Emergency Department Management of COVID-19: An Evidence-Based Approach

McManus, Nicholas M.; Offman, Ryan; Oetman, Jason D

doi:10.5811/westjem.2020.8.48288

Cited by 6 publications

(4 citation statements)

References 120 publications

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“…Since the onset of the COVID-19 pandemic, this need has become more crucial than ever. The consequences of mistaking a COVID-19 patient for an ADHF patient not only compromise the patient’s treatment, but also the hospital infection control measures [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Speckled Tracking of Pleura—A Novel Tool for Lung Ultrasound; Distinguishing COVID-19 from Acute Heart Failure

Tzadok

Blumberg

Shubert

et al. 2022

JCM

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For the acutely dyspneic patient, discerning bedside between acute decompensated heart failure (ADHF) and COVID-19 is crucial. A lung ultrasound (LUS) is sensitive for detecting these conditions, but not in distinguishing between them; both have bilateral B-lines. The Blue protocol uses pleural sliding to differentiate decreased pneumonia; however, this is not the case in ADHF. Nonetheless, this pleural sliding has never been quantified. Speckled tracking is a technology utilized in the echocardiography field that quantifies the motion of tissues by examining the movement of ultrasound speckles. We conducted a retrospective study of LUS performed in emergency room patients during the COVID-19 pandemic. Speckled tracking of the pleura by applying software to the B-mode of pleura was compared between COVID-19 patients, ADHF patients, and patients with no respiratory complaints. A significant difference was found between the patient groups on speckled tracking both in respect of displacement and velocity. ADHF had the highest displacement, followed by COVID-19, and then non-respiratory patients: 1.63 ± 1.89, 0.59 ± 0.71, and 0.24 ± 0.45, respectively (p < 0.01). A similar trend was seen in velocity with ADHF having the highest velocity 0.34 ± 0.37, followed by COVID-19 0.14 ± 0.71, and non-respiratory patients 0.02 ± 0.09 (p <0.01). Speckled tracking of the pleura is a potential tool for discerning between different causes of dyspnea.

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Section: Introductionmentioning

confidence: 99%

Speckled Tracking of Pleura—A Novel Tool for Lung Ultrasound; Distinguishing COVID-19 from Acute Heart Failure

Tzadok

Blumberg

Shubert

et al. 2022

JCM

View full text Add to dashboard Cite

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“…This unprecedented pandemic has changed daily life and medical service usage. Studies have reported decreased health-care services usage, particularly for non-COVID-19 visits to the emergency department (ED) [ 2 ] due to public panic and the fear of contacting suspected COVID-19 patients [ 3 ]. Delays in symptom onset to hospital arrival time are also common.…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on the Loading and Quality of an Emergency Department in Taiwan: Enlightenment from a Low-Risk Country in a Public Health Crisis

Chen

Chang

Lin

et al. 2021

JCM

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The impact of the coronavirus disease 2019 (COVID-19) pandemic on health-care quality in the emergency department (ED) in countries with a low risk is unclear. This study aimed to explore the effects of the COVID-19 pandemic on ED loading, quality of care, and patient prognosis. Data were retrospectively collected from 1 January 2018 to 30 September 2020 at the ED of Tri-service general hospital. Analyses included day-based ED loading, quality of care, and patient prognosis. Data on triage assessment, physiological states, disease history, and results of laboratory tests were collected and analyzed. The number of daily visits significantly decreased after the pandemic, leading to a reduction in the time to examination. Admitted patients benefitted from the pandemic with a reduction of 0.80 h in the length of stay in the ED, faster discharge without death, and reduced re-admission. However, non-admitted visits with chest pain increased the risk of mortality after the pandemic. In conclusion, the COVID-19 pandemic led to a significant reduction in low-acuity ED visits and improved prognoses for hospitalized patients. However, clinicians should be alert about patients with chest pain due to their increased risk of mortality in subsequent admission.

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“…Evidence-based medical education (Evidence-based medicine) is a well discussed approach to the teaching and practice of medicine during the last two decades 1 . In this recent COVID-19 situation the influence of evidence-based medicine in patient care and use of healthcare resources worldwide has become more evident 2 . It is very difficult for clinicians, health care Stakeholders and Associates to extract admirable aspects from the bulk of primary research which is growing at an ever-increasing rate.…”

Section: Introductionmentioning

confidence: 99%