J Appl Biomed 22:59-65, 2024 | DOI: 10.32725/jab.2024.006

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

Martin Jakl^{1, 2, *}, Jana Berková^{1, 3}, Tomáš Veleta^{1, 3}, Vladimír Palička^{3, 4}, Petra Polcarová⁵, Jan Smetana⁵, Petr Grenar^{1, 2}, Martina Čermáková^{1, 3}, Jan Vaněk⁶, Jan M. Horáček², Jaromír Kočí^{1, 3}

¹ University Hospital Hradec Králové, Department of Emergency Medicine, Hradec Králové, Czech Republic

² University of Defence, Military Faculty of Medicine, Department of Military Internal Medicine and Military Hygiene, Hradec Králové, Czech Republic

³ Charles University, Faculty of Medicine in Hradec Králové, Hradec Králové, Czech Republic

⁴ Charles University, Faculty of Medicine in Hradec Králové and University Hospital, Department of Clinical Biochemistry and Diagnostics, Hradec Králové, Czech Republic

⁵ University of Defence, Military Faculty of Medicine, Department of Epidemiology, Hradec Králové, Czech Republic

⁶ University of Hradec Králové, Faculty of Science, Centre of Advanced Technology, Hradec Králové, Czech Republic

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%, RR 5.8 (3.8-8.3), 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.

Keywords: COVID-19; SARS-CoV-2; Triage

Grants and funding:

The work was supported by the Ministry of Defence of the Czech Republic “Long Term Organization Development Plan 1011” – Clinical Disciplines II of the Military Faculty of Medicine Hradec Králové, University of Defence, Czech Republic (Project No: DZRO-FVZ22-KLINIKA II).

Conflicts of interest:

The authors have no conflict of interest to declare.

Received: October 27, 2023; Revised: February 5, 2024; Accepted: March 1, 2024; Prepublished online: March 13, 2024; Published: March 15, 2024  Show citation