Pre-triage screening and isolation of patients suspected of COVID-19 in the Emergency Department of St. Paul`s Hospital Millennium Medical College

Abstract

Background: Early identification and isolation of suspected Coronavirus Disease 2029 (COVID-19) patients decrease disease transmission  in the emergency department. Using clinical pre-triage criteria, suspected patients were kept in the isolation ward and treated for the identified illness until the confirmatory test for Severe Acute Respiratory Syndrome- Corona Virus 2 (SARS-COV2) arrived.  However, the effectiveness of the pre-triage screening was not known.

Objectives: The main goal of this study was to describe the clinical  characteristics of isolated COVID-19-suspected patients at the emergency department of St. Paul’s Hospital Millennium Medical  College.

Methods: A hospital-based cross-sectional study was conducted involving patients who were suspected to have COVID-19 but  waiting for the confirmatory result and those who tested positive for COVID-19 after emergency department presentation. Trained  general practitioners collected data using a structured questionnaire, and entered it into SPSS version 25 for cleaning and analysis.  Descriptive statistics were used to analyze the data. The findings are presented using tables and text descriptions.

Results: A total of  4,350 patients were screened and 202 patients fulfilled COVID-19 suspect criteria and triaged to the isolation ward; among which 130  (64.3%) tested positive for COVID-19. In addition, 40 patients who were not suspected at triage, tested positive for COVID-19 after they  were kept in the emergency department. Cough 54 (26.7%) and shortness of breath 31 (15.4%) were the most common presenting symptoms and the number of lymphocytes decreased in 161 cases (79.7%).

Conclusion: One fifth of COVID-19 patients were missed to be  isolated during triaging and mixed with other patients. Emergency rooms should be well designed to prevent cross-transmission of  disease.