Reorganising the emergency department to manage the COVID-19 outbreak
Reorganising the emergency department to manage the COVID-19 outbreak
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DOI：
10.1186/s12245-020-00294-w
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发表时间：
2020-06-17
影响因子：
3.2
通讯作者：
Venkataraman, Anantharaman
中科院分区：
文献类型：
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作者：
Quah, Li Juan Joy;Tan, Boon Kiat Kenneth;Venkataraman, Anantharaman
背景2019年12月在中国武汉首次出现的COVID-19疫情席卷全球，几乎蹂躏了世界上所有国家。医院的急诊室（艾德）处于第一线，在识别这些患者方面发挥着重要作用，在提供紧急医疗护理的同时及早隔离他们。这次疫情加强了急诊医学在公共卫生中的作用。本文记录了新加坡一家三级医院的艾德在应对疫情时所面临的挑战和采取的措施。主体艾德于2020年1月22日在新加坡发现首例COVID-19病例，患者为一名中国游客，并于2020年2月3日发现首例本地传播的COVID-19病例。病人会经过艾德的病人接待区，接受发烧筛查，然后转往隔离区。艾德与传染病科紧密合作，指导管理及处置疑似COVID-19病人。随着病人人数的增加，已经制定了扩大空间和增加工作人员的后备计划。工作人员的安全也至关重要，提供了个人防护设备和团队隔离的规定和准则，以确保工作人员之间没有交叉感染。由于艾德署已及早设立行动指挥及控制架构，负责管理人手、后勤、行动、通讯及资讯管理，以及与其他临床部门的联络，因此，上述工作得以进行。结论迄今为止，随着艾德管理的大量未分化患者，医院已确定820多名COVID-19患者。SGH急诊科的工作人员中没有一个人感染了这种疾病。该署采取的各项措施，有助确保员工士气高昂，并严格遵守安全程序。我们分享经验教训，以便世界各地管理ED的其他人可以从我们的经验中受益。
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.