https://doi.org/10.4081/ecj.2021.9708
COVID-19 or not COVID-19, that is the question. The role of screening criteria and point-of-care lung ultrasound in the triage decision-making process in an Emergency Department during the phase 2 of the COVID-19 Italian epidemic
Submitted: 26 February 2021
Accepted: 6 April 2021
Published: 28 June 2021
Accepted: 6 April 2021
Abstract Views: 1161
PDF: 358
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
In the COVID-19 era the real challenge for the Emergency Departments (ED) is to avoid the spread of the viral infection within the so called “clean area” of the emergency room and the hospital. Different protocols have been proposed and adopted in the EDs to quickly identify suspected COVID-19 patients and to correctly manage these patients, all based on clinical and epidemiological criteria. To the best of our knowledge, our pre-triage decisional making-process first integrates the pre-triage interview with pointof- care Lung Ultrasound (LUS) performed in the triage area. The aim of our study is to assess the sensitivity and specificity of our screening clinical and/or epidemiological criteria, and to investigate the role of LUS in the triage decision-making process during the “phase 2” of the COVID-19 Italian epidemic. Our study confirms the pivotal role of the triage in the decision-making process and the management of the entire ED, and it demonstrates that further studies are necessary to validate the role of LUS as tool to promptly identify COVID-19 patients, if combined with a correct pre-triage interview.
Comelli I, Scioscioli F, Cervellin G. Impact of the covid-19 epidemic on census, organization and activity of a large urban emergency department. Acta Biomed 2020;91:45-9.
Erika P, Andrea V, Cillis MG, et al. Triage decision-making at the time of COVID-19 infection: the Piacenza strategy. Intern Emerg Med 2020;15:879-82.
DOI: https://doi.org/10.1007/s11739-020-02350-y
Poggiali E, Vercelli A, Mazzoni S, et al. COVID-19 pandemic, piacenza calling. The survival strategy of an Italian emergency department. Acta Biomed 2020;91:1-3.
Maniscalco P, Poggiali E, Quattrini F, et al. The deep impact of novel covid-19 infection in an Orthopedics and traumatology department: The experience of the Piacenza hospital. Acta Biomed 2020;91:97-105.
Dacrema A, Silva M, Rovero L, et al. A simple lung ultrasound protocol for the screening of COVID-19 pneumonia in the emergency department. Intern Emerg Med 2021. doi:10.1007/s11739-020-02596-6. Online ahead of print.
DOI: https://doi.org/10.1007/s11739-020-02596-6
Poggiali E, Dacrema A, Bastoni D, et al. Can Lung US Help Critical Care Clinicians in the Early Diagnosis of Novel Coronavirus (COVID-19) Pneumonia? Radiology 2020:200847.
DOI: https://doi.org/10.1148/radiol.2020200847
Fiala MJ. A Brief Review of Lung Ultrasonography in COVID-19: Is It Useful? Ann Emerg Med 2020;75:784-5.
DOI: https://doi.org/10.1016/j.annemergmed.2020.03.033
Soldati G, Smargiassi A, Inchingolo R, et al. Proposal for International Standardization of the Use of Lung Ultrasound for Patients With COVID-19. J Ultrasound Med 2020;39:1413-9.
DOI: https://doi.org/10.1002/jum.15285
Vetrugno L, Bove T, Orso D, et al. Our Italian experience using lung ultrasound for identification, grading and serial follow-up of severity of lung involvement for management of patients with COVID-19. Echocardiography 2020;37:625-7.
DOI: https://doi.org/10.1111/echo.14664
Sorlini C, Femia M, Nattino G, et al. The role of lung ultrasound as a frontline diagnostic tool in the era of COVID-19 outbreak. Intern Emerg Med 2020. doi:10.1007/s11739-020-02524-8
DOI: https://doi.org/10.1007/s11739-020-02524-8
Buonsenso D, Piano A, Raffaelli F, Bonadia N, de Gaetano Donati K, Franceschi F. Point-of-care lung ultrasound findings in novel coronavirus disease-19 pnemoniae: A case report and potential applications during COVID-19 outbreak. Eur Rev Med Pharmacol Sci 2020;24:2776-2780.
Poggiali E, Mateo Ramos P, Bastoni D, et al. Abdominal pain: a real challenge in novel COVID-19 infection. Eur J Case Rep Intern Med 2020;7:001632.
Carenzo L, Costantini E, Greco M, et al. Hospital surge capacity in a tertiary emergency referral centre during the COVID-19 outbreak in Italy. Anaesthesia 2020;75:928-34.
DOI: https://doi.org/10.1111/anae.15072
Levy Y, Frenkel Nir Y, Ironi A, et al. Emergency Department Triage in the Era of COVID-19: The Sheba Medical Center Experience. Isr Med Assoc J 2020;22:470-5.
Turcato G, Zaboli A, Pfeifer N. The COVID-19 epidemic and reorganisation of triage, an observational study. Intern Emerg Med 2020;15:1517-1524.
DOI: https://doi.org/10.1007/s11739-020-02465-2
Wee LE, Fua TP, Chua YY, et al. Containing COVID-19 in the emergency department: the role of improved case detection and segregation of suspect cases. Acad Emerg Med 2020;27:379-87.
DOI: https://doi.org/10.1111/acem.13984
Volpicelli G, Gargani L. Sonographic signs and patterns of COVID-19 pneumonia. Ultrasound J 2020;12.
DOI: https://doi.org/10.1186/s13089-020-00171-w
Poggiali E, Vercelli A, Vadacca GB, et al. Negative nasopharyngeal swabs in COVID-19 pneumonia: The experience of an italian emergency department (Piacenza) during the first month of the italian epidemic. Acta Biomed 2020;91:1-4.
Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507-13.
DOI: https://doi.org/10.1016/S0140-6736(20)30211-7
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.
DOI: https://doi.org/10.1016/S0140-6736(20)30183-5
Pan F, Ye T, Sun P, et al. Time course of lung changes at chest CT during recovery from Coronavirus disease 2019 (COVID-19). Radiology 2020;295:715-21.
DOI: https://doi.org/10.1148/radiol.2020200370
Chakraborty C, Sharma AR, Sharma G, Bhattacharya M, Lee SS. SARS-CoV-2 causing pneumonia-associated respiratory disorder (COVID-19): Diagnostic and proposed therapeutic options. Eur Rev Med Pharmacol Sci 2020;24:4016-26.
Nakao H, Ukai I, Kotani J. A review of the history of the origin of triage from a disaster medicine perspective. Acute Med Surg 2017;4:379-84.
DOI: https://doi.org/10.1002/ams2.293
How to Cite
Poggiali, E., Bastoni, D., Ferrari, M. ., Moretto, D. ., Buttafava, F., Mateo Ramos, P., Burzio, V., Petri, J., Magnacavallo, A., & Vercelli, A. (2021). COVID-19 or not COVID-19, that is the question. The role of screening criteria and point-of-care lung ultrasound in the triage decision-making process in an Emergency Department during the phase 2 of the COVID-19 Italian epidemic. Emergency Care Journal, 17(2). https://doi.org/10.4081/ecj.2021.9708
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