Since the end of 2019, a new coronavirus desease has been reported in Wuhan, China, indicated as 2019-nCoV or SARS-CoV-2, or Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) responsible for a syndrome called new coronavirus disease 2019 (COVID-19). Emergency Room activity are described in the literature, starting with under-triage, a topic that has been studied for years in the context of major trauma, as it had been the first time-dependent pathology to get into the Emergency Departments and its mortality correlations are known. The primary objective of our study is to evaluate the appropriateness of the color/priority codes assigned to patients who accessed the Infectious Emergency Room with symptoms of dyspnea, fever, or altered vital signs, by comparing the color code provided by the protocol in use in this ER with the actual color code assignment based on the symptoms described in the patients' computer or paper health records. The main limitation of this study is in its nature of a retrospective study, requiring data to be retrieved from patient records; some data may not have been reported, especially considering the seriousness of the emergency situation. This study provides those descriptive elements of the under-triage phenomenon that will allow to plan future studies aimed at investigating the causes of inadequate appropriateness in order to define tools and training courses that limit the possible impact on citizens' health.
Alla fine del 2019 è stata segnalata una nuova malattia da coronavirus a Wuhan, in Cina, indicata come 2019-nCoV o SARS-CoV-2, o Coronavirus respiratorio acuto grave 2 (SARS-CoV-2) responsabile di una sindrome chiamata nuovo malattia da coronavirus 2019 (COVID-19). L’appropriatezza in Pronto Soccorso è descritta in letteratura, a partire dall’under-triage, argomento studiato da anni nell'ambito di traumi maggiori, in quanto prima patologia tempo-dipendente ad essere studiata nei Pronto Soccorso e le sue correlazioni di mortalità sono conosciute. Obiettivo primario del nostro studio è valutare l'adeguatezza dei codici colore / priorità assegnati ai pazienti che accedono al Pronto Soccorso Infettivo con sintomi di dispnea, febbre o segni vitali alterati, confrontando il codice colore fornito dal protocollo in uso in questo pronto soccorso con l'effettiva assegnazione del codice colore, in base ai sintomi descritti nella cartella informatizzata del paziente o nelle cartelle cliniche cartacee. Il limite principale di questo studio è nella sua natura di studio retrospettivo, che richiede il recupero dei dati dalle cartelle dei pazienti; alcuni dati potrebbero non essere stati riportati, soprattutto considerando la gravità della situazione di emergenza. Lo studio fornisce quegli elementi descrittivi del fenomeno under-triage, che consentiranno di programmare futuri studi volti ad indagare le cause di inappropriatezza al fine di definire strumenti e percorsi formativi che limitino il possibile impatto sulla salute dei cittadini.
L’appropriatezza dei codici di priorità nei pazienti affetti da COVID-19 al triage in Pronto Soccorso: studio osservazionale retrospettivo monocentrico
COSI, MATTEO
2019/2020
Abstract
Since the end of 2019, a new coronavirus desease has been reported in Wuhan, China, indicated as 2019-nCoV or SARS-CoV-2, or Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) responsible for a syndrome called new coronavirus disease 2019 (COVID-19). Emergency Room activity are described in the literature, starting with under-triage, a topic that has been studied for years in the context of major trauma, as it had been the first time-dependent pathology to get into the Emergency Departments and its mortality correlations are known. The primary objective of our study is to evaluate the appropriateness of the color/priority codes assigned to patients who accessed the Infectious Emergency Room with symptoms of dyspnea, fever, or altered vital signs, by comparing the color code provided by the protocol in use in this ER with the actual color code assignment based on the symptoms described in the patients' computer or paper health records. The main limitation of this study is in its nature of a retrospective study, requiring data to be retrieved from patient records; some data may not have been reported, especially considering the seriousness of the emergency situation. This study provides those descriptive elements of the under-triage phenomenon that will allow to plan future studies aimed at investigating the causes of inadequate appropriateness in order to define tools and training courses that limit the possible impact on citizens' health.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/13488