Assessment for SEVERE ACUTE RESPIRATORY SYNDROME (SARS)

 

Date of Assessment ___/___/__ (dd/mm/yy)

 

DEMOGRAPHICS

 

Age: _______             Sex: ______________            Occupation: _______________

 

Married (Y/N): _______________     Children (Y/N, number): _______________

 

HISTORY

 

Date of Exposure From ___/___/___ (YY/MM/DD)  To ___/___/___ (YY/MM/DD)

 

Type of Exposure

        Travel              

If yes,   Hong Kong  or Guandong, China or Taiwan or

 

  Hanoi, Vietnam or Singapore

                       

From ___/___/__ (YY/MM/DD) To ___/___/__ (YY/MM/DD)

 

        Close Contact to a person with “suspect or probable SARS case” or “quarantined person”

 

        Other, specify: ______________________________

 

Setting of Exposure (Ö all that applies):

        Occupational exposure (i.e. the patient being assessed is a healthcare worker)

            If yes, what precautions were taken? (Ö all that applies):

                                no precautions

                                mask (not N95 or equivalent)

                                N95 mask or equivalent

                                goggles

                                gown

                                gloves

                                other, specify: __________________

 

        household contact

        face-to-face  (within 1 meter) contact

        contact with respiratory secretions (ie. Fluid from mouth/nose)

        Other form of contact _________________________________

                       

Who was the patient in exposed to?        __________________________

Where ?                               Scarborough Grace Hospital

                                            York Central Hospital

                    Other ______________

 

Date of Illness Onset of Symptoms ___/___/__ (YY/MM/DD)

 

Symptom

Yes

No

Duration and/or Date of Onset (YY/MM/DD)

Fever (> 38° C)

 

Cough

 

Sore throat

 

Myalgia

 

Headache

 

SOB / difficulty breathing

 

Diarrhea

 

Loss of appetite

 

Nausea

 

Vomiting

 

Rash

 

Confusion

 

Other Symptoms

 

 

 

 

 

 

Details of Exposure and symptoms _________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________

 

Past Medical History _____________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

        Anemia, thalassemia, sickle cell anemia, other ____________ (circle)

        Kidney disease,             if yes ________________________________

        Heart disease,               if yes ________________________________

        Liver disease,                if yes ________________________________

 

Medications_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Allergies________________________________________________________________

 

 

Physical Examination

 

Temp: _______ O2 sat on R/A: _______  HR: ________  BP: _______  RR: ________

 

 

 

 

 

 

 

 

 

 

Bloodwork (* markers of SARS)

 

Hb: ________             WBC: _________       Lymphocyte count*: _________

 

INR: _________        PTT: __________       Platelet count: _________

 

 

Na: _________           K: _________             Chloride: ________             CO3: ________

 

Cr: _________            urea: _________        BS: _________

 

Mg: ________            Ca: _________           Albumin: _________

 

 

AST*: _______          ALT*: _________      ALP: _________        Bilirubin: _________

 

LDH*: ________       CK*: ________          Lipase*: _________

 

 

Serum Beta-HCG for women: _________

 

 

CXR: __________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

 

ECG: __________________________________________________________________


 

Assessment:

________________________________________________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________

 

 

Plan:

________________________________________________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________

 

 

***********************************

 

 

Date of Assessment___/___/___( YY/MM/DD)                     Assessment by _____________(RN)

Assessment by _____________(MD)

 

  Exposed Contact – Asymptomatic

  Exposed Contact – Symptomatic but does NOT meet “suspect case” definition

  Suspect Case – Symptomatic (but does not meet case definition of probable case)     

  Probable Case

  Person under Investigation

  Other, specify

 

 

  Admit

  Discharge

 

Prepared by Marie Louie

Revised on April 18, 2003 by Dr. Mona Loutfy And Dr. Anita Rachlis