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ACEP ED COVID-19 Management Tool

COVID-19Emergency medicineSeverity classificationBeta toolThis tool is in beta. It has undergone internal validation but still requires additional testing. Always confirm the data entered and the results obtained before clinical use. It should not be used as the sole basis for clinical decisions.
Respiratory failure presentAny critical criterion takes precedence over every lower severity category.
Septic shock present
Multiorgan dysfunction or failure present
Use resting room-air saturation. Values below 94% meet a severe critérion.
%
Baseline resting oxygen saturation is normal for this patientThe moderate category requires lower respiratory disease plus SpO2 >=94% and normal baseline resting saturation.
Enter breaths per minute as a whole number. Values above 30/min meet a severe critérion.
/min
Optional. Enter only if arterial blood gas was obtained. Values below 300 mm Hg meet a severe critérion.
mm Hg
Optional. Enter only if infiltrate extent was assessed. Values above 50% meet a severe critérion.
%
Evidence of lower respiratory disease on clinical assessment or imaging
Dyspnea or shortness of breath present
Abnormal chest imaging if obtained
COVID-19-compatible symptoms present

Clinical noticeEducational emergency-department COVID-19 severity support only. Interpret with full clinical assessment and the current ACEP/NIH pathway.

Context and use

Critical if respiratory failure, septic shock, or multiorgan dysfunction/failure is present.

Otherwise Severe if SpO2 <94%, PaO2/FiO2 <300 mm Hg, respiratory rate >30/min, or lung infiltrates >50%. Moderate if lower respiratory disease is present with SpO2 >=94% and normal baseline resting saturation. Mild if compatible symptoms are present without dyspnea and without abnormal chest imaging when obtained.

Precedence is fixed: critical > severe > moderate > mild. SpO2 94%, PaO2/FiO2 300, respiratory rate 30, and infiltrates 50% do not count as severe.

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Certifications and Compliance

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