Triage Strategies for COVID-19 Cases: A Scope Review

Mazoni, Simone Roque; Andrade, Juliane; Antonio, Priscila da Silva; Baraldi, Solange; Cauduro, Fernanda Letícia Frates; Santos, Paulo Henrique Fernandes dos; Sousa, Pablo Ribeiro de; Pinho, Diana Lúcia Moura

doi:10.1177/00469580221095824

Cited by 3 publications

(4 citation statements)

References 34 publications

(98 reference statements)

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“…Even in a pandemic situation, a system that allows patients with a disease other than COVID-19 to receive appropriate medical care is needed. In addition to triage at medical sites, various methods such as home visits, online medical consultations, and drive-through polymerase chain reaction tests were used around the world (16) . The triage method is considered to be regulated by the number of patients with COVID-19 in the area and the availability of medical resources (16) .…”

Section: Discussionmentioning

confidence: 99%

“…In addition to triage at medical sites, various methods such as home visits, online medical consultations, and drive-through polymerase chain reaction tests were used around the world (16) . The triage method is considered to be regulated by the number of patients with COVID-19 in the area and the availability of medical resources (16) . However, it is important to consider that patients with conditions unrelated to COVID-19 may be at a disadvantage by imposing practice restrictions or closing ICUs for patients with COVID-19.…”

Section: Discussionmentioning

confidence: 99%

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Impact of the Coronavirus Disease 2019 Pandemic on Medical Practices in Awaji Island

2024

JMA J

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Introduction: Since the first confirmed case of coronavirus disease 2019 (COVID-19) in China, COVID-19 continues to be a global threat and exerts a significant impact on medical practices. This study aims to investigate the impact of the COVID-19 pandemic on medical practices in Awaji Island, a remote island in Japan. Methods: First, we conducted a survey on the epidemiological characteristics of COVID-19 on Awaji Island before and during the pandemic. Next, using a questionnaire, we conducted a survey with doctors working full time at Hyogo Prefectural Awaji Medical Center, which is the only designated infectious disease hospital on Awaji Island. Results: The COVID-19 infection rate of Awaji Island was lower than that of Hyogo Prefecture and of Japan as a whole, although the peaks occurred simultaneously. Outpatient visits as well as hospitalized patients, i.e., inpatients, decreased during the pandemic as a result of restrictions on surgeries and hospitalizations, with no changes in the disease composition ratio. The results of the questionnaire show that during the pandemic, doctors working full time at our hospital worked less and slept more. Furthermore, data obtained from the Medical Affairs Department showed a decrease in overtime hours worked and an increase in the number of days of paid holidays taken. Conclusions: Epidemiologically, the impact of the COVID-19 pandemic on Awaji Island showed a similar trend to that in Japan, but the results of the survey questionnaire indicated that doctors working full time at our hospital were not necessarily adversely affected.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of the Coronavirus Disease 2019 Pandemic on Medical Practices in Awaji Island

2024

JMA J

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“…Triage was a widely discussed topic during the COVID-19 pandemic, with many ambiguous and misleading concepts. Several reviews have shown that out of thousands of articles related to COVID-19 and triage, most contain only statements, policy papers, public recommendations, and standard operating procedures based on little to no evidence (Alemi et al 2023;Roque Mazoni et al, 2022;Vinay et al, 2021). The remaining scientific papers addressed several different strategies.…”

Section: Triage and Covid-19mentioning

confidence: 99%

Rapid triage and transfer system for patients with proven Covid-19 at emergency department

Jakl,

Berková,

Veleta

et al. 2024

JAB

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Background: COVID-19 is a viral disease notorious for frequent worldwide outbreaks. It is difficult to control, thereby resulting in overload of the healthcare system. A possible solution to prevent overcrowding is rapid triage of patients, which makes it possible to focus care on the high-risk patients and minimize the impact of crowding on patient prognosis. Methods: The triage algorithm assessed self-sufficiency, oximetry, systolic blood pressure, and the Glasgow coma scale. Compliance with the triage protocol was defined as fulfillment of all protocol steps, including assignment of the correct level of care. Triage was considered successful if there was no change in the scope of care (e.g., unscheduled hospital admission, transfer to different level of care) or if there was unexpected death within 48 hours. Results: A total of 929 patients were enrolled in the study. Triage criteria were fulfilled in 825 (88.8%) patients. Within 48 hours, unscheduled hospital admission, transfer to different level of care, or unexpected death occurred in 56 (6.0%), 6 (0.6%), and 5 (0.5%) patients, respectively. The risk of unscheduled hospital admission or transfer to different level of care was significantly increased if triage criteria were not fulfilled [13.1% vs. 76.1%,, p < 0.001; 0.5% vs. 5.2%, RR 11.4 (2.3-57.7), p = 0.036, respectively]. Conclusion:The proposed algorithm for triage of patients with proven COVID-19 is a simple, fast, and reliable tool for rapid sorting for outpatient treatment, hospitalization on a standard ward, or assignment to an intensive care unit.

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“…Some studies have offered encouraging data regarding digital triage which can, at least partly, improve certain crucial aspects of analogue triage, such as: reducing the triage execution time with greater sensitivity and specificity [ 14 ], reducing treatment time for more severe patients thanks to less managing time and more effective medical decisions [ 15 ], better accessibility and universality of healthcare in communities with limited resources, such as rural areas [ 16 ] and facilitating medical research thanks to its practicality in terms of data gathering, thus helping to create algorithms and protocols more efficiently, among other points [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Digitalisation of information and management optimisation in Multiple Victim Incidents. Analytical study

Behzadi Koochnai,

Muñoz Romo,

Riera López

et al. 2024

PLoS ONE

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Introduction Triage is a crucial tool for managing a Multiple Victim Incident (MVI). One particularly problematic issue is the communication of results to the chain of command and control. Favourable data exists to suggest that digital triage can improve some features of analogue triage. Within this context we have witnessed the emergence of the Valkyries Project, which is working to develop strategies to respond to MVIs, and especially cross-border incidents. To that end, an IT platform called “SIGRUN” has been created which distributes, in real time, all the information to optimise MVI management. A full-scale simulation, held on the Spain-Portugal border and featuring contributions from different institutions on both sides of the border, put to the test the role of information digitalisation in this type of incidents. Objective To evaluate the impact of the synchronous digitalisation of information on the optimal management of Multiple Victim Incidents. Method Clinical evaluation study carried out on a cross-border simulation between Spain and Portugal. A Minimum Data Set (MDS) was established by means of a modified Delphi by a group of experts. The digital platform “SIGRUN” integrated all the information, relaying it in real time to the chain of command and control. Each country assigned two teams that would carry out digital and analogue triage synchronously. Analogue triage variables were gathered by observers accompanying the first responders. Digital triage times were recorded automatically. Each case was evaluated and classified simultaneously by the two participating teams, to carry out a reliability study in a real time scenario. Results The total duration of the managing of the incident in the A group of countries involved compared to the B group was 72.5 minutes as opposed to 73 minutes. The total digital assistance triage (AT) time was 37.5 seconds in the digital group, as opposed to 32 minutes in the analogue group. Total evacuation (ET) time was 28 minutes in the digital group compared with 65 minutes in the analogue group. The average differences in total times between the analogue and the digital system, both for primary and secondary evaluation, were statistically significant: p = 0.048 and p = 0.000 respectively. For the “red” category, AT obtained a sensitivity of 100%, also for ET, while with regard to AT safety it obtained a PPV of 61.54% and an NPV of 100%, and for ET it obtained a PPV of 83.33% and an NPV of 100%. For the analogue group, for AT it obtained a sensitivity of 62.50%, for ET, 70%, for AT safety it obtained a PPV of 45.45% and an NPV of 92.31%, while for ET it obtained a PPV of 70% and an NPV of 92.50%. The gap analysis obtained a Kappa index of 0.7674. Conclusion The triage system using the developed digital tool demonstrated its validity compared to the analogue tool, as a result of which its use is recommended.

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Triage Strategies for COVID-19 Cases: A Scope Review

Cited by 3 publications

References 34 publications

Impact of the Coronavirus Disease 2019 Pandemic on Medical Practices in Awaji Island

Impact of the Coronavirus Disease 2019 Pandemic on Medical Practices in Awaji Island

Rapid triage and transfer system for patients with proven Covid-19 at emergency department

Digitalisation of information and management optimisation in Multiple Victim Incidents. Analytical study

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