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Organising a COVID-19 Triage Unit: A Swiss Perspective
15 Pages Posted: 1 Jun 2020
More...Abstract
BACKGROUND: With the rapid global spread of the acute respiratory syndrome coronavirus 2 (SARS-CoV-2), urgent health-care measures have been implemented on both international and local levels. Here, we describe the organizational process in setting up a coronavirus disease 2019 (COVID-19) triage unit in a Swiss tertiary care hospital.
METHODS: Our triage unit was set-up outside of the main hospital building and consists of three areas: 1. Pre-triage, 2. Triage, and 3. Triage plus. The Pre-triage check-points identify any potential COVID-19-infected patients and re-direct them to the main Triage area where trained medical staff screen which patients undergo diagnostic testing. If testing is indicated, nasopharyngeal swabs are performed. If patients require further investigations, they are referred to Triage plus. At this stage, patients are then discharged home after additional testing or admitted to the hospital for management.
FINDINGS: A total of 1265 patients were screened between March 10th 2020 and April 12th 2020 at our Triage unit. Of these, 112 (8•9%) adults and 67 (5•3%) children tested positive for COVID-19. 73 (65%) of the positively-tested patients were female and 39 (35%) were male. The mean age for all patients was 43•8 years (SD 16.3 years). Distinguishing between genders, the mean age for females was 41•1 (SD 16•5) and the mean age for males was 48•6 (SD 14•9), with females being significantly younger than males (p<0•001). Of note, 15 of the 112 (14%) positively-tested patients required hospitalisation, including one patient who was transferred to ICU. Following admission, there were 14 patients who were discharged home and one reported mortality.
INTERPRETATION: Our triage unit was set-up as part of a large-scale restructuring process. Current challenges include low sensitivity for test results as well as limited staff and resources. Nevertheless, our triage facility has been able to successfully screen and control the infection within our hospital while continuing to perform emergency operations without compromising patient safety. We hope that our experience will help other health care institutions develop and adapt similar triage systems.
FUNDING STATEMENT: No Funding.
DECLARATION OF INTERESTS: All Author declare no competing financial interest.
ETHICS APPROVAL STATEMENT: Not required as of national and institutional policy.
Note: The manuscript is now accepted in emerging microbes & infections. The proofs are made and we are waiting for the final publication. You can find it under: https://doi.org/10.1080/22221751.2020.1787107
Keywords: cover-19; covid; coronavirus; triage; pandemic; emergency
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