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Identify-Isolate-Inform: A Modified Tool for Initial Detection and Management of Middle East Respiratory Syndrome Patients in the Emergency Department.

Koenig KL - West J Emerg Med (2015)

Bottom Line: Middle East respiratory syndrome (MERS) is a novel infectious disease caused by a coronavirus (MERS-CoV) first reported in Saudi Arabia in September 2012.Due to international travel opportunities, all countries are at risk of imported cases of MERS, even if outbreaks do not spread globally.The Identify-Isolate-Inform (3I) tool, originally conceived for initial detection and management of Ebola virus disease patients in the ED and later adjusted for measles, can be adapted for real-time use for any emerging infectious disease.

View Article: PubMed Central - PubMed

Affiliation: University of California, Irvine, Department of Emergency Medicine, Irvine, California. University of California, Irvine, Center for Disaster Medical Sciences, Irvine, California.

ABSTRACT
Middle East respiratory syndrome (MERS) is a novel infectious disease caused by a coronavirus (MERS-CoV) first reported in Saudi Arabia in September 2012. MERS later spread to other countries in the Arabian Peninsula, followed by an outbreak in South Korea in 2015. At least 26 countries have reported MERS cases, and these numbers may increase over time. Due to international travel opportunities, all countries are at risk of imported cases of MERS, even if outbreaks do not spread globally. Therefore, it is essential for emergency department (ED) personnel to be able to rapidly assess MERS risk and take immediate actions if indicated. The Identify-Isolate-Inform (3I) tool, originally conceived for initial detection and management of Ebola virus disease patients in the ED and later adjusted for measles, can be adapted for real-time use for any emerging infectious disease. This paper reports a modification of the 3I tool for use in initial detection and management of patients under investigation for MERS. Following an assessment of epidemiologic risk factors, including travel to countries with current MERS transmission and contact with patients with confirmed MERS within 14 days, patients are risk stratified by type of exposure coupled with symptoms of fever and respiratory illness. If criteria are met, patients must be immediately placed into airborne infection isolation (or a private room until this type of isolation is available) and the emergency practitioner must alert the hospital infection prevention and control team and the local public health department. The 3I tool will facilitate rapid categorization and triggering of appropriate time-sensitive actions for patients presenting to the ED at risk for MERS.

No MeSH data available.


Related in: MedlinePlus

Koenig’s Identify-Isolate-Inform tool adapted for Middle East respiratory syndrome.
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f3-wjem-16-619: Koenig’s Identify-Isolate-Inform tool adapted for Middle East respiratory syndrome.

Mentions: The Identify-Isolate-Inform tool initially developed for Ebola virus disease and subsequently adapted for measles can be modified for the ED evaluation and management of patients under investigation (PUI) for MERS (Figure 3). A PUI is a person who has both clinical features of MERS and an epidemiologic risk factor. The MERS tool could be accessed real-time on a triage nurse’s computer screen or printed as a poster for display in the triage area. The first step is to identify patients with a possible MERS-CoV exposure within 14 days before symptom onset. CDC and the World Health Organization (WHO) provide case definitions that are comprehensive,10,11 but do not lend themselves to use by frontline emergency personnel who must make rapid risk assessments. Therefore, the 3I tool provides a concise and simplified version of exposure types coupled with symptoms for both severe and milder illness.


Identify-Isolate-Inform: A Modified Tool for Initial Detection and Management of Middle East Respiratory Syndrome Patients in the Emergency Department.

Koenig KL - West J Emerg Med (2015)

Koenig’s Identify-Isolate-Inform tool adapted for Middle East respiratory syndrome.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4644025&req=5

f3-wjem-16-619: Koenig’s Identify-Isolate-Inform tool adapted for Middle East respiratory syndrome.
Mentions: The Identify-Isolate-Inform tool initially developed for Ebola virus disease and subsequently adapted for measles can be modified for the ED evaluation and management of patients under investigation (PUI) for MERS (Figure 3). A PUI is a person who has both clinical features of MERS and an epidemiologic risk factor. The MERS tool could be accessed real-time on a triage nurse’s computer screen or printed as a poster for display in the triage area. The first step is to identify patients with a possible MERS-CoV exposure within 14 days before symptom onset. CDC and the World Health Organization (WHO) provide case definitions that are comprehensive,10,11 but do not lend themselves to use by frontline emergency personnel who must make rapid risk assessments. Therefore, the 3I tool provides a concise and simplified version of exposure types coupled with symptoms for both severe and milder illness.

Bottom Line: Middle East respiratory syndrome (MERS) is a novel infectious disease caused by a coronavirus (MERS-CoV) first reported in Saudi Arabia in September 2012.Due to international travel opportunities, all countries are at risk of imported cases of MERS, even if outbreaks do not spread globally.The Identify-Isolate-Inform (3I) tool, originally conceived for initial detection and management of Ebola virus disease patients in the ED and later adjusted for measles, can be adapted for real-time use for any emerging infectious disease.

View Article: PubMed Central - PubMed

Affiliation: University of California, Irvine, Department of Emergency Medicine, Irvine, California. University of California, Irvine, Center for Disaster Medical Sciences, Irvine, California.

ABSTRACT
Middle East respiratory syndrome (MERS) is a novel infectious disease caused by a coronavirus (MERS-CoV) first reported in Saudi Arabia in September 2012. MERS later spread to other countries in the Arabian Peninsula, followed by an outbreak in South Korea in 2015. At least 26 countries have reported MERS cases, and these numbers may increase over time. Due to international travel opportunities, all countries are at risk of imported cases of MERS, even if outbreaks do not spread globally. Therefore, it is essential for emergency department (ED) personnel to be able to rapidly assess MERS risk and take immediate actions if indicated. The Identify-Isolate-Inform (3I) tool, originally conceived for initial detection and management of Ebola virus disease patients in the ED and later adjusted for measles, can be adapted for real-time use for any emerging infectious disease. This paper reports a modification of the 3I tool for use in initial detection and management of patients under investigation for MERS. Following an assessment of epidemiologic risk factors, including travel to countries with current MERS transmission and contact with patients with confirmed MERS within 14 days, patients are risk stratified by type of exposure coupled with symptoms of fever and respiratory illness. If criteria are met, patients must be immediately placed into airborne infection isolation (or a private room until this type of isolation is available) and the emergency practitioner must alert the hospital infection prevention and control team and the local public health department. The 3I tool will facilitate rapid categorization and triggering of appropriate time-sensitive actions for patients presenting to the ED at risk for MERS.

No MeSH data available.


Related in: MedlinePlus