Clinical Decision Rules in the Emergency Department to Improve the Management of Acute Respiratory Infection and Acute Infectious Diarrhea

Acute Respiratory Infections :

Inclusion criteria

• 18 years of age or older;
• Able to consent to the study;
• Reachable by phone;
• Consent to be reached directly by phone;
• At least one of the following respiratory symptoms consistent with an acute respiratory infection for 10 days or less, i. Cough and/or ii. Purulent sputum and/or iii. Pharyngeal pain and/or iv. Nasal congestion and/or v. Rhinorrhea and/or vi. Agueusia and/or vii. Anosmia;
• A triage score of 3 (30 minutes), 4 (60 minutes) or 5 (120 minutes) on the Canadian Triage and Acuity Scale (CTAS);
• Triaged by the ED nurse and managed according to standard ED care protocols;
• Resident of Québec;
• Holder of a Québec health insurance number.

Exclusion criteria

• Cognitive impairment that prevents the patient from reliably answering the risk stratification tool or research questions;
• Resident of a long-term care facility;
• Refusal of nasopharyngeal swab.

Acute infectious diarrhea :

Inclusion criteria

• 18 years of age or older;
• Able to consent to the study;
• Reachable by phone;
• Consent to be reached directly by phone;
• At least three loose or liquid stools over a 24-hour period and for 10 days or less;
• A triage score of 3 (30 minutes), 4 (60 minutes) or 5 (120 minutes) on the Canadian Triage and Acuity Scale (CTAS);
• Triaged by the ED nurse and managed according to standard ED care protocols;
• Resident of Québec.
• Holder of a Québec health insurance number.

Exclusion criteria

• Known neutropenia (<500 neutrophils);
• Active inflammatory bowel disease;
• Anorectal pathology;
• Recent colonic surgery (< 6 months);
• Cognitive impairment preventing the patient from reliably answering the risk stratification tool or research questions;
• Resident of a long-term care facility;
• Refusal of the rectal swab.