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2021, vol. 2, br. 3, str. 220-227
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Trijaža u ne-kovid ustanovi za vreme KOVID-19 pandemije
Triage at a non-covid hospital during the COVID-19 pandemic
aKlinički centar Srbije, Urgentni centar, Klinika za urgentnu hirurgiju , Beograd, Srbija bKlinički centar Srbije, Klinika za neurologiju, Beograd, Srbija
e-adresa: marina.djikic81@gmail.com
Keywords: COVID-19; epidemiological risk; triage Emergency Center
Sažetak
U vreme KOVID-19 pandemije, Urgentni centar Univerzitetskog kliničkog centra Srbije (UC-UKCS), iako ne-kovid ustanova, morao je da se prilagodi zbrinjavanju velikog broja kritično obolelih i potencijalno zaraznih bolesnika. U ovom radu prikazujemo prilagođavanje UC-UKCS-a uslovima pandemije, u situaciji pret-hodno nedovoljno definisanih protokola za postupanje u ovakvim situacijama. U martu 2019. godine, formirano je Prijemno trijažno odeljenje urgentne medicine (PTOUM). Osnovni zadatak ovog odeljenja je jasno razdvajanje bolesnika sa epidemiološkim rizikom (ER) od onih koji taj rizik nemaju, te njihovo dalje izolovano zbrinjavanje. Procena epidemiološkog rizika podrazumeva popunjavanje epidemiološkog upitnika, ciljanu kratku anamnezu, merenje temperature i procenu respiratornog statusa bolesnika. Kompletan proces trijaže, inicijalne dijagnostike i lečenja bolesnika sa ER-om je domen rada i odgovornosti specijalista urgentne medicine. Od 15. marta 2020. godine do 15. marta 2021. godine je kroz trijažu obrađeno 155.000 bolesnika, od toga 9.519 sa ER-om, koji su zbrinuti u PTOUM-u. Ovakvom trijažom je minimalizovano širenje infekcije uz istovremeno zbrinjavanje svih kritično obolelih, bez obzira na ER. Međutim, na istom mestu su zbrinjavani bolesnici sa manjim, ali i oni sa visokim rizikom za KOVID-19, zbog deficita prostora. Takođe, trijaža se odnosi samo na "kovid trijažu" a ne i na trijažu po ste-penu hitnosti obolelih, što je osnova rada svakog savremenog urgentnog centra.
Abstract
At the time of the COVID-19 pandemic, the Emergency Center of the University Clinical Center of Serbia (EC-UCCS), although a non-covid hospital, had to adapt to taking care of a large number of critically ill and, at the same time, potentially contagious patients. In this paper, we present the ways that the EC-UCCS has adjusted to the conditions of the pandemic, where no precise protocols had previously been established for acting in these types of situations. In March 2019, the Admissions Triage Facility of Emergency Medicine (ATFEM) was established. The main task of this facility was to separate patients with epidemiological risk (ER) from patients without risk and to carry out their further isolated care. ER assessment involves completing an epidemiological questionnaire, a targeted brief history, body temperature measurement, and assessment of the patient's respiratory status. The complete triage process, initial diagnosis, and treatment of patients with ER is the task and responsibility of emergency medicine specialists. Between March 15, 2020 and March 15, 2021, about 155,000 patients were examined in triage, of whom 9,519 had ER and were taken care of in the ATFEM. This triage method minimizes the spread of infection while taking care of all critically ill patients, regardless of ER. However, both patients with low and high risk of COVID-19, were all admitted to the same facility, due to the shortage of available space. Also, triage relates only to "covid triage" and not to triage according to the degree of urgency of the patients, which is the primary task of every modern emergency center.
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