ABSTRACT

Background: With the rapid global spread of the acute respiratory syndrome coronavirus 2, urgent health-care measures have been implemented. We describe the organizational process in setting up a coronavirus disease 2019 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. Observations: A total of 1265 patients were screened between 10 March 2020 and 12 April 2020 at our Triage unit. Of these, 112 (8.9%) tested positive. 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, mean age for females was 41.1 (SD 16.5) and mean age for males was 48.6 (SD 14.9), with females being significantly younger than males (p < 0.001). Conclusion: 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. We hope that our experience will help other health care institutions develop similar triage systems.

摘要

背景：随着急性呼吸综合征冠状病毒2在全球的迅速传播，已采取了紧急医疗措施。我们描述了在瑞士三级医院建立冠状病毒疾病2019分诊部门的组织过程。方法：我们的分诊单位设在主医院大楼外，包括三个区域：1.预分诊，2。分诊和3. Triage plus。会诊前检查点可识别出任何可能感染COVID-19的患者，并将他们重定向到主要会诊区，在那儿，训练有素的医务人员会筛选要接受诊断测试的患者。如果需要检查，则进行鼻咽拭子检查。如果患者需要进一步检查，则转诊至Triage plus。在此阶段，患者需要接受额外检查后才能出院，或者入院治疗。观察结果：在2020年3月10日至2020年4月12日之间，我们的Triage部门共筛查了1265名患者。其中112（8.9％）个测试呈阳性。接受正面测试的患者中有73名（65％）是女性，而39名（35％）是男性。所有患者的平均年龄为43.8岁（标准差16.3岁）。区分性别时，女性的平均年龄为41.1（SD 16.5），男性的平均年龄为48.6（SD 14.9），女性明显比男性年轻（p  <0.001）。结论：我们的分流部门是大规模重组过程的一部分。当前的挑战包括对测试结果的敏感性低以及人员和资源有限。我们希望我们的经验可以帮助其他医疗保健机构开发类似的分类系统。