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An adapted emergency department triage algorithm for the COVID-19 pandemic
Douglas W Wallace1, Samuel L Burleson1, Matthew A Heimann1
1Department of Emergency Medicine University of Alabama at Birmingham Birmingham Alabama.
Insights
This study presents an adapted COVID-19 triage algorithm for emergency departments, optimizing patient care and personal protective equipment (PPE) use during the pandemic. The algorithm guides clinicians in managing patients effectively while conserving vital resources.
Area of Science:
- Emergency Medicine
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic presents significant public health challenges, including high case fatality rates and strained hospital resources.
- Effective patient triage is crucial for optimal care, resource allocation, and infection control during pandemics.
- Shortages of personal protective equipment (PPE) necessitate strategic management in emergency departments (EDs).
Purpose of the Study:
- To describe an adapted COVID-19 triage algorithm for emergency departments.
- To provide recommendations for clinician PPE use based on triage levels.
- To support evidence-based patient management and resource conservation during the pandemic.
Main Methods:
- Development of an adapted triage algorithm for COVID-19 patients in the ED.
- Integration of best available evidence and lessons from prior pandemics.
- Inclusion of specific recommendations for PPE utilization at each triage encounter level.
Main Results:
- The algorithm facilitates accurate patient triage, ensuring appropriate care levels.
- It guides rational use of PPE, addressing shortages effectively.
- The protocol supports the safe discharge of mild symptom patients with clear instructions.
Conclusions:
- The adapted COVID-19 triage algorithm enhances ED patient management during the pandemic.
- It promotes efficient PPE usage and mitigates nosocomial exposures.
- Adherence to CDC guidelines and clear patient education are key components for successful implementation.
Abstract:
The novel coronavirus disease 2019 (COVID-19) pandemic, with its public health implications, high case fatality rate, and strain on hospital resources, will continue to challenge clinicians and researchers alike for months to come. Accurate triage of patients during the pandemic will assign patients to the appropriate level of care, provide the best care for the maximum number of patients, rationally limit personal protective equipment (PPE) usage, and mitigate nosocomial exposures. The authors describe an adapted COVID-19 pandemic triage algorithm for emergency departments (EDs) guided by the best available evidence and responses to prior pandemics, with recommendations for clinician PPE use for each level of encounter in the setting of an ongoing PPE shortage. Our algorithm adheres to Centers for Disease Control and Prevention guidelines and supports discharge of patients with mild symptoms coupled with explicit and strict return precautions and infection control education.
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