What triage model is safest and most effective for the management of 999 callers with suspected COVID-19

10 August 2020

Congratulations to Professor Alan Watkins, Professor Helen Snooks and colleagues from PRIME's emergency, unscheduled and pre-hospital care work package on being awarded funding from the Medical Research Council UKRI COVID-19 Rapid Response Rolling Call to investigate what triage model is safest and most effective for the Management of 999 callers with suspected COVID-19. The study builds on existing collaborative links between PRIME Centre Wales, SAIL, Swansea Trials Unit, Stirling University, Kingston and St George's Medical School, and ambulance services in Wales, East of England and East Midlands.
999 emergency ambulance calls related to COVID-19  increased enormously at points during the coronavirus pandemic. In some areas, at some times, the volume of calls tripled. Ambulance services cannot send an ambulance to every caller within a reasonable timeframe and not every patient with suspected COVID-19 can – or should – be taken to hospital.

If the right patients are not sent an ambulance or are left at home, they could suffer serious harm or death. But, if every patient is taken to hospital, Emergency Department and inpatient services may be overwhelmed and patients exposed unnecessarily to risk of infection. Ambulance services use different models to sort  - or triage – callers, but little is known about what model of triage works most safely and effectively during a pandemic.

The team will survey all UK ambulance services and use results to categorise triage models used in the call centre and on scene during the 2020 pandemic. They will then retrieve anonymised linked outcomes of patients treated within different models from NHS datasets, including deaths; hospital and ITU admissions; Emergency Department attendances; and COVID-19 diagnosis. Health services staff will be interviewed to understand experiences and concerns.

They will deliver findings quickly to help implement the best model for sorting and treating 999 callers with suspected COVID-19 symptoms.

Professor Helen Snooks who co-leads the study comments:

"We are delighted to have secured funding to support ambulance services to provide the safest and most effective emergency care to patients with suspected and confirmed COVID 19. We will work with our NHS and academic partners to provide evidence quickly, and in policy friendly formats, to ensure that it is useful for development and implementation of triage models during any further waves of this, or future pandemics."