Video triage in calls concerning children with fever at an out-of-hours medical helpline: a prospective quality improvement study

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Original Research

Annette Kjær Ersbøll¹  Hejdi Gamst-Jensen²  Fredrik Folke³  Gitte Linderoth⁴  Caroline Gren⁵  Dina Cortes⁵  Asbjoern Boerch Hasselager⁶  Marianne Sjølin Frederiksen⁶ 

[1] Copenhagen University Hospital - Copenhagen Emergency Medical Services, Copenhagen, Denmark;National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark;Department of Anesthesia, Center of Head and Orthopedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark;Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;Copenhagen University Hospital - Copenhagen Emergency Medical Services, Copenhagen, Denmark;Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark;Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;Department of Anesthesia and Intensive Care, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark;Copenhagen University Hospital - Copenhagen Emergency Medical Services, Copenhagen, Denmark;Department of Pediatrics and Adolescence Medicine, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark;Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;Department of Pediatrics and Adolescence Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark;

关键词: Triage;    Telemedicine;    Primary health care;    Fever;    Pediatrics;    Telenursing;    Parents;    Patient participation;   

DOI  :  10.1186/s13049-023-01106-9

 received in 2023-01-19, accepted in 2023-07-31,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundParents often contact out-of-hours services due to worry concerning febrile children, despite the children rarely being severely ill. As telephone triage of children is challenging, many children are referred to hospital assessment. This study investigated if video triage resulted in more children staying at home. Secondary aims included safety, acceptability and feasibility of this new triage tool.MethodsIn this prospective quality improvement study, nurse call-handlers enrolled febrile children aged 3 months-5 years to video or telephone triage (1:1), with follow-up within 48 h after call. The setting was an out-of-hours call-center for non-urgent illness in Copenhagen, Denmark, receiving over 1 million calls annually and predominately staffed by registered nurses. Main outcome measure was difference in number of children assessed at hospital within 8 h after call between video-and telephone triage group. Rates of feasibility, acceptability and safety (death, lasting means, transfer to intensive care unit) were compared between the triage groups.ResultsThere was no difference in triage outcome (home care vs. hospital referral) or number of patients assessed at hospital between triage groups. However, more video triaged patients received in-hospital treatment, testing and hospitalization.ConclusionVideo triage was feasible to conduct, acceptable to parents and as safe as telephone triage. The study did not show that more children stayed at home after video triage, possibly because the allocation strategy was not upheld, as video triage sometimes was chosen in cases of complex and severe symptoms, and this likely has changed study outcome.Trial registration: Clinicaltrials.gov.: Id NCT04074239. Registered 2019-08-30. https://clinicaltrials.gov/ct2/show/study/NCT04074239

【 授权许可】

CC BY   
© Norwegian Air Ambulance Foundation 2023

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