Pre-Triage Screening Criteria for COVID-19 and TB symptoms

This document is intended to identify COVID-19 symptoms. The initial pre-screening at

triage will screen for ILI and GI symptoms. Expanded symptoms do not require
isolation/Contact and Droplet precautions. The expanded screening may be performed
by the primary care nurse.

A. Triage nurse instructions:

Screen all patients for ANY of the following symptoms within the last 7
days: COVID-19 Core Respiratory Symptoms (new or worse):
 Cough
 Fever/chills/rigors:
o Adults >37.8C (reported or documented)
o Pediatrics ≥38.0C (reported or documented)
 Shortness of breath, increased O2 requirements, difficulty breathing
 Sore throat/painful swallowing
 Runny nose/nasal congestion

COVID-19 Gastrointestinal (GI) Symptoms (new or worse):

 Vomiting must have had 2 or more episodes of
 Diarrhea vomiting and/or diarrhea
Seasonal ILI Symptoms (see below), plus one of the following:
 Immunocompromised, critical respiratory failure, or outbreak investigation
o Adults: New or changed cough AND fever (38.0C or higher) AND any
of the following: sore throat, joint pain, muscle ache, extreme
exhaustion/weakness
o Pediatrics: cough OR sneezing OR runny
nose Screen all patients for ANY of the following Risk
Factors
 COVID-19 test; positive COVID-19 within the last 14 days or currently pending
 Had close contact* with a confirmed or probable case of COVID-19 within
14 days before illness onset
 Had close contact* with a person with acute respiratory illness who has
travelled anywhere outside of Canada in the 14 days before their illness
 Travelled anywhere outside of Canada within the last 14 days
 Had laboratory exposure to biological material known to contain COVID-19
virus within the last 14 days
  Associated with any healthcare unit/facility, congregate living, or other
(e.g. workplace or social gathering) COVID-19 outbreak/cluster
 Direction has been given for the patient to remain on Contact &
Droplet Precautions

*A close contact is someone who:

 Provided care for the individual, including healthcare workers,
family members or other caregivers, or who had other similar close
physical contact with the person without consistent and appropriate
use of personal protective equipment (PPE),
OR
 Lived with or otherwise had close prolonged contact which may be
cumulative, i.e., multiple interactions for a total of 15 min or more and
within two metres with a case without consistent and appropriate use
of PPE and not isolating,
OR
 Had direct contact with infectious body fluids of a someone who has
tested positive for COVID-19 (e.g., shared cigarettes,
glasses/bottles, eating utensils) or was coughed or sneezed on
while not wearing recommended PPE.

If positive for any of the above symptoms and/or risk factors these must
be documented within the patient care record. Immediately have the
patient perform hand hygiene and put on procedure mask and implement
Contact & Droplet Precautions. For pediatric patients who cannot tolerate a
mask, cover them with a blanket or have them cuddle with care provider to
minimize exposure to others.
If Yes to ANY of the symptoms and/or risk factors:
• Staff involved in patient assessment and transport should immediately
initiate Contact and Droplet precautions.
• If available, place patient in a single room with hard walls, a door and dedicated
toilet or commode and implement Contact and Droplet precautions as soon as
possible.
o If patient requires an Aerosol Generating Medical Procedure (AGMP),
place patient in negative pressure isolation room if available (not required)
o If no single room with hard walls and a door is available, contact IPC
and/or follow site specific processes.
• If questions regarding patient isolation contact IPC. Follow site practice regarding
notification of person in charge.
Physician instructions
• For patients whom pre-triage/triage have screened as positive for COVID-19
symptoms/risk factors, don Contact & Droplet PPE (i.e., procedure/surgical
mask, eye/face protection, gown, gloves) before assessing patient;
• Complete patient history (including confirming travel and exposure history)
and physical exam;
• Consider COVID-19 testing if the patient has new or worse, and
unexplained symptoms from the Expanded Symptoms list:
 Headache  Altered mental status
 Myalgia (muscle pain)/arthralgia (joint  Loss of/change to sense of smell
pain) (anosmia)/taste (dysgeusia)
 Fatigue/extreme exhaustion  Conjunctivitis/red eye/chemosis
(conjunctival edema)
 Nausea/sudden loss of appetite  Any additional symptoms at
clinician’s discretion (e.g. skin
manifestations such as “COVID toes”)
• If there is a plausible, alternate (non-COVID-19) clinical diagnosis AND
patient does not have any risk factors as determined by the MRHP, COVID-
19 testing is not required.
• Patients who meet the expanded symptom criteria and who do not have
other risk factors do not require Contact and Droplet precautions.
• All patients being admitted to hospital with symptoms consistent with COVID-
19 should be tested
All symptoms/risks will be communicated to the receiving unit on
admission A nasopharyngeal or throat swab, collected under strict
Contact and Droplet
precautions and transported in viral transport medium, should be submitted. For
questions on test appropriateness and information on TDG B shipping requirements,
call the ProvLab Virologist on-call (VOC) in Edmonton (780-407-8822) or Calgary
(403- 333-4942).
• COVID-19 testing requests can be made through your site’s clinical information
system or by submitting respiratory specimens with the Serology and Molecular
Testing Requisition (https://www.albertahealthservices.ca/frm-20676.pdf ) and writing
“COVID- 19” in the bottom box (Specify Other Serology and Molecular Tests).
• Presenting symptoms, date of symptom onset and travel history, including country
of travel and return date, MUST be included.
• Advise all patients and close contacts to follow public health directions to self-isolate.
 Adult Tuberculosis (TB) Signs and Symptoms pre triage Screening
Questionnaire

Tuberculosis (TB, or M. tuberculosis) is a contagious disease that can be spread from person to person
through the air. People who breathe in the TB germs may become infected and develop signs or
symptoms of the disease. While most people in arero woreda are at high risk for exposure to the TB
germs, certain settings have a greater risk of transmission and require staff, volunteers, or residents to
be screened for TB upon hire or prior to admission to a congregate setting.

Settings that require TB screening may use this form to identify adults with signs or symptoms of TB
disease who may need further medical evaluation.

• Adults who answer yes to any question on this form should be referred for a medical evaluation that may include a tuberculin
skin test (TST) or Interferon-Gamma Release Assay (IGRA), chest x- ray, and/or sputum (phlegm) collection.
• Adults with signs and symptoms of TB should be separated from others until cleared by a medical professional or person in
charge of TB evaluation.
• Known or suspected TB disease is reportable to your local health department within one working
day. TB infection is reportable within one week.

TB SIGNS AND SYMPTOMS SCREENING QUESTIONNAIRE

Do you have any of the following TB signs and/or symptoms?

1. Cough lasting (3) weeks or more
□ No □ Yes
2. Loss of appetite and/or unexplained weight loss □ No □ Yes
3. Persistent fevers □ No □ Yes
4. Night sweats
□ No □ Yes
5. Unexplained persistent weakness/fatigue
□ No □ Yes
6. Coughing up blood (hemoptysis)
□ No □ Yes

REFERRAL
If any of the above answer is “yes” instruct adult to wear a surgical mask and refer
adult to a clinician for medical evaluation.