Impact of COVID-19 on inpatient clinical emergencies: A single-center experience
Autor: | George L. Anesi, Jeff Min, Scott A. Falk, William D. Schweickert, Oscar J.L. Mitchell, Jennifer C Ginestra, Michael G.S. Shashaty, Stacie Neefe, Brian J. Anderson, Cameron Baston, Nahreen H. Ahmed, Michael J. Frazer, Jose L. Pascual, Steven W Gudowski |
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Rok vydání: | 2021 |
Předmět: |
2019-20 coronavirus outbreak
medicine.medical_specialty Respiratory distress Coronavirus disease 2019 (COVID-19) business.industry Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) COVID-19 Rapid response team Specialties of internal medicine Single Center Article Coronavirus Clinical emergencies Patient safety RC581-951 Medical emergency response team Emergency medicine medicine business Earth-Surface Processes |
Zdroj: | Resuscitation Plus, Vol 6, Iss, Pp 100135-(2021) Resuscitation plus |
ISSN: | 2666-5204 |
Popis: | Aim: Determine changes in rapid response team (RRT) activations and describe institutional adaptations made during a surge in hospitalizations for coronavirus disease 2019 (COVID-19). Methods: Using prospectively collected data, we compared characteristics of RRT calls at our academic hospital from March 7 through May 31, 2020 (COVID-19 era) versus those from January 1 through March 6, 2020 (pre-COVID-19 era). We used negative binomial regression to test differences in RRT activation rates normalized to floor (non-ICU) inpatient census between pre-COVID-19 and COVID-19 eras, including the sub-era of rapid COVID-19 census surge and plateau (March 28 through May 2, 2020). Results: RRT activations for respiratory distress rose substantially during the rapid COVID-19 surge and plateau (2.38 (95% CI 1.39–3.36) activations per 1000 floor patient-days v. 1.27 (0.82–1.71) during the pre-COVID-19 era; p = 0.02); all-cause RRT rates were not significantly different (5.40 (95% CI 3.94–6.85) v. 4.83 (3.86–5.80) activations per 1000 floor patient-days, respectively; p = 0.52). Throughout the COVID-19 era, respiratory distress accounted for a higher percentage of RRT activations in COVID-19 versus non-COVID-19 patients (57% vs. 28%, respectively; p = 0.001). During the surge, we adapted RRT guidelines to reduce in-room personnel and standardize personal protective equipment based on COVID-19 status and risk to providers, created decision-support pathways for respiratory emergencies that accounted for COVID-19 status uncertainty, and expanded critical care consultative support to floor teams. Conclusion: Increased frequency and complexity of RRT activations for respiratory distress during the COVID-19 surge prompted the creation of clinical tools and strategies that could be applied to other hospitals. |
Databáze: | OpenAIRE |
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