scholarly journals Triage guidelines for emergency department patients with COVID-19

2020 ◽  
Vol 8 (1) ◽  
pp. 12-12
Author(s):  
Abbas Dadashzadeh ◽  
Nima Garaje Alamdari ◽  
Alireza Ala ◽  
Javad Dehghannejad ◽  
Faranak Jabbarzadeh ◽  
...  

The recent emergence of corona virus disease-2019 (COVID-19), demonstrates the pandemic potential of COVID-19, the rapid spread of this virus across the world in only a few months highlights the transmissibility of this disease and the significant morbidity and mortality that it can cause, And these reasons make the importance of triage even more colorful at this point.Thus, we designed the principles for better emergency department triage of these patients and reducing the possible risks of transmitting this disease. We hope that with this study, we will be able to partially solve the triage problems of these patients and the problems of the health care staff.

mSphere ◽  
2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Stuart Weston ◽  
Matthew B. Frieman

ABSTRACT The recent emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from the Hubei province in China in late 2019 demonstrates the epidemic potential of coronaviruses. The rapid spread of this virus across the world in only 2 months highlights the transmissibility of this family of viruses and the significant morbidity and mortality that they can cause. We highlight the current state of knowledge of coronavirus biology while answering questions concerning the current outbreak of SARS-CoV-2.


Author(s):  
Shivaram Poigai Arunachalam ◽  
Mustafa Sir ◽  
Gomathi Marisamy ◽  
Annie Sadosty ◽  
David Nestler ◽  
...  

Emergency Department (ED) is a complex care delivery environment in a hospital that provides time sensitive urgent and lifesaving care [1]. Emergency medicine is an unscheduled practice and therefore providers experience extreme fluctuations in their workload. ED crowding is a major concern that affects the efficacy of the ED workflow, which often is challenged by long wait times, overuse of observation units, patients either leaving without being seen by a provider and non-availability of inpatient beds to accommodate patients after diagnosis [2]. Evaluating ED workflow is a challenging task due to its chaotic nature, with some success using time-motion studies and novel capacity management tools are nowadays becoming common in ED to address workflow related issues [3]. Several studies reveal that Electronic Medical Record (EMR) adoption has not resulted in significant ED workflow improvements nor reduced the cost of ED operations. Since raw EMR data does not offer operational and clinical decision making insights, advanced EMR data analytics are often sought to derive actionable intelligence from EMR data that can provide insights to improve ED workflow. Improving ED workflow has been an important topic of research because of its great potential to optimize the urgent care needed for the patients and at the same time save time and cost. Radio Frequency Identification Device (RFID) is a wireless automatic identification and data capture technology device that has the potential for improving safety, preventing errors, saving costs, and increasing security and therefore improving overall organizational performance. RFID technology use in healthcare has opened a new space in healthcare informatics research that provides novel data to identify workflow process pitfalls and provide new directions [4]. The potential advantages of RFID adoption in healthcare and especially in ED has been well recognized to save costs and improve care delivery [5]. However, the large upfront infrastructure costs, need for an integrated health information technology (HIT), advanced analytical tools for big data analysis emerging from RFID and skilled data scientists to tackle the data to derive actionable intelligence discourage many hospitals from adoption RFID technology despite its potential advantages. Our recent pilot study on the RFID data analytics demonstrated the feasibility of quantifying and analyzing two novel variables such as ‘patient alone’ time defined as the total time a patient spends alone without interaction with a health care staff in the ED and ‘provider time’ defined as the total time a patient spends interacting with any health care staff [6]. The study motivated a more comprehensive big data analytics of RFID data which can provide better insights into optimizing ED workflow which can improve the quality of care in the ED and also reduce cost. In this work, the authors attempt to describe the RFID adoption in the ED at the Saint Mary’s Hospital at Mayo Clinic, in Rochester, MN, a level one trauma center both for children and adults as a step towards optimizing ED workflow.


2020 ◽  
pp. 102490792097163
Author(s):  
Kai Yeung Cheung ◽  
Ling Pong Leung

Background: Older people (⩾65 years) present a unique challenge in emergency department triage. Hong Kong’s Hospital Authority adopts a five-level emergency department triage system, with no special considerations for older people. We evaluated the validity and reliability of this triage scale in older people in a regional Hong Kong emergency department. Methods: In total, 295 cases stratified by triage category were randomly selected for review from November 2016 to January 2017. Validity was established by comparing the real emergency department patients’ triage category against (1) that of an expert panel and (2) the need for life-saving intervention. Triage notes were extracted to make case scenarios to evaluate inter- and intra-rater reliabilities. Emergency department nurses (n = 8) were randomly selected and grouped into <5 and ⩾5 years emergency department experience. All nurses independently rated all 295 scenarios, blinded to clinical outcomes. Results: The percentage agreement between the real emergency department patients’ triage category and the expert panel’s assignment was 68.5%, with 16.3% and 15.3% over-triage and under-triage, respectively. Quadratic weighting kappa for agreement with the expert panel was 0.72 (95% confidence interval: 0.53–0.91). The sensitivity, specificity and positive likelihood ratio for the need for life-saving interventions were 75.0% (95% confidence interval: 47.6%–92.7%), 97.1% (95% confidence interval: 94.4%–98.8%) and 26.2 (95% confidence interval: 12.5%–54.8%), respectively. The Fleiss kappa value for inter-rater reliability was 0.50 (95% confidence interval: 0.47–0.54) for junior and senior nurse groups, respectively. Conclusion: The current triage scale demonstrates reasonable validity and reliability for use in our older people. Considerations highlighting the unique characteristics of older people emergency department presentations are recommended.


Author(s):  
Mariam Sughra ◽  
Farwa Fatima ◽  
Mouzma Marrium ◽  
Khizer Abbas

Background: An emergency department or emergency room is a medical treatment facility specializing in emergency medicine, the acute care of patients who present without any prior appointment either by their own means or by that of an ambulance. The main objective of this study was to determine the efficiency of emergency service in Shaykh Zayed Hospital Rahim Yar Khan, Pakistan.Methods: This cross sectional study was carried out in the Emergency Department of Shaykh Zayed Hospital Rahim Yar Khan, Pakistan, from 05-06-2017 to 04-11-2017. A total of 139 subjects were involved in the study. Patients attending Emergency Department of Shaykh Zayed Hospital Rahim Yar Khan, Pakistan were included. Patients were observed and followed silently through their stay in the Emergency Department. All the data taken was entered in predesigned perform.Results: In the Emergency Department, among all the patients, 25.9% came with GIT complaints and only 3.6% had eye, ENT and Dental issues. About 48.2% of the patients had the first contact within 4 minutes. This study shows that the treatment of 49.7% patients started within 10 minutes after entering the emergency however for only 3.5% of the patients it took more than 25 minutes to start the treatment. About 42.4% of all the patients left the emergency after treatment within 20 minutes.Conclusions: Emergency medical services are a critical component of national health system in developing countries. Governments and ministries of health need to pay specific attention to develop emergency services and also to increase the health care staff.


Author(s):  
Sarfaraz Alam Khan ◽  
Nazeem Ishrat Siddiqui

A series of acute and atypical serious respiratory illnesses were reported in December 2019 from Wuhan, a city of China. It spread to other places and became a global pandemic involving more than 200 countries of the world. Soon, it was discovered that this atypical respiratory illness was caused by a novel corona virus. It was named as the severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) and the disease caused by it as corona virus disease-19 (COVID-19). Since COVID-19 is a new viral disease, world is still struggling to find out a permanent remedy to control this serious health problem. It seems prudent to study or have a look on the pathophysiology of SARS CoV-2 in the light of available research. Further, a review on pathophysiology may give an insight on the potential therapeutic options. Being a new virus and having potential to cause significant morbidity and mortality in short span of time various approved drugs are being repurposed for the treatment of COVID-19.


2021 ◽  
Vol 11 (2) ◽  
pp. 260-262
Author(s):  
Saikou Omar Sillah ◽  
Xu Yihua

On 31st December 2019, the World Health Organization (WHO) was notified of a cluster of cases of pneumonia of unknown cause detected in the Wuhan, Hubei Province of China which eventually was named to be the Corona virus disease. In response to the rapid spread of the virus, WHO declared it a public health emergency of international concern (PHEIC) on 30th January, 2020. As per the quest to recharge the COVID-19 response power, there is seemingly little or no tangible plans to help permanently reorient Africa’s health care system. In the wake of widespread vaccine nationalism, donor countries continue to secure large quantities of vaccines from developers and manufacturers, causing global disparity in access to COVID-19 vaccines.


physioscience ◽  
2021 ◽  
Author(s):  
Balz Winteler ◽  
Franziska Geese ◽  
Beat Lehmann ◽  
Kai-Uwe Schmitt

Abstract Background Many countries report a significant increase in emergency department (ED) visits. Patients with musculoskeletal disorders account for a large proportion of non-urgent cases. Objective Characterization and evaluation of a new service that provides immediate access to physiotherapy for patients in the ED. Method To characterize a new service at the Department of Emergency Medicine, Bern University Hospital, and to evaluate first experiences with it, a mixed methods approach was chosen. Data was collected from the electronic patient file and from a logbook kept by the physiotherapists. In addition, guideline-based interviews with involved health care staff were conducted. Results During the 63 days of the pilot study 79 patients were treated by physiotherapists. The most frequently reported patient complaint was back pain (47 %). Interventions included taking the medical history, performing manual tests and multimodal treatment and developing recommendations for further treatment. In 59 % of patients no medical imaging and in 58 % no additional physiotherapy was prescribed. Patients rated the physiotherapeutic service as very good or excellent (88 %). Physiotherapy was experienced as positive and appreciated by the other professions, and all interviewees emphasized the added value for patients. Conclusion The pilot study indicates that the physiotherapeutic consultation service has the potential to improve quality of care. The findings of this study are therefore valuable when considering the introduction of such a service in an ED.


2020 ◽  
Vol 2 (1) ◽  
pp. 1
Author(s):  
Aurang Zeb

In the late December 2019, a unique type of pneumonia was observed in Wuhan city and was reported by China Centre for Disease Control (China CDC). The pathogen was identifed on January 07, 2020 and was named as COVID-19. The COVID-19 has transmission rate more than MERS-COV and SARS-COV. The fatality rate, so far, is around 5% that is more than the common infuenza.1 According to WHO report until the end of June, 2020, there are approximately 10 million confrmed cases worldwide with total approximately 0.5 million deaths. In Pakistan alone until now there are 0.2 million confrmed cases with more than 4000 deaths.2 The whole world is affected by this pandemic psychosocially, economically and physically. To control the spread of infection almost all the countries have started lockdowns. Majority of them are following smart lockdowns where the infected cluster population is sealed only and the restrictions on economic activities are under the safety guidelines. The scientists and medical experts are trying to develop treatment and vaccine against the infection.3 Those who have already got the infections have been quarantined and those with severe symptoms are hospitalized for treatment almost all-over the world. The health care staff including doctors, nurses, pharmacists and other paramedical staff are struggling for the prevention and cure of the disease. This struggle makes them on risk for getting infection by themselves. Thousands of doctors and nurses have already been affected by the infections and hundreds of them have sacrificed their lives in fighting against it. Among all the health care workers, nurses are the professionals who spent more time than the other with the patients and are directly involved in care of the infected patients. Over 20 million nurses worldwide are fighting as front-line soldiers against COVID-19 all-over the world4 and because of the unique patient facing nature of the profession, nurses are at high occupational risk in communities and hospitals.5 It would not be wrong to say that the most vulnerable professionals in this life-threatening pandemic are nurses. Nurses need to be supported by the government and non-governmental organizations by providing them safe environment and protective equipment. Their duties should be scheduled as per WHO recommendations and they need to be compensated in terms of treatment and screening test if anyone of them is suspected for the infection. Today, the health care workers are the real heroes and nurses are the front-line members of the team. The brave efforts of these frontline soldiers are acknowledged all over the world and they have been saluted.


2007 ◽  
Vol 6 (1) ◽  
pp. 9-13
Author(s):  
Hanif Esmail ◽  
◽  
Emma Aarons ◽  

Avian (H5N1) influenza has been responsible for millions of wild bird and poultry deaths throughout the world. Sporadic human cases with a high mortality have occurred, almost exclusively in association with very close contact with sick, dying or dead birds. Appropriate management of suspected cases requires their prompt recognition via attention to travel and bird-exposure history. The early isolation, diagnosis and treatment of suspected cases as well as prompt involvement of the health protection unit should enable patients to be optimally managed with minimum risk to health care staff.


Author(s):  
Kandra Naga Vishnu ◽  
Praveen Kumar Uppala ◽  
Yakaiah Vangoori ◽  
Siva Naga Koteswara Rao Gudhanti

The novel Corona Virus Disease popularly known as COVID-19 brought all sectors to a temporary standstill since its first outbreak in Wuhan China in 2019. The rapid spread of this disease to all countries of the world made it to be declared a pandemic by the world health organization in the first quarter of the year 2020. This pandemic exposed the world population to the understanding of immunity since that was the only remedy at present to this new pandemic. The morbidity and mortality of this new virus were estimated across the globe by many institutions and organizations. The tropical regions where malaria epidemic is more pronounced is less affected by COVID-19 probably due to high immunity already developed by the population as a result of frequent malaria disease and regular use of anti-malarial drug.


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