tetano
Editor, Senior Moderator
Emerg Med J. 2020 Apr 22. pii: emermed-2020-209634. doi: 10.1136/emermed-2020-209634. [Epub ahead of print]
Dynamic adaptation to COVID-19 in a Singapore paediatric emergency department.
Tan RMR[SUP]1,[/SUP][SUP]2[/SUP], Ong GY[SUP]3,[/SUP][SUP]2[/SUP], Chong SL[SUP]3,[/SUP][SUP]2[/SUP], Ganapathy S[SUP]3,[/SUP][SUP]2[/SUP], Tyebally A[SUP]3,[/SUP][SUP]2[/SUP], Lee KP[SUP]3,[/SUP][SUP]2[/SUP].
Author information
Abstract
Singapore was one of the earliest countries affected by the coronavirus disease 2019 (COVID-19) pandemic, with more laboratory-confirmed COVID-19 cases in early February 2020 than any other country outside China. This short report is a narrative review of our tertiary paediatric emergency department (ED) perspective and experience managing the evolving outbreak situation. Logistic considerations included the segregation of the ED into physically separate high-risk, intermediate-risk and low-risk areas, with risk-adapted use of personal protective equipment (PPE) for healthcare personnel in each ED area. Workflow considerations included the progressive introduction of outpatient COVID-19 testing in the ED for enhanced surveillance; adapting the admissions process particularly for high-risk and intermediate-risk cases; and the management of unwell accompanying adult caregivers. Manpower considerations included the reorganisation of medical manpower into modular teams to mitigate the risk of hospital transmission of COVID-19. Future plans for a tiered isolation facility should include structural modifications for the permanent isolation facility such as anterooms for PPE donning/doffing; replication of key ED functions in the tent facility such as a separate resuscitation room and portable X-ray room; and refresher PPE training. Dynamic reassessment of ED workflow processes, in conjunction with the hospital and national public health response, may help in managing this novel disease entity.
? Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
KEYWORDS:
infectious diseases; paediatrics, paediatric emergency medicine
PMID:32321705DOI:10.1136/emermed-2020-209634
Dynamic adaptation to COVID-19 in a Singapore paediatric emergency department.
Tan RMR[SUP]1,[/SUP][SUP]2[/SUP], Ong GY[SUP]3,[/SUP][SUP]2[/SUP], Chong SL[SUP]3,[/SUP][SUP]2[/SUP], Ganapathy S[SUP]3,[/SUP][SUP]2[/SUP], Tyebally A[SUP]3,[/SUP][SUP]2[/SUP], Lee KP[SUP]3,[/SUP][SUP]2[/SUP].
Author information
Abstract
Singapore was one of the earliest countries affected by the coronavirus disease 2019 (COVID-19) pandemic, with more laboratory-confirmed COVID-19 cases in early February 2020 than any other country outside China. This short report is a narrative review of our tertiary paediatric emergency department (ED) perspective and experience managing the evolving outbreak situation. Logistic considerations included the segregation of the ED into physically separate high-risk, intermediate-risk and low-risk areas, with risk-adapted use of personal protective equipment (PPE) for healthcare personnel in each ED area. Workflow considerations included the progressive introduction of outpatient COVID-19 testing in the ED for enhanced surveillance; adapting the admissions process particularly for high-risk and intermediate-risk cases; and the management of unwell accompanying adult caregivers. Manpower considerations included the reorganisation of medical manpower into modular teams to mitigate the risk of hospital transmission of COVID-19. Future plans for a tiered isolation facility should include structural modifications for the permanent isolation facility such as anterooms for PPE donning/doffing; replication of key ED functions in the tent facility such as a separate resuscitation room and portable X-ray room; and refresher PPE training. Dynamic reassessment of ED workflow processes, in conjunction with the hospital and national public health response, may help in managing this novel disease entity.
? Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
KEYWORDS:
infectious diseases; paediatrics, paediatric emergency medicine
PMID:32321705DOI:10.1136/emermed-2020-209634