{"pk":13410,"title":"Triage in The Time of Diphtheria","subtitle":null,"abstract":"Introduction: \nA diphtheria outbreak occurred in 2017 in Jakarta, Indonesia, during which our hospital was appointed as a referral hospital where patients with upper respiratory tract symptoms were sent for confirmation of the diagnosis and medical intervention. In this study we review the implementation of the emergency department (ED) triage process and patient flow management during the diphtheria outbreak. No previous study in Indonesia has provided a detailed report on the triage process during infectious disease outbreaks.\nMethod:\n We modified our pre-existing hospital triage method according to the “identify, isolate, and inform” principle. We developed novel criteria for triage to identify triage-suspected cases and also a diphtheria package to simplify the diagnostic process. Four separate rooms were modified to isolation spaces to enable medical staff to observe these patients. We obtained data from the ED outbreak registry and electronic health records.\nResults: \nOf 60 cases of triage-suspected diphtheria, six were classified as suspected diphtheria. The mean time from “identify” to “isolate” was 3.5 minutes, and from “isolate” to “inform” was 10 minutes. Mean ED length of stay for probable diphtheria was 24.46 hours. No medical personnel in the ED showed any signs of diphtheria 30 days after the outbreak had abated.\nConclusion:\n The modified criteria can help triage officers detect suspected diphtheria cases and measure the triage response time. Use of the diphtheria package and four separate rooms in the ED could act as an infection control procedure and facilitate the improvement of the diagnostic process.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Triage, Diphtheria, Emergency"}],"section":"Endemic Infections","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7733421r","frozenauthors":[{"first_name":"Hadiki","middle_name":"","last_name":"Habib","name_suffix":"","institution":"Emergency Unit, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia","department":"None"},{"first_name":"Hesty","middle_name":"","last_name":"Kurniawaty","name_suffix":"","institution":"Emergency Unit, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia","department":"None"}],"date_submitted":"2019-12-06T17:03:39-08:00","date_accepted":"2019-12-06T17:03:39-08:00","date_published":"2020-08-21T13:49:55-07:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13410/galley/7041/download/"}]}