Journal of Emergency Practice and Trauma

Final triage methods to decide on home-isolation versus hospitalization in COVID-19 pandemic: a challenge for clinicians

Document Type : Review Article

Authors

Mojtaba Miladinia 1
Farhad Abolnezhadian 2
Joachim G. Voss 3
Kourosh Zarea 1
Naser Hatamzadeh 4
Mandana Ghanavati 5

1 Nursing Care Research Center in Chronic Diseases, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

2 Department of Pediatrics, Abuzar Children’s Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

3 Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA

4 Department of Health Education & Promotion, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

5 Emergency Medicine Specialist, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

https://doi.org/10.34172/jept.2020.37
Abstract
Objective: Final patient triage determines which patients can be home-isolated and
which patients require hospitalization on the basis to predict the patient’s prognosis
most accurately. Final triage is an important link in the clinical management chain of the
coronavirus disease 2019 (COVID-19) pandemic, and a comprehensive review of various
patient triage methods is very important to guide decision making and triage efficiency.
Decision by clinicians about hospitalization or home-discharge is one of the main challenges
in places with limited hospital facilities compared to the high volume of COVID-19 patients.
This review was designed to guide clinicians on how to address this challenge.
Methods: In this mini review we searched scientific databases to obtain the final triage
methods of COVID-19 patients and the important criteria in each method. In order to
conducted searches a period from December 2019 to July 2020 was considered. All searches
were done in electronic databases and search engines.
Results: Findings revealed four current methods for final triage (decision-making regarding
home-isolation or hospitalization of COVID-19 patients). These methods included 1)
demographic and background information, 2) clinical information, 3) laboratory indicators
and 4) initial chest CT-scan. Each of the aforementioned methods encompassed significant
criteria according to which decisions on the patient’s prognosis and final triage were made.
Finally, by evaluating each final triage method, we found that each method had some
limitations.
Conclusion: An effective and quick final triage requires simultaneous complementary use
of all four methods to compensate for each other’s weaknesses and add to each other’s
strengths. It is therefore suggested to assure that clinicians are trained in all four COVID-19
patient’s triage methods and their useful criteria in order to achieve evidence-based
performance for better triage (decision between home-isolation versus hospitalization).

Keywords

Coronavirus
SARS-CoV-2
Prognosis
Triage
Emergency
Infection
Subjects
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Journal of Emergency Practice and Trauma
Volume 8, Issue 2
July 2022
Pages 90-94

  • Receive Date 12 July 2020
  • Revise Date 07 September 2020
  • Accept Date 14 September 2020

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