Lesson 4: Precautions During Home Care of Patients with Known or Suspected Exposure to COVID-19

Department of Homeland Security Federal EmergencyManagement Agency and Center for Domestic Preparedness logo Training the Best for the Worst Precautions and Controls for Coronavirus Disease2019 (COVID-19) prepared by the Federal Emergency Management Agency’s Center for DomesticPreparedness Image of a microscopic view of the SevereAcute Respiratory Syndrome coronavirus 2 from the Centers for Disease Control and Preventionphoto by Alissa Eckert and Dan Higgins.

Lesson 4: Precautions and Controls DuringHome Care of Patients with Known or Suspected Exposure to Coronavirus Disease 2019 (COVID-19) Image of a house photo by Binyamin Mellish.

Home Care Decision Making Given the strain on medical resources, individuals who do not require hospitalization can possiblybe cared for in their own home.

In making the decision for home care, healthcareprofessionals must consider the suitability of the residential setting and the abilityof caregivers to be able to assist the patient.

If the home is suitable, caregivers capable, and the patient does not require hospitalization, then home care is an ideal alternative toconserve medical resources for those most in need of them.

In general, if recommended, people shouldremain isolated within their homes until the risk of secondary transmission is thoughtto be low.

Suitability of the Residential Setting forHome Care In consultation with state and local healthdepartments, healthcare professionals should assess whether a residence is appropriatefor home care.

Healthcare professionals should ask the followingquestions.

Is the patient stable enough to receive careat home? Are appropriate caregivers available at home? Is there a separate bedroom where the patientcan recover without sharing immediate space with others? Are resources for access to food and othernecessities available? Is appropriate PPE (gloves and facemask ata minimum) available and are household members capable of adhering to precautions recommended(specifically respiratory hygiene and cough etiquette, hand hygiene)? Are there household members who may be at an increased risk of complications from COVID-19 infection (for example are they older than 65 years old, young children, pregnant women, people who are immunocompromised or who have chronic heart, lung, or kidney conditions)? Upon answering these questions and takinginto consideration current medical resources, the healthcare professional can make a decisionon whether the patient can be cared for at home.

Recommendations for Close Contacts DuringHome Care Close contacts still in the home (such ashousehold members, caregivers) will be the main care providers for the patient.

The following recommendations are providedfor close contacts providing support for a home care patient.

Help the patient follow healthcare provider’sinstructions for medications and care Help patient with basic needs Provide support for getting groceries, prescriptions, and other personal needs Monitor the patient’s symptoms Notify healthcare provider if symptoms worsen Always notify healthcare providers or EMS/911dispatcher that the patient either has a laboratory confirmed case of COVID 19 or is a personsuspected of having COVID 19 Ensure the patient wears a facemask while around other people.

Close contacts still in the home will be susceptibleto contract COVID-19.

The following recommendations are providedto help close contacts protect themselves and others during support for a home carepatient.

Ensure good air flow in shared spaces, suchas air conditioner or an opened window, weather permitting.

Perform hand hygiene frequently.

Wash hands often with soap and water for atleast 20 seconds or use an alcohol-based hand rub that contains 60 to 95% alcohol Avoid touching your eyes, nose, and mouthwith unwashed hands When you touch or have contact with the patient’sblood, stool, or body fluids such as saliva, sputum, nasal mucus, vomit, and urine, youmust wear a disposable facemask and gloves because you will need to throw them out afterusing them.

Do not reuse your mask.

When removing personal protective equipment, first remove and dispose of gloves.

Then, immediately clean your hands with soapand water or alcohol-based hand rub.

Next, remove and dispose of your facemask, and immediately clean your hands again with soap and water or alcohol-based hand rub.

Place all used disposable gloves, facemasks, and other contaminated items in a lined container and then dispose of them with other householdwaste.

Clean your hands immediately after handling these items.

If your hands are visibly dirty, it’s preferred that you use soap and water.

Stay in another room or be separated fromthe patient as much as possible Avoid sharing household items (like dishes, drinking glasses, cups, eating utensils, towels, bedding).

After the patient uses these items, you shouldwash them thoroughly.

Wash laundry thoroughlyImmediately remove and wash clothes or bedding that have blood, stool, or body fluids onthem.

Wear disposable gloves while handling soileditems and keep soiled items away from your body.

Clean your hands immediately after wearinggloves.

Clean all “high-touch” surfaces (for examplecounters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets) everyday.

Use a separate bathroom, if available Prohibit visitors who do not have an essential need to be in the home Care for any animals.

The home care patient should not care for any animals during home isolation Discontinuation of Precautions for IndividualsUnder Home Isolation The decision to discontinue home care andisolation should be made based on one of two options: The first option is the non-test-based strategy, which means: The patient must have had 3 continuous days(72 hours) since recovery.

Recovery is defined as being fever-free withoutthe use of fever-reducing medications ANDImprovement in respiratory symptoms (specifically cough and shortness of breath)AND At least 10 days have passed since symptomsfirst appeared.

The second option is the Test-based Strategy, which means: The patient must be fever-free without theuse of fever-reducing medications ANDHave improvement in respiratory symptoms (specifically cough, shortness of breath) ANDHave negative results from an FDA Emergency Use Authorized COVID-19 molecular assay todetect SARS-CoV-2-RNA from at least two, consecutive nasopharyngeal swab specimens collected atleast 24 hours apart.

(That is a total of two negative specimens).

Individuals with laboratory-confirmed COVID-19who have not had any symptoms may discontinue home isolation when at least 10 days havepassed since the date of their first positive COVID-19 diagnostic test and have had no subsequentillness during that time.

For the most current information on COVID-19 The outbreak of COVID-19 is rapidly evolving.

Visit the CDC website for the most up-to-dateinformation at www.

cdc.

gov/covid19 or by scanning the QRcode below Visit the Center for Domestic PreparednessWebsite at Cdp.

dhs.

gov Or their Facebook page at www.

facebook.

com/cdpfema Questions can be emailed to studentservices@cdpemail.

dhs.

gov Or call 1-866-213-9553.

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