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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Korean+Med+Sci
2020 ; 35
(19
): e189
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Revised Triage and Surveillance Protocols for Temporary Emergency Department
Closures in Tertiary Hospitals as a Response to COVID-19 Crisis in Daegu
Metropolitan City
#MMPMID32419401
Chung HS
; Lee DE
; Kim JK
; Yeo IH
; Kim C
; Park J
; Seo KS
; Park SY
; Kim JH
; Kim G
; Lee SH
; Cheon JJ
; Kim YH
J Korean Med Sci
2020[May]; 35
(19
): e189
PMID32419401
show ga
BACKGROUND: When an emergency-care patient is diagnosed with an emerging
infectious disease, hospitals in Korea may temporarily close their emergency
departments (EDs) to prevent nosocomial transmission. Since February 2020,
multiple, consecutive ED closures have occurred due to the coronavirus disease
2019 (COVID-19) crisis in Daegu. However, sudden ED closures are in contravention
of laws for the provision of emergency medical care that enable the public to
avail prompt, appropriate, and 24-hour emergency medical care. Therefore, this
study ascertained the vulnerability of the ED at tertiary hospitals in Daegu with
regard to the current standards. A revised triage and surveillance protocol has
been proposed to tackle the current crisis. METHODS: This study was
retrospectively conducted at 6 level 1 or 2 EDs in a metropolitan city where ED
closure due to COVID-19 occurred from February 18 to March 26, 2020. The present
status of ED closure and patient characteristics and findings from chest
radiography and laboratory investigations were assessed. Based on the experience
from repeated ED closures and the modified systems that are currently used in
EDs, revised triage and surveillance protocols have been developed and proposed.
RESULTS: During the study period, 6 level 1 or 2 emergency rooms included in the
study were shut down 27 times for 769 hours. Thirty-one confirmed COVID-19 cases,
of whom 7 died, were associated with the incidence of ED closure. Typical patient
presentation with respiratory symptoms of COVID-19 was seen in less than 50% of
patients, whereas abnormal findings on chest imaging investigations were detected
in 93.5% of the study population. The chest radiography facility, resuscitation
rooms, and triage area were moved to locations outside the ED, and a new
surveillance protocol was applied to determine the factors warranting quarantine,
including symptoms, chest radiographic findings, and exposure to a source of
infection. The incidence of ED closures decreased after the implementation of the
revised triage and surveillance protocols. CONCLUSION: Triage screening by
emergency physicians and surveillance protocols with an externally located chest
imaging facility were effective in the early isolation of COVID-19 patients. In
future outbreaks of emerging infectious diseases, efforts should be focused
toward the provision of continued ED treatment with the implementation of revised
triage and surveillance protocols.