In times when hospitals nationwide may already be filled to capacity, how can they plan to handle an unexpected influx of patients? Gabor Kelen, director of the Johns Hopkins Office of Critical Event Preparedness and Response and of the Department of Emergency Medicine, was the lead author of a paper published online in February in JAMA Pediatrics that discusses reverse triage, an early-discharge strategy that has been previously modeled for adults, and how it could impact a sudden surge of patients in a pediatric hospital, including during disasters.
The study included inpatients from seven pediatric units during 196 randomly chosen mock disaster days during a one-year period. The researchers found that based on previously determined classifications, out of 501 patients sampled, more than 10 percent were eligible for immediate low-risk reverse triage, and more than 13 percent were eligible for discharge by 96 hours. They also found that by accepting higher-risk patients only, reverse triage would increase surge capacity by nearly 50 percent. Researchers concluded that the reverse could have a meaningful but modest impact when facing a sudden influx of patients.
The study complemented a previously published paper by Kelen and others that looked at reverse triage for adult hospital inpatients.
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