1) If concern for ?MPX, use .monkeypox to assess if the patient meets criteria for testing 2) If yes, place an order for MPX testing in Epic 4) Grab a specimen kit from Eval Supply room 5) Use kit to swab a single skin lesion of concern (swab one lesion with both swabs) 6) Place specimen in MPX bag into coolers where we put COVID swabs 7) If patient needs TPOXX, page ID for a consult If you have any questions regarding management of one of these patients, feel free to page the emergency preparedness on-call at p22292

We are now giving Bebtelovimab to ED patients based on the COVID therapy algorithm. To order: 1. Page ID for approval (except overnight), then pharmacy will order the mAB 3. Nursing will give the infusion 4. Patients need one hour of monitoring prior to discharge

For patients needing a period of monitoring and treatment who are expected to do well at home: For an ED/EDOU Clinician to request VOU for an MGH ED or EDOU patient: 1. Place an EDVOU bed request in the same location in Epic for EDOU bed requests 2. Go to the “ED Virtual Observation – General Order Set” and place the “ED Place in ED Observation” order 3. Ensure the patient’s home medications are listed in Epic and perform a Medication Review 4. Write an Initial Observation note using the EDVOU Initial Note template 5. The VOU Physician will call the Responding Clinician to discuss the patient. The VOU Nurse may also contact the patient’s ED Nurse. 6. If the patient is accepted, a VOU Coordinator will consent the patient. 7. DO NOT DISCHARGE the patient in Epic. The VOU Team will work with the ED Nurse to transfer the patient home. 8. When the VOU patient leaves the ED, their Epic tile will be moved to the VOU care area by the VOU Team. The VOU Team will assume care of the patient once the patient leaves the ED.

https://partnershealthcare.sharepoint.com/sites/mghEmergencyResources/Shared%20Documents/Forms/AllItems.aspx?csf=1&web=1&e=qYc4D0&cid=07a683d2%2D3e7d%2D49f1%2D8006%2D1c742e9169bc&FolderCTID=0x012000D1ECD771F093654797C5B549DBCAA12C&id=%2Fsites%2FmghEmergencyResources%2FShared%20Documents%2FVirtual%20Observation%20Unit&viewid=17024593%2D03fd%2D4cdd%2Dbc70%2D4c43de9d8103

1) If concern for ?MPX, use .monkeypox to assess if the patient meets criteria for testing 2) If yes, place an order for MPX testing in Epic 4) Grab a specimen kit from Eval Supply room 5) Use kit to swab a single skin lesion of concern (swab one lesion with both swabs) 6) Place specimen in MPX bag into coolers where we put COVID swabs 7) If patient needs TPOXX, page ID for a consult If you have any questions regarding management of one of these patients, feel free to page the emergency preparedness on-call at p22292

We are now giving Bebtelovimab to ED patients based on the COVID therapy algorithm. To order: 1. Page ID for approval (except overnight), then pharmacy will order the mAB 3. Nursing will give the infusion 4. Patients need one hour of monitoring prior to discharge

For patients needing a period of monitoring and treatment who are expected to do well at home: For an ED/EDOU Clinician to request VOU for an MGH ED or EDOU patient: 1. Place an EDVOU bed request in the same location in Epic for EDOU bed requests 2. Go to the “ED Virtual Observation – General Order Set” and place the “ED Place in ED Observation” order 3. Ensure the patient’s home medications are listed in Epic and perform a Medication Review 4. Write an Initial Observation note using the EDVOU Initial Note template 5. The VOU Physician will call the Responding Clinician to discuss the patient. The VOU Nurse may also contact the patient’s ED Nurse. 6. If the patient is accepted, a VOU Coordinator will consent the patient. 7. DO NOT DISCHARGE the patient in Epic. The VOU Team will work with the ED Nurse to transfer the patient home. 8. When the VOU patient leaves the ED, their Epic tile will be moved to the VOU care area by the VOU Team. The VOU Team will assume care of the patient once the patient leaves the ED.

https://partnershealthcare.sharepoint.com/sites/mghEmergencyResources/Shared%20Documents/Forms/AllItems.aspx?csf=1&web=1&e=qYc4D0&cid=07a683d2%2D3e7d%2D49f1%2D8006%2D1c742e9169bc&FolderCTID=0x012000D1ECD771F093654797C5B549DBCAA12C&id=%2Fsites%2FmghEmergencyResources%2FShared%20Documents%2FVirtual%20Observation%20Unit&viewid=17024593%2D03fd%2D4cdd%2Dbc70%2D4c43de9d8103