Emergency Department Management of COVID-19 Suspected Patients. An International Perspective

Abstract

Objectives: In December 2019, an invasive viral outbreak, the Corona Virus Disease 19 spread to the whole world. An international cross-sectional study was conducted to evaluate how healthcare workers in Emergency departments dealt with this pandemic.Methods: A questionnaire was sent to 180 healthcare workers around the world during May and June of the year 2020.Results: A total of 134 HCW from 23 countries responded with a majority of Emergency physicians (36.8%). The PCR testing is available in 72.9% of the hospitals. Different architectural strategies were used to isolate suspected cases in the Emergency department (ED). Half of the institutions would not allow visitors, while the other half, restricted visiting hours and the number of visitors. Triage for suspected patients relied in 82.8% on symptoms. Almost 98% of HCW used a combination of mask, gloves, gown and face shield. Around 65% of the HCW have a tendency to discharge more patients from the ED than what they were used to.Conclusion: The COVID-19 pandemic made a major change within the emergency departments worldwide.

Operational Status of Isolation Rooms in Emergency Departments and Patient Concentration in Higher-Level Emergency Departments in Daegu Metropolitan City and Neighboring Provinces, South Korea, during the COVID-19 Pandemic

“…Previous studies that aimed at preventing nosocomial transmissions through the ED have mainly proposed new systems, such as the resetting of the isolation method, revision of the ED at triage, restrictions on patient visits, and telemedicine [ 9 , 10 , 11 , 12 , 13 , 14 ]. It has been three years since the COVID-19 pandemic, so it is time to examine the problems identified in the new systems that have been implemented thus far and develop countermeasures.…”

Effect of the pandemic on prehospital management of patients with mental and behavioral disorders: a retrospective cohort study

“…The ongoing pandemic of COVID-19 has invaded all factors of public and social life during the last 3 years, with profound effects on how healthcare for other medical entities is delivered. Not only do ED physicians have to face an increased workload due to the additional coronavirus cases presenting for examination and treatment, but also effectively organizing EDs in order to protect working staff, patients, and other visitors from the spread of the virus has been a challenge for hospitals worldwide ( 13 , 14 ). Poland, a wide country with a multitude of middle-range populated towns and their respective county hospitals ( 15 ) has not remained unaffected by the above situation, with the country’s nationals recognizing a decline in the offered healthcare services compared to before the pandemic era ( 16 ).…”

A study to assess the impact of cobas Liat point-of-care PCR assays (SARS-CoV-2 and Influenza A/B) on patient clinical management in the emergency department of the University of California at Davis Medical Center

“…Symptomatic patients should be isolated in an examination room or designated area, in the absence of a laboratory-confirmed diagnosis, with consequences for allocations of hospital resources, including the need for isolation bays and personal protective equipment (15, 16). Given the implications for infection prevention, and the variability in isolation capacity (16), rapid results are helpful for the effective triage of ED patients with suspected SARS-CoV-2, both to reduce transmission and to identify those that may benefit from hospital admission or other therapeutic intervention (4). Further, performing on-demand POC testing in the ED while using centralized high-throughput systems for less urgent testing needs could increase overall testing capacity.…”

“…In the emergency department (ED), test results are often not immediately available (13); typical TATs for high-throughput NAATs can range from ~1.5 hours to 8 hours (14), with approximately 97% of polymerase chain reaction (PCR) results available within 23 hours 6 from arrival in the ED (13). Symptomatic patients should be isolated in an examination room or designated area, in the absence of a laboratory-confirmed diagnosis, with consequences for allocations of hospital resources, including the need for isolation bays and personal protective equipment (15,16). Given the implications for infection prevention, and the variability in isolation capacity (16), rapid results are helpful for the effective triage of ED patients with suspected SARS-CoV-2, both to reduce transmission and to identify those that may benefit from hospital admission or other therapeutic intervention (4).…”