?

They should be encouraged to recover at home. If their symptoms worsen, you should direct them to the emergency department and call head to the ED to alert them the patient is coming.

what steps can providers take to stay healthy during the COVID-19 pandemic?

See the 6 steps to stay healthy. Also consider wearing a mask while seeing patients.

what should providers do when they have been exposed to COVID-19?

Check the CDC or ODH for most recent guidelines however, current options include:

  • Self-monitor by taking your temperature twice a day and observing any appearance of cough or trouble breathing. Consider wearing a mask.
  • Self-quarantine for 14 days.

respiratory illness season 2020

The respiratory illness season in 2020 will be unlike any we have seen before. The situation with COVID-19 is fluid and there are multiple unknowns. Our goal at Dayton Children's it to help community providers navigate this wave of uncertainty. If you have additional questions or concerns, please reach out.

how do I keep everyone safe, healthy and the doors of my practice open?

Personal protective equipment (PPE) is key. Masks and eye protection (face shields or goggles) are recommended for all patient interactions. N95 masks are only recommended during aerosolizing procedures.

when do I need to close an exam room?

Following an aerosol-generating procedure, a room should be closed for two hours and then wiped down.

Procedure Aerosol-generating Close Room
Trach suctioning Yes Yes
BBG suctioning No No
NP swab/ nasal wash No No
Nebulized medication No No

 

can this time be shortened?

Yes, if a HEPA air filter (air scrubber) is used, the time can be shortened to one hour or less depending on the room size.

how can we avoid getting into room lock?

  • Leverage virtual visits for appropriate issues to lighten in-person volume
  • Consider referring children with tracheostomies and URI symptoms to the urgent care, emergency department or their pulmonologist
  • Bring higher risk kids and children with tracheostomies in at the end of the day
  • Designate one room that will be used for aerosolizing procedures and schedule patients accordingly

when do my staff need to quarantine?

Staff need to quarantine when they have had close unprotected exposure within six feet for at least 15 minutes with a person that is positive for COVID-19. Since it is recommended that all staff wear a face mask and eye protection when dealing with patients, this is more likely to occur outside of the office.

does the quarantine need to be for 14 days or does a negative test clear them for return?

The incubation period for SARS-CoV-2 is 2-14 days. A negative test on day 5 does not guarantee that the exposed staff member will not develop sickness on day 13 or 14. Best practice would be to remain in quarantine the full 14 days. If a staff member develops symptoms, they should be tested.

If quarantine for 14 days puts the practice at significant risk for not being able to take care of patients, an office could consider a return to work after a negative test (completed after day five of exposure) with self-monitoring of symptoms, safe social distancing, and appropriate masking and personal protective equipment.

Practices should anticipate potential situations that will require staff to quarantine. The potential for increased volumes of kids needing return-to-school clearance is high. Preparing now for ways to manage this shortage will keep practices at an advantage.

  • Cross-train staff for the different tasks required to keep the office operating.
  • Identify staff tasks that can be conducted at home and then give that role to someone in quarantine, if needed.
  • Divide staff into working teams to help minimize exposures to the entire staff at one time.
  • Extend hours: have smaller teams work different hours of the day or weekend to increase accessibility and decrease staff in the office at one time.
  • Increase virtual visit options for the office and market these to your patients.
  • Strategically schedule follow-ups, behavioral and well visits throughout the day to minimize not only exposure but to help with room flow through the office.
  • Anticipate that more CLIA testing may be required to rule/in and rule/out other diagnosis for parents (more rapid flu, strep and RSV testing potentially). This may lengthen appointment times and change flow through the office in comparison to other years.
  • Advocate early patients to get flu vaccine. This may help decrease the number of patients ill from flu.

Due to COVID-19, our couriers are trying to limit close contact. To that end, we are requesting that, you bring any deliveries out to the courier's vehicle. We are pleased to continue to partner with your office, and thank you for your understanding and cooperation during this time.

updates on COVID-19

Please use our coronavirus information hub for resources and answers to frequently asked questions about Dayton Children's response to COVID-19. You can also call our COVID-19 parent hotline at 1-888-746-KIDS (5437) from 8:00 am – 8:00 pm for additional questions.