June 7, 2022

COVID-19 ED Management Tool Now Available, Updated

PLEASE NOTE: This tool is focused on the care of adult (≥18 years of age) patients in the emergency department. MIS-C protocols for pediatric patients can be accessed here: CHOP, Minnesota, Yale

A recent Pediatric EM Section panel reviewed the data on Monoclonal Antibodies in Children and recommended against their use.

Updated June 7, 2022

COVID-19 Severity Classification Tool

A team of clinicians from around the country have been working for several months to update the original ACEP COVID-19 Severity Classification Tool.

The new tool, which can be accessed here and on the MDCalc site and app, is a complete reboot and lays out a pragmatic approach to management of COVID-19 patients in the emergency department.

The new tool walks clinicians through the following steps in the management of patients in the emergency department with COVID-19:

  1. Severity Classification
  2. Risk Prognostication
  3. Risk Assessment
  4. Diagnostic Testing
  5. Diagnostic Interpretation
  6. Disposition
  7. Treatment

By using this tool, emergency physicians are able to better determine the severity of disease their patient is manifesting, as well as determine the prognostic risks that patient has for mortality or end-organ failure. From there, determination of the optimal diagnostic, therapeutic, and disposition approaches can be undertaken.

The tool now offers treatment recommendations that are curated from guidelines from the NIH and IDSA that are consistently being updated as the evidence on therapeutic options evolve.

Additionally, Smart Phrases have been included in this tool, so that clinicians have guidance on the appropriate documentation to include in the EMR based on the management approach that is best for each patient.

“We are so excited to be able to offer this tool to the emergency medicine community,” said Dr. Brian Fengler, Chief Medical Officer of EvidenceCare and an ACEP member who co-led the ACEP working group who compiled these recommendations.

"We finally have enough data to make evidence-based recommendations on the on best-practice approach to managing these patients in the emergency department,” he added.

The working group will be continuing to make updates over the coming months, so revisit this page for the latest version of the PDF document.

Additional Resources

The Society of Academic Emergency Medicine (SAEM) has developed toolkits for providers and patients. Released on Jan. 3, 2022, these toolkits were developed from an educational grant from GlaxoSmithKline.

The following ACEP members contributed to the development of the COVID-19 Severity Classification Tool:


  • Brian Fengler, MD - Chief Medical Officer, EvidenceCare
  • Stephen Cantrill, MD, FACEP - Emergency Physician and Consultant, Denver Health


  • Shannon Brown - Veterans Health Administration
  • Christopher R. Carpenter, MD, MSc, FACEP, AGSF - Professor, Washington University in St. Louis
  • Brenna Farmer, MD, MBA, MS - Associate Professor of Clinical Emergency Medicine, NYP/Weill Cornell Medical Center
  • Kent C. Grimes - Medical Student, Texas Tech University Health Sciences Center El Paso
  • Tara Khan, DO, MS - Emergency Medicine Physician, Department of Veterans Affairs
  • Dan Mayer, MD - Retired Professor of Emergency Medicine, Niskayuna, NY
  • Laura Melville, MD, MS - Associate Research Director, NYP/Brooklyn Methodist Medical Center
  • David Ng, MD, MS, FACEP - Chief of Emergency Medicine and Occupational Health, Veterans Health Administration
  • Christopher Sampson, MD, FACEP - Associate Professor of Emergency Medicine, University of Missouri School of Medicine
  • Sandy Schneider, MD, FACEP - Associate Executive Director, ACEP
  • Sam Shahid, MBBS - Practice Management Manager, ACEP
  • Bradley Shy, MD, FACEP - Associate Professor, University of Colorado - School of Medicine
  • Peter A.D. Steel, MA, MBBS - Director of Clinical Services, NYP/Weill Cornell Medical Center
  • Edward H. Suh, MD - Assistant Professor of Emergency Medicine, Columbia University Medical Center

Contributors to a previous version of this tool include:

  • Amy Baxter, MD - Clinical Associate Professor, Augusta University
  • Matt Burton, MD - VP Clinical Informatics, Apervita
  • Christopher Corbit, MD, FACEP - Facility Medical Director, Summerville Medical Center
  • Pawan Goyal, MD, MHA, FAMIA - Associate Executive Director, Quality, ACEP
  • Jonathan A. Handler, MD - Adjunct Associate Professor, Northwestern University Feinberg School of Medicine
  • Sharon Hibay, DNP, RN - Chief Clinical Officer, Arch Systems, LLC
  • Andrew S. Kanter, MD, MPH, FACMI, FAMIA - Chief Medical Officer, Intelligent Medical Objects
  • Tamara Moores Todd, MD - Medical Director of Care Transformation and Information Services, Intermountain Health
  • Phil Parker, MD - SVP of Integration, SCP-Health
  • Amos J. Shemesh, MD - Assistant Director of Clinical Services, NYP/Weill Cornell Medicine
  • Todd B. Taylor, MD, FACEP - Clinical Informaticist, Independent Consultant
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