The impending storm: COVID-19, pandemics and our overwhelmed emergency departments

Mareiniss, Darren P.

doi:10.1016/j.ajem.2020.03.033

Cited by 78 publications

(67 citation statements)

References 8 publications

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“…In some geographic areas, EDs are overwhelmed by the volume of COVID-19 infected patients combined with critical shortages of supplies, staffing, and physical space. 44 Other EDs anecdotally report lower census levels, likely due to a combination of fewer accidental injuries during public lockdown efforts and ED avoidance behaviors by patients fearing exposure to the virus. As a result, staffing models have either decreased or adjusted to focus attention on the surges of COVID-19 cases 45 and there may be fewer staff available to handle agitated patients in many EDs.…”

Section: Clinical Resource Limitationsmentioning

confidence: 99%

Management of Agitation During the COVID-19 Pandemic

Wong

Roppolo

Yonkers

et al. 2020

WestJEM

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Section: Clinical Resource Limitationsmentioning

confidence: 99%

Management of Agitation During the COVID-19 Pandemic

Wong

Roppolo

Yonkers

et al. 2020

WestJEM

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“…As COVID-19 spreads around the world, it causes an influx in the emergency departments of the hospitals [1,2]. In this context, quick triage of patients towards the COVID+ and COVID− hospital units is essential.…”

Section: Introductionmentioning

confidence: 99%

Chest CT for rapid triage of patients in multiple emergency departments during COVID-19 epidemic: experience report from a large French university hospital

et al. 2020

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Objectives To assess the diagnostic performances of chest CT for triage of patients in multiple emergency departments during COVID-19 epidemic, in comparison with reverse transcription polymerase chain reaction (RT-PCR) test. Method From March 3 to April 4, 2020, 694 consecutive patients from three emergency departments of a large university hospital, for which a hospitalization was planned whatever the reasons, i.e., COVID-or non-COVID-related, underwent a chest CT and one or several RT-PCR tests. Chest CTs were rated as "Surely COVID+," "Possible COVID+," or "COVID−" by experienced radiologists. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using the final RT-PCR test as standard of reference. The delays for CT reports and RT-PCR results were recorded and compared. Results Among the 694 patients, 287 were positive on the final RT-PCR exam. Concerning the 694 chest CT, 308 were rated as "Surely COVID+", 34 as "Possible COVID+," and 352 as "COVID−." When considering only the "Surely COVID+" CT as positive, accuracy, sensitivity, specificity, PPV, and NPV reached 88.9%, 90.2%, 88%, 84.1%, and 92.7%, respectively, with respect to final RT-PCR test. The mean delay for CT reports was three times shorter than for RT-PCR results (187 ± 148 min versus 573 ± 327 min, p < 0.0001). Conclusion During COVID-19 epidemic phase, chest CT is a rapid and most probably an adequately reliable tool to refer patients requiring hospitalization to the COVID+ or COVID− hospital units, when response times for virological tests are too long. Key Points • In a large university hospital in Lyon, France, the accuracy, sensitivity, specificity, PPV, and NPV of chest CT for COVID-19 reached 88.9%, 90.2%, 88%, 84.1%, and 92.7%, respectively, using RT-PCR as standard of reference.

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“…COVID-19 is extremely transmissible and can cause severe respiratory failure. COVID-19 has the potential to overwhelm healthcare resources at all levels including emergency [1], critical-intensive [2,3], and post-intensive care levels [4]. Although all healthcare systems are at risk of becoming overwhelmed by COVID-19 cases, countries in the Global South are more likely to be exhausted [5,6].…”

mentioning

confidence: 99%

Knowledge, attitudes, and practices towards COVID-19 among Colombians during the outbreak: an online cross-sectional survey

Bates

Botero

Grijalva

2020

Journal of Communication in Healthcare

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Background: Preventing the spread of COVID-19 requires the modification of behavior, including social distancing, mask-wearing, and regular handwashing. Modifying behavior requires understanding people's knowledge, attitudes, and practices (KAPs) regarding health threats. We explored KAPs among Colombians to examine whether KAPs affect adherence to recommended practices during the initial outbreak. Methods: We distributed a cross-sectional, internet-based questionnaire using referral network techniques. The questionnaire addressed three areas: knowledge about COVID-19; attitudes toward the ability to control it; and, self-reported practices related to the control of COVID-19. Demographic data were also collected. Results: A total of 482 individuals completed the questionnaire. Participants had low to moderate levels of knowledge about COVID-19. They expressed mixed levels of optimism about the world eventually controlling COVID-19, but they were very optimistic about Colombia's ability to control the disease. They reported extremely high levels of adoption of preventive practices. Binomial regression suggests few demographic factors associated with KAPs. Generally, knowledge had no association with optimism and little association with self-reported adoption of recommended practices. Conclusions: These findings indicate that greater knowledge of COVID-19 is insufficient to prompt behavior change. Colombians' greater optimism about their own country's ability to overcome COVID-19 as compared to the world's ability should be explored in greater depth. Since attitudes are associated with actions, future investigation of Colombians' optimism may provide guidance for improving attitudes elsewhere. Because adoption of preventive practices is extremely high in Colombia, Colombia may serve as a model case for how other nations can respond to COVID-19.

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The impending storm: COVID-19, pandemics and our overwhelmed emergency departments

Cited by 78 publications

References 8 publications

Management of Agitation During the COVID-19 Pandemic

Management of Agitation During the COVID-19 Pandemic

Chest CT for rapid triage of patients in multiple emergency departments during COVID-19 epidemic: experience report from a large French university hospital

Knowledge, attitudes, and practices towards COVID-19 among Colombians during the outbreak: an online cross-sectional survey

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