Drumheller Byron C, Mareiniss Darren P, Overberger Ryan C, Sabolick Erin E
Department of Emergency Medicine Einstein Healthcare Network Einstein Medical Center Philadelphia Philadelphia Pennsylvania USA.
J Am Coll Emerg Physicians Open. 2020 Nov 23;1(6):1255-1260. doi: 10.1002/emp2.12323. eCollection 2020 Dec.
The ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in rapid surges of critically ill patients infected with coronavirus disease 2019 (COVID-19) pneumonia presenting to the emergency department (ED) and requiring ICU admission nationwide. Despite adaptations in critical care personnel staffing, bed availability and supply provision, many inpatient ICUs have become acutely crowded, leading to boarding of critically ill patients with COVID-19 and other diseases in the ED. To address this scenario at our urban, safety net, tertiary care institution in the spring of 2020, we designed and implemented a temporary "emergency department-intensive care unit" (ED-ICU) patient care service. Critical care-trained emergency physicians took call and came into the hospital overnight/on weekends to provide bedside treatment to admitted ICU patients boarding for prolonged periods in our ED. In this manuscript, we describe the creation and execution of the ED-ICU service and the characteristics and management of the patients who received care under this model.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引发的持续大流行，导致感染2019冠状病毒病（COVID-19）肺炎的危重症患者数量在全国范围内迅速激增，这些患者前往急诊科（ED）就诊并需要入住重症监护病房（ICU）。尽管在重症护理人员配备、床位供应和物资提供方面进行了调整，但许多住院ICU已严重拥挤，导致COVID-19危重症患者以及患有其他疾病的患者滞留在急诊科。为应对2020年春季我们这家城市安全网三级医疗机构面临的这种情况，我们设计并实施了一项临时的“急诊科-重症监护病房”（ED-ICU）患者护理服务。经过重症护理培训的急诊医生随时待命，在夜间/周末到医院为长时间滞留在我们急诊科的入住ICU患者提供床边治疗。在本手稿中，我们描述了ED-ICU服务的创建与实施，以及在此模式下接受治疗的患者的特征和管理情况。
