M Finke1, M Pin2, M Bernhard3, A Rovas1, H-J Pavenstädt1, P Kümpers4. 1. Medizinische Klinik D (Allg. Innere Medizin und Notaufnahme sowie Nieren- und Hochdruckkrankheiten und Rheumatologie), Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland. 2. Zentrale interdisziplinäre Notaufnahme, Florence-Nightingale-Krankenhaus der Kaiserswerther Diakonie, Düsseldorf, Deutschland. 3. Zentrale Notaufnahme, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland. 4. Medizinische Klinik D (Allg. Innere Medizin und Notaufnahme sowie Nieren- und Hochdruckkrankheiten und Rheumatologie), Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland. philipp.kuempers@ukmuenster.de.
Abstract
BACKGROUND: Since the beginning of the coronavirus disease 19 (COVID-19) pandemic, German emergency departments (ED) have been working in the area of conflict between high case load and demanding hygienic and organizational challenges. The aim of this study was to gain an overview of the current status of isolation measures, diagnostics and patient allocation of suspected COVID-19 cases. METHODS: Supported by the German Society for Interdisciplinary Emergency and Acute Medicine (DGINA) we invited leading ED physicians to answer an anonymous online survey regarding isolation measures, diagnostics and organization in emergency rooms during the COVID-19 pandemic. RESULTS: A total of 139 responders from all federal states and all levels of care took part in the survey. Standard operating procedures on COVID-19 exist in almost all participating EDs, although concrete measures to end isolation are often missing. Most EDs screen patients for the "classic" COVID-19 symptoms such as fever, respiratory symptoms or contact to positive subjects in a standardized fashion, although the threshold for prophylactic isolation varies greatly. The individual swab-testing and allocation strategies vary relatively strongly. Less than half of all EDs have a separate procedure for uninterrogatable patients (e.g. major trauma). In about 8% of suspected cases, COVID-19-specific thoracic computed tomography is performed in the ED. CONCLUSION: The current survey shows that the German EDs are well positioned for the moment, even though the isolation threshold is too high at some locations. In view of a possible increase in the number of cases during the winter season, a more precise differentiation of the previous recommendations of the Robert Koch Institute, especially for emergency admission patients, would be desirable. In this context, we propose a universal algorithm for the (de-)isolation of suspect cases in the ED.
BACKGROUND: Since the beginning of the coronavirus disease 19 (COVID-19) pandemic, German emergency departments (ED) have been working in the area of conflict between high case load and demanding hygienic and organizational challenges. The aim of this study was to gain an overview of the current status of isolation measures, diagnostics and patient allocation of suspected COVID-19 cases. METHODS: Supported by the German Society for Interdisciplinary Emergency and Acute Medicine (DGINA) we invited leading ED physicians to answer an anonymous online survey regarding isolation measures, diagnostics and organization in emergency rooms during the COVID-19 pandemic. RESULTS: A total of 139 responders from all federal states and all levels of care took part in the survey. Standard operating procedures on COVID-19 exist in almost all participating EDs, although concrete measures to end isolation are often missing. Most EDs screen patients for the "classic" COVID-19 symptoms such as fever, respiratory symptoms or contact to positive subjects in a standardized fashion, although the threshold for prophylactic isolation varies greatly. The individual swab-testing and allocation strategies vary relatively strongly. Less than half of all EDs have a separate procedure for uninterrogatable patients (e.g. major trauma). In about 8% of suspected cases, COVID-19-specific thoracic computed tomography is performed in the ED. CONCLUSION: The current survey shows that the German EDs are well positioned for the moment, even though the isolation threshold is too high at some locations. In view of a possible increase in the number of cases during the winter season, a more precise differentiation of the previous recommendations of the Robert Koch Institute, especially for emergency admission patients, would be desirable. In this context, we propose a universal algorithm for the (de-)isolation of suspect cases in the ED.
Authors: Maximilian Schulze-Hagen; Christian Hübel; Michael Meier-Schroers; Can Yüksel; Anton Sander; Marwin Sähn; Michael Kleines; Peter Isfort; Christian Cornelissen; Sebastian Lemmen; Nikolaus Marx; Michael Dreher; Jörg Brokmann; Andreas Kopp; Christiane Kuhl Journal: Dtsch Arztebl Int Date: 2020-06-01 Impact factor: 5.594
Authors: Michael Dreher; Alexander Kersten; Johannes Bickenbach; Paul Balfanz; Bojan Hartmann; Christian Cornelissen; Ayham Daher; Robert Stöhr; Michael Kleines; Sebastian W Lemmen; Jörg Christian Brokmann; Tobias Müller; Dirk Müller-Wieland; Gernot Marx; Nikolaus Marx Journal: Dtsch Arztebl Int Date: 2020-04-17 Impact factor: 5.594
Authors: D O Wennmann; C P Dlugos; A Hofschröer; M Hennies; J Kühn; W Hafezi; S Kampmeier; A Mellmann; S Triphaus; J Sackarnd; P Tepasse; M Keller; H Van Aken; H Pavenstädt; P Kümpers Journal: Med Klin Intensivmed Notfmed Date: 2020-04-22 Impact factor: 0.840
Authors: Marco Francone; Franco Iafrate; Giorgio Maria Masci; Simona Coco; Francesco Cilia; Lucia Manganaro; Valeria Panebianco; Chiara Andreoli; Maria Chiara Colaiacomo; Maria Antonella Zingaropoli; Maria Rosa Ciardi; Claudio Maria Mastroianni; Francesco Pugliese; Francesco Alessandri; Ombretta Turriziani; Paolo Ricci; Carlo Catalano Journal: Eur Radiol Date: 2020-07-04 Impact factor: 5.315