Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-10T13:08:31.086Z Has data issue: false hasContentIssue false

Ebola Triage Screening and Public Health: The New “Vital Sign Zero”

Published online by Cambridge University Press:  29 October 2014

Kristi L. Koenig*
Affiliation:
Center for Disaster Medical Sciences, University of California at Irvine, Orange, California.
*
Correspondence and reprint requests to Kristi L. Koenig, MD, Center for Disaster Medical Sciences, Department of Emergency Medicine, UC Irvine Medical Center, 101 The City Drive South, Route 128, Orange, CA 92868 (e-mail: kkoenig@uci.edu).

Abstract

During public health emergencies of international concern such as the 2014 Ebola event, health care leaders need to educate clinicians on the front lines to make uncomfortable, but real triage decisions that focus on optimization of population health outcomes over individual care. Health care workers must consider their own protection first before direct contact with potentially contagious patients. In an era of globalization and emerging infectious disease, routine triage including evaluation of the standard vital signs must shift to include public health considerations with immediate consequences. A new “vital sign zero” should be taken at the time of initial patient evaluation to assess for risk and exposure to potentially contagious infectious diseases.

Type
Commentaries
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Koenig, KL, Majestic, C, Burns, MJ. Ebola virus disease: essential public health principles for clinicians [published online ahead of print September 26, 2014]. West J Emerg Med. http://www.escholarship.org/uc/item/1bh1352j#page-1. Accessed October 23, 2014.Google Scholar
2.Koenig, KL, Kahn, CA, Schultz, CH. Medical strategies to handle mass casualties from the use of biological weapons. Clin Lab Med. 2006;26(2):313-327.Google Scholar
3.Koenig, KL. Preparedness for terrorism: managing nuclear, biological and chemical threats. Ann Acad Med Singapore. 2009;38(12):1026-1030.CrossRefGoogle ScholarPubMed
4.Koenig, KL, Lim, S, Tsai, S. Crisis standard of care: refocusing health care goals during catastrophic disasters and emergencies. J Exp Clin Med. 2011;3(4):159-165. doi:10.1016/j.jecm.2011.06.003. http://download.journals.elsevierhealth.com/pdfs/journals/1878-3317/PIIS187833171100088X.pdf. Accessed October 23, 2014..Google Scholar
5.Davidson, SJ, Koenig, KL, Cone, DC. The daily flow of patients is not surge: “management is prediction”. Acad Emerg Med. 2006;13(11):1095-1096.Google Scholar
6.Cone, DC, Koenig, KL. Mass casualty triage in the chemical, biological, radiological, or nuclear environment. Eur J Emerg Med. 2005;12(6):287-302.Google Scholar
7.Burkle, FM Jr. Mass casualty management of a large-scale bioterrorist event: an epidemiological approach that shapes triage decisions. Emerg Med Clin North Am. 2002;20(2):409-436.Google Scholar
8.Koenig, KL, Hatchett, RJ, Mettler, FA, et al. Medical treatment of radiologic casualties: current concepts. Ann Emerg Med. 2005;45(6):643-652.Google Scholar
9.Gamage, SD, Kravolic, SM, Roselle, G. Emerging infectious diseases: concepts in preparing for and responding to the next microbial threat. In: Koenig KL, Schultz CH, eds. Koenig and Schultz's Disaster Medicine: Comprehensive Principles and Practices. Cambridge University Press; 2009:75-102.Google Scholar