Department of Emergency Medicine, University of California, San Diego, San Diego, California.
Department of Emergency Medicine, University of California, San Diego, San Diego, California; Department of Biomedical Informatics, University of California, San Diego, San Diego, California; Department of Computer Science and Engineering, University of California, San Diego, San Diego, California.
J Emerg Med. 2021 Apr;60(4):548-553. doi: 10.1016/j.jemermed.2020.11.026. Epub 2021 Jan 7.
In March of 2020, the World Health Organization declared coronavirus disease 2019 (COVID-19)-a disease caused by a novel coronavirus-a pandemic, and it continued to spread rapidly in the community. Our institution implemented an emergency medicine telehealth system that sought to expedite care of stable patients, decrease provider exposure to COVID-19, decrease overall usage rate of personal protective equipment, and provide a platform so that infected or quarantined physicians could continue to work. This effort was among the first to use telehealth to practice emergency medicine in the setting of a pandemic in the United States.
Outside the main emergency departments at each of 2 sites of our academic institution, disaster tents were erected with patient care equipment and medications, as well as technology to allow for telehealth visits. The triage system was modified to appropriately select low-risk patients with symptoms suggestive of COVID-19 who could be seen in these disaster tents. Despite some issues that needed to be addressed, such as provider discomfort, limited medication availability, and connectivity problems, the model was successful overall.
Other emergency departments might find this proof of concept article useful. Telehealth will likely be used more broadly in the future, including emergency care. It is imperative that the health care system continues to adapt to respond appropriately to challenges such as pandemics.
2020 年 3 月，世界卫生组织宣布由新型冠状病毒引起的 2019 年冠状病毒病（COVID-19）——一种疾病为大流行，该疾病在社区中继续迅速传播。我们机构实施了紧急医疗远程医疗系统，旨在加快对稳定患者的治疗，减少医护人员接触 COVID-19 的风险，降低个人防护设备的总体使用率，并提供一个平台，使受感染或隔离的医生能够继续工作。这是美国在大流行期间首次使用远程医疗实践急诊医学的努力之一。
在我们学术机构的 2 个地点的主要急诊部门外，搭建了带有患者护理设备和药物的救灾帐篷，以及用于远程医疗访问的技术。分诊系统经过修改，以便适当选择有 COVID-19 症状的低风险患者，这些患者可以在这些救灾帐篷中接受治疗。尽管存在一些需要解决的问题，例如提供者的不适、有限的药物供应和连接问题，但总体而言，该模式是成功的。
其他急诊部门可能会发现这篇概念验证文章很有用。远程医疗在未来可能会更广泛地使用，包括紧急护理。医疗保健系统必须继续适应，以应对大流行等挑战。
