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统一服务和野战医院在 2019 年冠状病毒病(SARS-CoV-2)大流行期间的经验:30 天内接收 1100 名患者后开放到关闭:Javits 纽约医疗站。

Uniformed Services and the Field Hospital Experience During Coronovirus Disease 2019 (SARS-CoV-2) Pandemic: Open to Closure in 30 Days With 1,100 Patients: The Javits New York Medical Station.

机构信息

338-1 Urban Augmentation Medical Task Forces, U.S. Army Reserves: Operation Gotham.

Brooke Army Medical Center, San Antonio, TX 78234, USA.

出版信息

Mil Med. 2022 May 3;187(5-6):e558-e561. doi: 10.1093/milmed/usab003.

Abstract

INTRODUCTION

The surge of SARS-CoV-2-virus infected (COVID-19) patients presenting to New York City (NYC) hospitals quickly overwhelmed and outnumbered the available acute care and intensive care resources in NYC in early March 2020. Upon the arrival of military medical assets to the Javits Convention Center in NYC, the planned mission to care for non-SARS-CoV-2 patients was immediately changed to manage patients with (SARS-CoV-2)COVID-19 and their comorbid conditions.Healthcare professionals from every branch of the uniformed services, augmented by state and local resources, staffed the Javits New York Medical Station (JNYMS) from April 2020.

METHODS

The data review reported aggregated summary statistics and participant observations collected by N.Y. State and U.S. military officials.

RESULTS

During the 28 days of patient intake at the JNYMS, 1,095 SARS-CoV-2-positive patients were transferred from NYC hospitals to the JNYMS. At its peak, the JNYMS accepted 119 patients in a single day, had a maximum census of 453, and had a peak intensive care unit census of 35. The median length of stay was 4.6 days (interquartile range: 3.1-6.9 days). A total of 103 patients were transferred back to local hospitals, and there were 6 deaths, with an overall mortality rate of 0.6% (95% CI, 0.3-1.2).

DISCUSSION AND CONCLUSIONS

This is the first report of the care provided at the JNYMS. Within 2 weeks, this multi-agency effort was able to mobilize to care for over 1,000 SARS-CoV-2 patients with varying degrees of illness in a 1-month period. This was the largest field hospital mobilization in the U.S. medical history in response to a non-wartime pandemic. Its success with huge patient throughput including disposition and low mortality relieved critical overcrowding and supply deficiencies throughout NYC hospitals. The downstream impact likely saved additional hundreds of lives and reduced stress on the system during this healthcare crisis.

摘要

简介

2020 年 3 月初,纽约市(NYC)医院收治的 SARS-CoV-2 病毒感染(COVID-19)患者数量迅速超过并超过了可用的急性护理和重症监护资源。2020 年 3 月初,当军事医疗资产抵达纽约市贾维茨会议中心时,照顾非 SARS-CoV-2 患者的计划任务立即改为管理 COVID-19 患者及其合并症。来自各军种和现役部队的医疗保健专业人员,以及州和地方资源,从 2020 年 4 月起在贾维茨纽约医疗站(JNYMS)工作。

方法

报告的数据审查汇总了由纽约州和美国军方官员收集的统计摘要和参与者观察结果。

结果

在 JNYMS 接受患者的 28 天内,有 1095 名 SARS-CoV-2 阳性患者从纽约市医院转至 JNYMS。在高峰期,JNYMS 每天接受 119 名患者,最大收容人数为 453 人,重症监护病房的最大收容人数为 35 人。中位住院时间为 4.6 天(四分位间距:3.1-6.9 天)。共有 103 名患者转回当地医院,有 6 人死亡,总死亡率为 0.6%(95%CI,0.3-1.2)。

讨论与结论

这是 JNYMS 提供的护理的首次报告。在 2 周内,这项多机构的努力能够在 1 个月内动员起来,为 1000 多名患有不同程度疾病的 SARS-CoV-2 患者提供护理。这是美国医疗史上为应对非战争时期大流行而进行的最大规模的野战医院动员。它的成功之处在于,在整个纽约市医院,大量的患者吞吐量(包括处置和低死亡率)缓解了严重的过度拥挤和供应不足。在这场医疗危机中,其下游影响可能挽救了数百人的生命,并减轻了系统的压力。

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