Article Data

  • Views 348
  • Dowloads 151

Original Research

Open Access

Prevention of temporary emergency medical center closure through isolation zone and screening triage in COVID-19 outbreak

  • Sin-Youl Park1
  • Kyung Woo Lee2
  • Suk Hee Lee2
  • Jong Kun Kim3
  • Jae Wan Cho3
  • Jae Cheon Jeon4
  • Jae Chul Cho5

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

DOI: 10.22514/sv.2021.111

Submitted: 09 April 2021 Accepted: 19 May 2021

Online publish date: 24 June 2021

*Corresponding Author(s): Kyung Woo Lee E-mail: turtle072@hanmail.net

Abstract

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.


Keywords

Coronavirus disease 2019 (COVID-19); Emergency medicine; Triage; Infection control; Isolation; Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); South Korea


Cite and Share

Sin-Youl Park,Kyung Woo Lee,Suk Hee Lee,Jong Kun Kim,Jae Wan Cho,Jae Cheon Jeon,Jae Chul Cho. Prevention of temporary emergency medical center closure through isolation zone and screening triage in COVID-19 outbreak. Signa Vitae. 2021.doi:10.22514/sv.2021.111.

References

[1] Kim JY, Choe PG, Oh Y, Oh KJ, Kim J, Park SJ, et al. The first case of 2019 novel coronavirus pneumonia imported into Korea from Wuhan, China: implication for infection prevention and control measures. Journal of Korean Medical Science. 2020; 35: e61.

[2] Daegu Metropolitan City. Current status of emergency medicalcare center. Available at: https://www.daegu.go.kr/health/index. do?menu_id=00933174 (Accessed date: 10 January 2021)

[3] Korea Centers for Disease Control and Prevention. Updates on COVID-19 in Republic of Korea (as of 1 May). 2019. Available at: http: //ncov.mohw.go.kr/en/tcmBoardView.do? (Accessed: 10 January 2021).

[4] Hong KH, Lee SW, Kim TS, Huh HJ, Lee J, Kim SY, et al. Guidelines for Laboratory Diagnosis of Coronavirus Disease 2019 (COVID-19) in Korea. Annals of Laboratory Medicine. 2020; 40: 351–360.

[5] Korean Society of Infectious Diseases; Korean Society of Pediatric Infectious Diseases; Korean Society of Epidemiology; Korean Society for Antimicrobial Therapy; Korean Society for Healthcare-associated Infection Control and Prevention; Korea Centers for Disease Control and Prevention. Report on the Epidemiological Features of Coronavirus Disease 2019 (COVID-19) Outbreak in the Republic of Korea from January 19 to March 2, 2020. Journal of Korean Medical Science. 2020; 35: e112.

[6] Kwon S, Lee E, Kim H, Kim J, Lim Y, Choi G. Middle East respiratory syndrome coronavirus (MERS-COV) outbreak in South Korea: risk management at the Korean Red Cross Seoul Nambu Blood Center: 3B-S11-05. Vox Sanguinis. 2015; 109: 18–19.

[7] Kim JY, Song JY, Yoon YK, Choi SH, Song YG, Kim SR, et al. Middle East Respiratory Syndrome Infection Control and Prevention Guideline for Healthcare Facilities. Infection & Chemotherapy. 2015; 47: 278–302.

[8] Lee DE, Ro YS, Ryoo HW, Moon S. Impact of temporary closures of emergency departments during the COVID-19 outbreak on clinical outcomes for emergency patients in a metropolitan area. The American Journal of Emergency Medicine. 2021; 47: 35–41.

[9] Kim YJ, Choe JY, Kwon KT, Hwang S, Choi G-S, Sohn JH, et al. How to keep patients and staff safe from accidental SARS-CoV-2 exposure in the emergency room: Lessons from South Korea’s explosive COVID-19 outbreak. Infection Control & Hospital Epidemiology. 2021; 42: 18–24.

[10] Lee JH, Hong SW, Hyun M, Park JS, Lee JH, Suh YS, et al. Epidemiological and clinical characteristics of coronavirus disease 2019 in Daegu, South Korea. International Journal of Infectious Diseases. 2020; 98: 462–466.

[11] Shen YC, Hsia RY. Association between Emergency Department Closure and Treatment, Access, and Health Outcomes among Patients with Acute Myocardial Infarction. Circulation. 2016; 134: 1595–1597.

[12] Sun BC, Mohanty SA, Weiss R, Tadeo R, Hasbrouck M, Koenig W, et al. Effects of hospital closures and hospital characteristics on emergency department ambulance diversion, Los Angeles County, 1998 to 2004. Annals of Emergency Medicine. 2006; 47: 309–316.

[13] Bostock B. South Korea is testing 200,000 members of a doomsday church linked to more than 60% of its coronavirus cases. Business Insider. 2020. (25 February 2020)

[14] Hong KS, Lee KH, Chung JH, Shin KC, Choi EY, Jin HJ, et al. Clinical Features and Outcomes of 98 Patients Hospitalized with SARS-CoV-2 Infection in Daegu, South Korea: a Brief Descriptive Study. Yonsei Medical Journal. 2020; 61: 431–437.

[15] Jang JG, Hur J, Choi EY, Hong KS, Lee W, Ahn JH. Prognostic Factors for Severe Coronavirus Disease 2019 in Daegu, Korea. Journal of Korean Medical Science. 2020; 35: e209.

[16] Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. New England Journal of Medicine. 2020; 382: 1708–1720.

[17] Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020; 395: 497–506.

[18] Stokes EK, Zambrano LD, Anderson KN, Marder EP, Raz KM, El Burai Felix S, et al. Coronavirus Disease 2019 Case Surveillance -United States, January 22-May 30, 2020. Morbidity and Mortality Weekly Report. 2020; 69: 759–765.

[19] Dennie C, Hague C, Lim RS, Manos D, Memauri BF, Nguyen ET, et al. Canadian Society of Thoracic Radiology/Canadian Association of Radi-ologists Consensus Statement Regarding Chest Imaging in Suspected and Confirmed COVID-19. Canadian Association of Radiologists Journal. 2020; 71: 470–481.

[20] Jacobi A, Chung M, Bernheim A, Eber C. Portable chest X-ray in coronavirus disease-19 (COVID-19): a pictorial review. Clinical Imaging. 2020; 64: 35–42.

[21] Wong HYF, Lam HYS, Fong AH, Leung ST, Chin TW, Lo CSY, et al. Frequency and Distribution of Chest Radiographic Findings in Patients Positive for COVID-19. Radiology. 2020; 296: E72–E78.

[22] Ng MY, Lee EYP, Yang J, Yang F, Li X, Wang H, et al. Imaging Profile of the COVID-19 Infection: Radiologic Findings and Literature Review. Radiology: Cardiothoracic Imaging. 2020; 2: e200034.

[23] Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology. 2020; 296: E115–E117.

[24] Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for Typical Coronavirus Disease 2019 (COVID-19) Pneumonia: Relationship to Negative RT-PCR Testing. Radiology. 2020; 296: E41–E45.

[25] Richterman A, Meyerowitz EA, Cevik M. Hospital-Acquired SARS-CoV-2 Infection. The Journal of the American Medical Association. 2020; 324: 2155–2156.

[26] Wee LE, Conceicao EP, Sim XYJ, Aung MK, Tan KY, Wong HM, et al. Minimizing intra-hospital transmission of COVID-19: the role of social distancing. Journal of Hospital Infection. 2020; 105: 113–115.


Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 0.5(2019) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

Top