Triage sieve no spread (v4.1)This document is an update of the “Triage Screening Questions- to...
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SYMPTOM BASED TESTING CRITERIA EPIDEMIOLOGICAL / HIGH RISK PATIENTS - Fever ≥37.5˚C - Recent history of fever or night sweats (without a known source) OR - Acute respiratory symptoms (eg cough, SOB, sore throat) - Returned overseas / interstate traveller ≤2/52 - Contact with a known confirmed or probable COVID case - Live in / visited an area confirmed by public health as having an increased risk of transmission (eg. health, aged or residential care workers, aircrew, pt from quarantine area or passengers or staff from cruise ships) - Hospitalised patient with no other clinical focus of infection / explanataion of illness B ED COVID-19: TRIAGE SIEVE (v4.1) NO COMMUNITY SPREAD / CONTAINED (Level 0) SPECIAL CASES OUT OF HOSPITAL CARDIAC ARREST RED: (known COVID or suspected COVID) Manage in ISO with airborne PPE GREEN: (Clear non-COVID arrest eg TRAUMA, OD, SAH) Manage patient in T2/1. Droplet PPE for staff <1.5m. De-escalate PPE once AGP complete SUSPECTED VIRAL INFLUENZA (NON- COVID) OR LRTI Treat as GREEN provided does not meet epidemiological risk factors Use droplet precautions for non-AGP in GREEN area Use airbornel precautions for AGP in RED (ISO / T1) area This document is an update of the “Triage Screening Questions- to categorise patients” and the “ED COVID Triage Sieve v2.2”. It contains some SCGH ED specific advice developed by senior SCGH clinicians based on current COVID community risk in WA and on best available evidence It is based on and refers to the following DoH documents: Hospital PPE Guide 04/2020 1 https://www.health.gov.au/sites/default/files/documents/2020/04/guidance-on-the-use-of-personal-protective-equipment-ppe-in-hospitals-during-the-covid-19-outbreak.pdf Coronavirus Disease 2019 (COVID-19) CDNA National Guidelines for Public Health Units 2 https://www1.health.gov.au/internet/main/publishing.nsf/Content/7A8654A8CB144F5FCA2584F8001F91E2/$File/COVID-19-SoNG-v3.1.pdf COVID-19 Clinician Alert #25 3 https://ww2.health.wa.gov.au/~/media/Files/Corporate/general%20documents/Infectious%20diseases/PDF/Coronavirus/COVID-19-Clinician-Alert-WA-14-May-2020-Clinicians.pdf IF UNSURE PLEASE CONTACT RAT OR DC TO DISCUSS COLOUR ALLOCATION NOTE: Screening criteria are different to COVID triage criteria. Patients may be screened for COVID without needing to be placed in ISO, T1 or TL7. Screening tests in a GREEN patient should not delay transfer to the ward IF UNSURE PLEASE DISCUSS WITH MEDICAL TEAM LEADER A NON-INFECTIVE ENT Patients presenting with eg epistaxis, oesophageal FB and who meet GREEN criteria may be managed safely in the GREEN areas. This includes AGP like nasal packing and tongue depressor examination. NO YES COVID+ PATIENT OR PATIENT AWAITING COVID RESULTS CONTACT WITH A SUSPECTED COVID PATIENT PATIENT IN QUARANTINE OR ISOLATION PATIENT WITH “QUARANTINE EXEMPTION” STATUS RECENT OVERSEAS OR INTERSTATE TRAVELLER ≤2/52 A B AND OR -Put mask on patient and send to ISO 1-4 or T1 -If ISO / T1 full, isolate in RAT room 1 or 2 or keep in ambulance -Notify DC -Droplet PPE for non-AGP -Airborne PPE for AGP RED? Suspected COVID patients at this level must have both symptom and epidem criteria 2 -Send to GREEN area -Avoid AGPs where possible (other viral influenza may be present) -GREEN patients must still be considered for infection control precautions: CONTACT (eg infectious diarrhoeal illness) DROPLET (eg influenza)- patient should wear L2 mask AIRBORNE (eg Measels and disseminated Zoster)- patient should wear L2 mask -Attach appropriate Infection Control precaution signage to bed -Provide appropriate PPE trolley and signage outside cubicle -Consider also reverse precautions in the case of Febrile Neutropenia and the immunocompromised GREEN All other patients that don’t meet RED criteria 2 CODE BLACK GREEN O2 mask on patient if spitting If risk of body fluid contact, staff with direct patient contact wear droplet PPE Use plastic apron instead of gown RED Manage ISO 2 All staff wear airborne PPE INFECTIVE ENT Triage to RED only if epidemiological criteria ENT Reg may request to perform ENT procedures in the ISO room with PPE YES IMPORTANT
Transcript of Triage sieve no spread (v4.1)This document is an update of the “Triage Screening Questions- to...
SYMPTOM BASEDTESTING CRITERIA
EPIDEMIOLOGICAL /HIGH RISK PATIENTS
- Fever ≥37.5˚C- Recent history of fever or night sweats (without a known source) OR- Acute respiratory symptoms (eg cough, SOB, sore throat)
- Returned overseas / interstate traveller ≤2/52- Contact with a known con�rmed or probable COVID case- Live in / visited an area con�rmed by public health as having an increased risk of transmission (eg. health, aged or residential care workers, aircrew, pt from quarantine area or passengers or sta� from cruise ships)- Hospitalised patient with no other clinical focus of infection / explanataion of illness B
ED COVID-19: TRIAGE SIEVE (v4.1)NO COMMUNITY SPREAD / CONTAINED (Level 0)
SPECIAL CASES
OUT OF HOSPITALCARDIAC ARREST
RED: (known COVID or suspectedCOVID) Manage in ISO with airbornePPE
GREEN: (Clear non-COVID arrest egTRAUMA, OD, SAH) Manage patient inT2/1. Droplet PPE for sta� <1.5m. De-escalate PPE once AGP complete
SUSPECTED VIRALINFLUENZA (NON-
COVID) OR LRTITreat as GREEN provided does not meetepidemiological risk factors
Use droplet precautions for non-AGPin GREEN area
Use airbornel precautions for AGP inRED (ISO / T1) area
This document is an update of the “Triage Screening Questions- to categorise patients” and the “ED COVID Triage Sieve v2.2”. It contains some SCGH ED speci�c advice developed by senior SCGH clinicians based on currentCOVID community risk in WA and on best available evidenceIt is based on and refers to the following DoH documents:Hospital PPE Guide 04/2020
1https://www.health.gov.au/sites/default/�les/documents/2020/04/guidance-on-the-use-of-personal-protective-equipment-ppe-in-hospitals-during-the-covid-19-outbreak.pdfCoronavirus Disease 2019 (COVID-19) CDNA National Guidelines for Public Health Units
2https://www1.health.gov.au/internet/main/publishing.nsf/Content/7A8654A8CB144F5FCA2584F8001F91E2/$File/COVID-19-SoNG-v3.1.pdfCOVID-19 Clinician Alert #25
3https://ww2.health.wa.gov.au/~/media/Files/Corporate/general%20documents/Infectious%20diseases/PDF/Coronavirus/COVID-19-Clinician-Alert-WA-14-May-2020-Clinicians.pdf
IF UNSURE PLEASE CONTACT RAT OR DC TO DISCUSS COLOUR ALLOCATION
NOTE: Screening criteria are di�erent to COVID triage criteria. Patients may be screened for COVID without needing to beplaced in ISO, T1 or TL7. Screening tests in a GREEN patient should not delay transfer to the ward
IF UNSURE PLEASE DISCUSS WITH MEDICAL TEAM LEADER
A
NON-INFECTIVE ENTPatients presenting with eg epistaxis,oesophageal FB and who meet GREENcriteria may be managed safely in theGREEN areas. This includes AGP likenasal packing and tongue depressorexamination.
NO
YES
COVID+ PATIENT OR PATIENT AWAITING COVID RESULTSCONTACT WITH A SUSPECTED COVID PATIENTPATIENT IN QUARANTINE OR ISOLATIONPATIENT WITH “QUARANTINE EXEMPTION” STATUSRECENT OVERSEAS OR INTERSTATE TRAVELLER ≤2/52
A BAND
OR
-Put mask on patient and send to ISO 1-4 or T1-If ISO / T1 full, isolate in RAT room 1 or 2 or keep in ambulance-Notify DC-Droplet PPE for non-AGP-Airborne PPE for AGP
RED?Suspected COVID patients
at this level must have bothsymptom and epidem criteria2
-Send to GREEN area-Avoid AGPs where possible (other viral in�uenza may be present)-GREEN patients must still be considered for infection control precautions: CONTACT (eg infectious diarrhoeal illness) DROPLET (eg in�uenza)- patient should wear L2 mask AIRBORNE (eg Measels and disseminated Zoster)- patient should wear L2 mask -Attach appropriate Infection Control precaution signage to bed-Provide appropriate PPE trolley and signage outside cubicle-Consider also reverse precautions in the case of Febrile Neutropenia and the immunocompromised
GREENAll other patients thatdon’t meet RED criteria2
CODE BLACKGREEN O2 mask on patient if spittingIf risk of body �uid contact, sta� withdirect patient contact wear droplet PPEUse plastic apron instead of gown
REDManage ISO 2All sta� wear airborne PPE
INFECTIVE ENTTriage to RED only if epidemiologicalcriteria
ENT Reg may request to perform ENTprocedures in the ISO room with PPE
YES IMPORTANT
