Hospital Emergency Management Plan During the COVID‐19 Epidemic

Cao, Yubin; Li, Qin; Chen, Jing; Guo, Xia; Cheng, Miao; Yang, Hui; Chen, Zihang; Li, Chunjie; Li, Longjiang

doi:10.1111/acem.13951

Cited by 198 publications

(180 citation statements)

References 9 publications

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“…By partitioning the ED into higher risk and lower-risk areas, and setting up different traffic flows, the risk of cross-infection can be mitigated. 30 Finally, while most COVID-19 cases presenting to our ED over a 12-week period were successfully isolated, one-fifth of cases did not have any known epidemiologic links that allowed detection based on case criteria alone. This suggests that, as community penetration deepens, likely through mildly symptomatic cases, it will be more and more difficult to use epidemiologic criteria to pick out potential cases at triage in the ED.…”

Section: Discussionmentioning

confidence: 91%

Containing COVID‐19 in the Emergency Department: The Role of Improved Case Detection and Segregation of Suspect Cases

Wee

Fua

Chua

et al. 2020

Academic Emergency Medicine

112

116

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Objectives: Patients with COVID-19 may present with respiratory syndromes indistinguishable from common viruses. This poses a challenge for early detection during triage in the emergency department (ED). Over a 3month period, our ED aimed to minimize nosocomial transmission by using broader suspect case criteria for better detection and using appropriate personal protective equipment (PPE) for health care workers (HCWs).Methods: All ED admissions with respiratory syndromes over a 3-month period were tested for COVID-19. The sensitivity and specificity of screening criteria in detecting COVID-19 were assessed. A risk-stratified approach was adopted for PPE usage in the ED, based on high-risk "fever areas" and lower-risk zones. When a case of COVID-19 was confirmed, surveillance was conducted for potentially exposed patients and HCWs.Results: A total of 1,841 cases presenting with respiratory syndromes required admission over the study period.Among these, 70 cases of COVID-19 were subsequently confirmed. The majority (84.2%, 59/70) were detected at ED triage because they fulfilled suspect case criteria. Of these, 34 met the official screening criteria; an additional 25 were detected by the broader internal screening criteria. Over the 12-week period, the cumulative sensitivity of internal screening criteria was 84.3% (95% confidence interval [CI] = 73.6% to 91.9%), whereas the sensitivity of the official screening criteria was 48.6% (95% CI = 36.4% to 60.8%). Given the broadened internal criteria, the preexisting ED "fever area" was insufficient and had to be expanded. However, there were no cases of nosocomial transmission from intra-ED exposure, despite extensive surveillance.Conclusion: Frontline physicians need to be given leeway to decide on the disposition of cases based on clinical suspicion during an ongoing outbreak of COVID-19. If a broader criterion is used at ED triage, ED facilities and isolation facilities need to be readied to accommodate a surge of suspect cases. Usage of appropriate PPE is essential in minimizing nosocomial transmission.

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Section: Discussionmentioning

confidence: 91%

Containing COVID‐19 in the Emergency Department: The Role of Improved Case Detection and Segregation of Suspect Cases

Wee

Fua

Chua

et al. 2020

Academic Emergency Medicine

112

116

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“…12,13 This is true among frontline physicians and departments, such as emergency rooms, as well as specialty providers, including otolaryngology. [14][15][16][17][18] Particularly pertinent to otolaryngology is a heightened concern regarding the increased risk of COVID-19 transmission owing to the nature of the head and neck examination and common otolaryngologic procedures. 7,8 Furthermore, telehealth and distance care can be especially difficult among subsets of otolaryngology diseases, including head and neck cancers and airway disorders.…”

Section: Discussionmentioning

confidence: 99%

Outpatient Otolaryngology in the Era of COVID‐19: A Data‐Driven Analysis of Practice Patterns

Kasle

Torabi

Savoca

et al. 2020

Otolaryngol.--head neck surg.

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Introduction Coronavirus disease 2019 (COVID-19) has induced a prioritization of acute care and telehealth, affecting the quantity of patients seen and the modality of their care. Study Design Retrospective review. Setting Single-institution study conducted within the Division of Otolaryngology at the Yale School of Medicine. Subjects and Methods Data on all outpatient appointments within the Division of Otolaryngology were obtained from administrative records of billing and scheduling from March 16 to April 10, 2020. For comparison, a corresponding period from 2019 was also utilized. Results Of 5913 scheduled visits, 3665 (62.0%) were seen between March 18 and April 12, 2019, in comparison with 649 of 5044 (12.9%) during the corresponding COVID-19–affected period. The majority of completed visits performed in weeks 1 and 2 were in person, while the majority in weeks 3 and 4 were via telehealth. Among subspecialties, a larger proportion of completed visits in 2020 were performed by pediatric and head and neck oncology otolaryngologists as compared with general/specialty otolaryngologists ( P < .001). Older adults (≥65 years) were less likely to have telehealth visits than younger adults (18-64 years; 45.6% vs 59.6%, P = .003). Conclusions A major decrease in the completion rates of scheduled visits was seen in the COVID-19–affected period, though this was not proportional among subspecialties. An associated increase in telehealth visits was observed. After COVID-19–related hospital policy changes, approximately 2 weeks passed before telehealth visits surpassed in-person visits, though this was not true among older adults.

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“…To reduce the spread of COVID-19 in hospitals, most hospitals in China have adopted a new medical management process for patients seeking mental health care [6]. Based on the online meeting of the Chinese Society of Child & Adolescent Psychiatry on April 2, we planned this process and gave suggestions to the respective hospitals accordingly ( Fig.…”

Section: Initial Contact Of Children/adolescents With Hospitals For Pmentioning

confidence: 99%

Mental health services for children in China during the COVID-19 pandemic: results of an expert-based national survey among child and adolescent psychiatric hospitals

Cui

Zheng

2020

Eur Child Adolesc Psychiatry

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Hospital Emergency Management Plan During the COVID‐19 Epidemic

Cited by 198 publications

References 9 publications

Containing COVID‐19 in the Emergency Department: The Role of Improved Case Detection and Segregation of Suspect Cases

Containing COVID‐19 in the Emergency Department: The Role of Improved Case Detection and Segregation of Suspect Cases

Outpatient Otolaryngology in the Era of COVID‐19: A Data‐Driven Analysis of Practice Patterns

Mental health services for children in China during the COVID-19 pandemic: results of an expert-based national survey among child and adolescent psychiatric hospitals

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