Management of Adult Inpatient Otolaryngologic Consultations During the COVID-19 Pandemic: A Proposed Tier-Based Triage System

Otolaryngol Head Neck Surg. 2020 Aug;163(2):330-334. doi: 10.1177/0194599820931011. Epub 2020 May 19.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has placed tremendous strain on health care systems, leading to unprecedented challenges and obstacles in the delivery of patient care. Otolaryngologists are frequently called on for inpatient consultations for an array of pathologies, ranging from chronic benign conditions to acutely life-threatening processes. Professional otolaryngologic societies across the world have proposed limiting patient care to time-sensitive and urgent matters; however, limited literature is available to describe how this transient change in philosophy may translate to clinical practice. Here we present a structured algorithm that allows for rapid triage of otolaryngologic consults during the ongoing pandemic, in efforts to minimize infectious spread and protect clinicians while preserving high-quality patient care. Considerations for managing these consults are presented, with a commentary on practical and ethical considerations.

Keywords: 2019; COVID-19; consultations; coronavirus; inpatient; safety; system; tier; tier-based; triage.

MeSH terms

  • Adult
  • Algorithms*
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections* / complications
  • Coronavirus Infections* / diagnosis
  • Endoscopy
  • Humans
  • Inpatients
  • Otolaryngology*
  • Pandemics*
  • Personal Protective Equipment
  • Pneumonia, Viral* / complications
  • Pneumonia, Viral* / diagnosis
  • Referral and Consultation*
  • SARS-CoV-2
  • Telemedicine
  • Triage / methods*