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Management at Emergency Department (Ed) : A. Screening & Triage of Patients at Ed HRPZ Ii

The document provides guidelines for managing patients at the Emergency Department during an influenza pandemic. It outlines procedures for screening, triaging, examining, and assessing patients with suspected influenza at designated areas and rooms in the ED. Suspected cases will be given masks and accompanied to examination rooms, and healthcare workers in contact must wear protective equipment. Stable patients will be directly admitted to isolation wards, while unstable patients will be resuscitated in a dedicated red zone before transfer if needed. Any high-risk procedures and dead bodies will be handled according to strict guidelines to prevent transmission.

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Nazif Aiman Ismail
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91 views3 pages

Management at Emergency Department (Ed) : A. Screening & Triage of Patients at Ed HRPZ Ii

The document provides guidelines for managing patients at the Emergency Department during an influenza pandemic. It outlines procedures for screening, triaging, examining, and assessing patients with suspected influenza at designated areas and rooms in the ED. Suspected cases will be given masks and accompanied to examination rooms, and healthcare workers in contact must wear protective equipment. Stable patients will be directly admitted to isolation wards, while unstable patients will be resuscitated in a dedicated red zone before transfer if needed. Any high-risk procedures and dead bodies will be handled according to strict guidelines to prevent transmission.

Uploaded by

Nazif Aiman Ismail
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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MANAGEMENT AT EMERGENCY DEPARTMENT ( ED )

A. SCREENING & TRIAGE OF PATIENTS AT ED HRPZ II


 A designated triage counter manned by dedicated staff will be set up in A&E
HRPZ II for suspected Influenza patients.
 Signage should be displayed at the entry of ED Department instructing
patients with ILI symptoms to inform the reception immediately on their
arrival.
 Attention to hand hygiene, respiratory hygiene and cough etiquette should be
reinforced by means of posters and provision of alcohol-based hand rub,
tissues, and waste bins.
 Patients should be instructed to stay in the designated waiting area only.
 Patients with ILI symptoms, who presented to ED HRPZ II should be
screened for PI.
 Patients with suspected PI should immediately be given surgical masks at the
triage counter to be worn with emphasis on the need and importance of using
face mask.
 Suspected PI patients are then accompanied by triage staff and immediately
directed to the designated Examination Room or Decontamination Room to
minimize transmission to others.
 Staff at triage counter should wear Personal Protective Equipment (i.e N95
masks, surgical caps with face shield, disposable gowns, non-sterile gloves
and plastic aprons).
 Staff must practice strict hand hygiene.
 Any staff in close contact with suspected PI must wear PPE.
B. ASSESSMENT OF PATIENTS IN A&E HRPZ II

 Patients are examined in designated Examination Room or Decontamination


Room. The Emergency Response Team (ERT) managing the patients must
wear PPE.
 A detailed history should be obtained (according to the PI clerking sheet)
 Assessment and stabilization of patients Airway, Breathing and Circulation
(ABC) take precedence.
 If the patient is stable, he/she is taken to the designated Examination Room.
The door must be kept closed at all times and number of staffs entering the
room should be limited.
 Operational Room (Bilik Gerakan) will be informed regarding the case of
suspected PI by ERT members; the Operations Center will then inform the
Emergency Physician-on-call.
 An authorized ED Medical Officer (MO) will review and examine the patient
assisted by paramedic.
 The ED MO /Emergency Physician will then inform the Medical Department
MO on-call/ Physician on call/ Pediatric MO/ Pediatrician/ Infectious Disease
(ID) Specialist on call.
 If admission criteria are fulfilled, the patient will be directly admitted to the
designated isolation ward (Respective ward staff should be informed prior to
patient’s transfer)
 The patient must be transported to designated isolation ward using dedicated
ambulance via a designated route.
 Patient will be accompanied by ED PPK.
 Chest x-ray (CXR) and other specimens/investigations will be taken at
designated ward.
 After sending patient, decontamination/disinfection process of staff,
equipment and transport must be carried out
 If the suspected PI patients is unstable or critically ill, he/she will be
resuscitated in the dedicated Red Zone area.
 The staff should be limited to 5 people during resuscitation. Staff involved
should wear proper PPE with respiratory protector/ face shield/ respirator.
 Patients that require ventilatory support must be referred to anesthetist
immediately and transferred to designated ICU through the designated route.
 The performance of aerosol generating procedures (intubation,
bronchoscopy, tracheostomy, nasopharyngeal aspiration and nebulizer)
should be minimized and only performed by the most skilled person without
compromising patient care.
 Dead bodies should be handled as per KKM Guidelines “Autopsy
Examination in Major Infectious Cases, Including Hendra-like Virus” and
“Transport and Disposal of Dead due to Hendra-like Virus Infection” released
in 1999.

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