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Video triage of children with respiratory symptoms at a medical helpline is safe and feasible-a prospective quality improvement study.
Gren, Caroline; Hasselager, Asbjoern Boerch; Linderoth, Gitte; Frederiksen, Marianne Sjølin; Folke, Fredrik; Ersbøll, Annette Kjær; Gamst-Jensen, Hejdi; Cortes, Dina.
  • Gren C; Department of Pediatrics and Adolescence Medicine, Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, Denmark.
  • Hasselager AB; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Linderoth G; Department of Pediatrics and Adolescence Medicine, Copenhagen University Hospital-Nordsjællands Hospital, Hillerød, Denmark.
  • Frederiksen MS; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Folke F; Department of Anesthesia and Intensive Care, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark.
  • Ersbøll AK; Copenhagen University Hospital-Copenhagen Emergency Medical Services, Copenhagen, Denmark.
  • Gamst-Jensen H; Department of Pediatrics and Adolescence Medicine, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.
  • Cortes D; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
PLoS One ; 18(4): e0284557, 2023.
Article in English | MEDLINE | ID: covidwho-2295816
ABSTRACT

BACKGROUND:

Young children are among the most frequent patients at medical call centers, even though they are rarely severely ill. Respiratory tract symptoms are among the most prevalent reasons for contact in pediatric calls. Triage of children without visual cues and through second-hand information is perceived as difficult, with risks of over- and under-triage.

OBJECTIVE:

To study the safety and feasibility of introducing video triage of young children with respiratory symptoms at the medical helpline 1813 (MH1813) in Copenhagen, Denmark, as well as impact on patient outcome.

METHODS:

Prospective quality improvement study including 617 patients enrolled to video or standard telephone triage (11) from February 2019-March 2020. Data originated from MH1813 patient records, survey responses, and hospital charts. Primary outcome was difference in patients staying at home eight hours after the call. Secondary outcomes weas hospital outcome, feasibility and acceptability. Adverse events (intensive care unit admittance, lasting injuries, death) were registered. Logistic regression was used to test the effect on outcomes. The COVID-19 pandemic shut the study down prematurely.

RESULTS:

In total, 54% of the included patients were video-triaged., and 63% of video triaged patients and 58% of telephone triaged patients were triaged to stay at home, (p = 0.19). Within eight and 24 hours, there was a tendency of fewer video-triaged patients being assessed at hospitals 39% versus 46% (p = 0.07) and 41% versus 49% (p = 0.07), respectively. At 24 hours after the call, 2.8% of the patients were hospitalized for at least 12 hours. Video triage was highly feasible and acceptable (>90%) and no adverse events were registered.

CONCLUSION:

Video triage of young children with respiratory symptoms at a medical call center was safe and feasible. Only about 3% of all children needed hospitalization for at least 12 hours. Video triage may optimize hospital referrals and increase health care accessibility.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Triage / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Qualitative research Limits: Child / Child, preschool / Humans Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2023 Document Type: Article Affiliation country: Journal.pone.0284557

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Triage / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Qualitative research Limits: Child / Child, preschool / Humans Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2023 Document Type: Article Affiliation country: Journal.pone.0284557