Introduction: This paper describes our experience in setting up a dedicated imaging facility within a temporary fever tentage in an acute tertiary hospital in Singapore during the coronavirus disease 2019 (COVID-19) pandemic. We review in detail the effectiveness of the setup and its role from the radiological perspective.
Methods: The dedicated imaging facility within the temporary fever tentage was equipped with a computer-on-wheels (COWs) to access patients’ medical records and a portable x-ray machine to allow for a smooth workflow. Radiation dose measurements were acquired around the imaging facility using phantoms and dosimeters to ensure radiation safety.
Results: Due to its rapid nature and availability as a screening tool, chest x-ray (CXR) is the most widely used imaging modality during the COVID-19 pandemic. Our dedicated fever tent setup minimizes possible in-hospital transmission between both patients and staff, and provides a more streamlined workflow to tackle the high workload. It allowed us to reduce the time required for each radiograph, providing timely imaging services and radiological reports for expedient clinical screening.
Discussion: The close collaboration between Radiology and Emergency Department in setting up the fever tentage is a crucial tool in allowing us to manage the COVID-19 pandemic. The fever tentage imaging facility is a highly effective tool, providing the means to handle the increased patient load in a streamlined and safe manner during a pandemic.
Conclusion: This paper provides insights and guidelines in setting up a dedicated imaging service within the fever tent for future infectious disease outbreak contingency plans.
No comprehensive cost estimates exist for performing ureteropyeloscopy (URS), which is increasingly utilised as a treatment of upper tract urolithiasis in Australia. To estimate expenditure associated with URS in an Australian public hospital setting and determine factors contributing to increased cost. Patients who underwent flexible URS for urolithiasis over a 2-year period at a Victorian public health site were included. Data describing demographics, stone factors, disposable equipment and admission length were retrospectively collected. Procedures were performed using reusable flexible scopes. Previously validated costing models for cystoscopic stent extraction, theatre and recovery per hour and ward admission were used to attach cost to individual episodes. The cost of emergency stent insertion was beyond the scope of this study. 222 patients underwent URS; the combined total number of procedures was 539, comprising 202 stent extractions and 115 stent insertions in addition to 222 URS. Mean procedural cost was $2885 (range $1380–$4900). Mean episode cost excluding emergency stent insertion was $3510 (range $1555–$7140). A combination of flexible scopes, operative time and disposable equipment accounted for nearly 90% of the total procedural cost. Significant cost is associated with URS for treatment of renal and ureteric stones. A large burden of the cost is time in theatre, equipment and the need for multiple associated procedures per episode. Utilising other available treatments such as extracorporeal shockwave therapy (SWL) where appropriate may reduce the financial burden of URS and associated procedures.
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