Effectiveness of negative pressure isolation stretcher and rooms for SARS-CoV-2 nosocomial infection control and maintenance of South Korean emergency department capacity

Abstract

Objective There are growing concerns regarding the lack of COVID-19 pandemic response capacity in already overwhelmed emergency departments (EDs), and lack of proper isolation facilities. This study evaluated the effectiveness of the negative pressure isolation stretcher (NPIS) and additional negative pressure isolation rooms (NPIRs) on the maintenance of emergency care capacity during the COVID-19 outbreak. Methods A before and after intervention study was performed between February 27, 2020 and March 31, 2020 at the ED of Chungbuk National University Hospital, Cheongju, South Korea. A total of 2455 patients who visited the ED during the study period were included. Interventions included the introduction of the NPIS and additional NPIRs in the ED. The main outcome of the study was frequency of medical cessation. Secondary outcomes were the average number of ED visits and lengths of stay. Results After the intervention, average frequency of medical cessation was significantly decreased from 1.6 times per day (range 0–4) in the pre-intervention period to 0.6 times per day (range 0–3) in the post-intervention period ( p -value <0.01). On the other hand, the number of patients visiting the ED increased significantly from 67.2 persons per day (range 58–79) pre-intervention to 76.3 persons per day (range 61–88) post-intervention ( p value <0.01). However, there were no statistically significant differences in the average ED length of stay across the study phases (p value = 0.50). Conclusions This intervention may provide an effective way to prepare and meet the ED response needs of the COVID-19 pandemic.

The Importance of Early Recognition, Timely Management, and the Role of Healthcare Providers in Multisystem Inflammatory Syndrome in Children

“…In addition, a negative pressure isolation stretcher (implemented at CBNUH early in the course of the pandemic) was utilized to protect HCPs during the CT scan. 14 Therefore, the fourth lesson we learned was that the concerns of HCPs caring for patients with possible SARS-CoV-2 infectivity cannot be ignored and should be respected. 15 This 12-year-old boy was one of the first two cases of MIS-C in Korea.…”

A review of facilities management interventions to mitigate respiratory infections in existing buildings

“…Since indoor airflow patterns significantly impact airborne virus transmission in buildings, air pressure created by HVAC systems has been widely used in sensitive settings to reduce virus transmission from contaminated spaces to other areas. In our review, ten articles discussed air pressure as an intervention measure, and they validated the effectiveness of air pressured facilities in various clinical settings, such as negative air ionisation [ 95 ], positively pressured operating rooms [ 103 ], negative pressure hoods [ 87 , 105 ], negative pressure isolation stretcher [ 104 ]. For example, Kim et al conducted a before-and-after intervention study at a South Korean hospital and discovered that the average frequency of medical cessation was considerably lowered following the intervention [ 104 ].…”

“…In our review, ten articles discussed air pressure as an intervention measure, and they validated the effectiveness of air pressured facilities in various clinical settings, such as negative air ionisation [ 95 ], positively pressured operating rooms [ 103 ], negative pressure hoods [ 87 , 105 ], negative pressure isolation stretcher [ 104 ]. For example, Kim et al conducted a before-and-after intervention study at a South Korean hospital and discovered that the average frequency of medical cessation was considerably lowered following the intervention [ 104 ]. Likewise, Phu et al confirmed that confining Covid-19 patients in negative pressure systems equipped with HEPA filtration effectively reduces pathogen transmission to health care personnel [ 87 ].…”

Reducing Morbidity and Mortality Rates from COVID-19, Influenza and Pneumococcal Illness in Nursing Homes and Long-Term Care Facilities by Vaccination and Comprehensive Infection Control Interventions

“…A 2020 systematic review of hand washing, distancing and mask wearing to prevent the transmission of SARS-CoV-2 identified 172 observational studies in 16 countries but no RCTs, and a meta-analysis of 44 non-randomised studies identified substantial protection by distancing more than one metre, hand washing, mask wearing and eye protection [80] (Table 9). A study in an emergency department demonstrated a reduction in cleaning needs after contamination by potential SARS-CoV-2 patients [81]. Four modelling studies demonstrated how to minimise the contamination of airflows in respiratory disease isolation rooms.…”