Prevention of temporary emergency medical center closure through isolation zone and screening triage in COVID-19 outbreak
1Department of Emergency Medicine, Yeungnam University College of Medicine, 42415 Daegu, Republic of Korea
2Department of Emergency Medicine, Catholic University of Daegu School of Medicine, 42472 Daegu, Republic of Korea
3Department of Emergency Medicine, School of Medicine, Kyungpook National University, 41944 Daegu, Republic of Korea
4Department of Emergency Medicine, Keimyung University School of Medicine, 42601 Daegu, Republic of Korea
5Department of Emergency Medicine, Daegu Fatima Hospital, 41199 Daegu, Republic of Korea
Submitted: 09 April 2021 Accepted: 19 May 2021
Online publish date: 24 June 2021
Background: In Korea, temporary emergency medical center (EMC) closures are used to prevent nosocomial transmission of COVID-19, but they can harm the local emergency medical system. This study aimed to evaluate the occurrence of temporary EMC closures and the adequacy of isolation zone and screening triage during the COVID-19 outbreak.
Methods: This retrospective study was conducted in Daegu, Korea from 18 February 2020 to 30 April 2020, in patients who caused temporary EMC closures. The distribution of EMC closures according to time and isolation zone installation, screening triage by four criteria (epidemiologic link, fever, respiratory symptoms, unknown pneumonia), reasons for RT-PCR SARS-CoV-2 tests, and causes of EMC closures was analysed.
Results: There were a total of 26 temporary EMCs closures including eight multi-center closures. Temporary EMCs closures occurred frequently in the early stages of outbreak. Temporary EMC closure was made without RT-PCR SARS-CoV-2 confirmation. Before and after isolation zone installation, there were 24 and two temporary EMC closures, respectively. Respiratory symptoms were the most common basis for identification at screening triage centers, and fevers were the symptoms most commonly recognized by clinicians. Most (88.5%) patients causing closures met one or more of the four criteria at EMC admission. The most common cause of temporary EMC closures was patient complaint of prominent symptoms suggestive of another disease regardless of presence of screening criteria (18 cases, 69.2%).
Conclusions: Isolation zone installation and strictly applying the four criteria individually in screening triage is useful in reducing temporary EMC closure.
Coronavirus disease 2019 (COVID-19); Emergency medicine; Triage; Infection control; Isolation; Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); South Korea
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