Reorganising the emergency department to manage the COVID-19 outbreak.

Autor: Quah LJJ; Department of Emergency Medicine, Singapore General Hospital, 1 Outram Road, Singapore, 169608, Singapore. joy.quah.l.j@singhealth.com.sg., Tan BKK; Department of Emergency Medicine, Singapore General Hospital, 1 Outram Road, Singapore, 169608, Singapore., Fua TP; Department of Emergency Medicine, Singapore General Hospital, 1 Outram Road, Singapore, 169608, Singapore., Wee CPJ; Department of Emergency Medicine, Singapore General Hospital, 1 Outram Road, Singapore, 169608, Singapore., Lim CS; Department of Emergency Medicine, Singapore General Hospital, 1 Outram Road, Singapore, 169608, Singapore., Nadarajan G; Department of Emergency Medicine, Singapore General Hospital, 1 Outram Road, Singapore, 169608, Singapore., Zakaria ND; Department of Emergency Medicine, Singapore General Hospital, 1 Outram Road, Singapore, 169608, Singapore., Chan SJ; Department of Emergency Medicine, Singapore General Hospital, 1 Outram Road, Singapore, 169608, Singapore., Wan PW; Department of Emergency Medicine, Singapore General Hospital, 1 Outram Road, Singapore, 169608, Singapore., Teo LT; Department of Emergency Medicine, Singapore General Hospital, 1 Outram Road, Singapore, 169608, Singapore., Chua YY; Department of Infectious Diseases, Singapore General Hospital, 1 Outram Road, Singapore, 169608, Singapore., Wong E; Department of Emergency Medicine, Singapore General Hospital, 1 Outram Road, Singapore, 169608, Singapore., Venkataraman A; Department of Emergency Medicine, Singapore General Hospital, 1 Outram Road, Singapore, 169608, Singapore.
Jazyk: angličtina
Zdroj: International journal of emergency medicine [Int J Emerg Med] 2020 Jun 17; Vol. 13 (1), pp. 32. Date of Electronic Publication: 2020 Jun 17.
DOI: 10.1186/s12245-020-00294-w
Abstrakt: Background: The COVID-19 disease outbreak that first surfaced in Wuhan, China, in December 2019, has taken the world by storm and ravaged almost every country in the world. Emergency departments (ED) in hospitals are on the frontlines, serving an essential function in identifying these patients, isolating them early whilst providing urgent medical care. This outbreak has reinforced the role of Emergency Medicine in public health. This paper documents the challenges faced and measures taken by a tertiary hospital's ED in Singapore, in response to the outbreak.
Main Body: The ED detected the first case of COVID-19 in Singapore on 22 January 2020 in a Chinese tourist and also the first case of locally transmitted COVID-19 on 3 February 2020. The patient journeys through the patient reception area in the ED and undergoes fever screening before being shunted to isolation areas within the ED. Management and disposition of suspect COVID-19 patients are guided by a close-knit collaboration between ED and department of infectious diseases. With increasing number of patients, back-up plans for expansion of space and staff augmentation have been enacted. Staff safety is also of utmost importance, with provision and guidelines for personal protective equipment and team segregation to ensure no cross-contamination across staff. These have been made possible with an early setup of an operational command and control structure within the ED, managing manpower, logistics, operations, communication and information management and liaison with other clinical departments.
Conclusion: With the large numbers of undifferentiated patients managed by the ED to date, more than 820 patients with COVID-19 have been identified in the hospital. Not a single member of the staff of the SGH Emergency Department has come down with the illness. The various measures undertaken by the department have helped to ensure good staff morale and strict adherence to safety procedures. We share the lessons learnt so that others who manage EDs around the world can benefit from our experience.
Databáze: MEDLINE
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