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‘The incident triage area’: a response to the COVID-19 pandemic in the Bristol Royal Infirmary
  1. Rebecca Sainsbury,
  2. Rose Brennan,
  3. Andy Lockyer
  1. Emergency Department, Bristol Royal Infirmary, Bristol, UK
  1. Correspondence to Dr Rebecca Sainsbury, Emergency Department, Bristol Royal Infirmary, Bristol BS2 8HW, UK; rebecca.l.sainsbury{at}


With the onset of the COVID-19 pandemic, hospitals nationwide have been presented with a number of potential challenges, including possible increased volume of patient attendances, acuity of illness and potential for patients to present with an infection that requires isolation. At the Bristol Royal Infirmary, an innercity teaching hospital that manages patients aged 16 and over, we present our response to these projected changes in ED attendances, with the initiation of the incident triage area (ITA). The ITA is a triage station situated outside the ED and staffed by a senior clinician, healthcare assistant and patient flow coordinator. It receives patients presenting as walk-in or via ambulance, and on their arrival aims to establish their risk of COVID-19 and their acuity of illness. This allows for triage of the patient to one of the four zones of the hospital, as well as providing clinical guidance on any initial interventions that patients may require. The benefits of the ITA are that it enables an early senior review of patients to establish their acuity of illness and initiate time-critical medical intervention as required. In addition, patients are immediately cohorted to zones within the hospital based on their infection risk, thereby reducing patient footfall throughout the hospital. Its aim is to reduce the spread of infection, by efficiently triaging and streaming patients who present to the hospital prior to them entering clinical areas, while maintaining patient safety and flow through the ED and initiating rapid management of acutely unwell patients.

  • clinical assessment
  • emergency care systems
  • emergency departments
  • emergency department operations
  • infectious diseases
  • viral

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  • Handling editor Richard John Parris

  • Contributors The concept of the Incident Triage Area was thought of and initiated by the consultant body of the Bristol Royal Infirmary Emergency Department. The idea and plan for this paper was conceived by RS, and co-authored by RS and RB, and by AL who was the consultant providing supervision of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.