Department of Emergency, Ankara City Hospital, Ankara, Turkey
Member of COVID-19 Scientific Advisory Board of Ministry of Health
Turk J Med Sci. 2021 Dec 17;51(SI-1):3221-3228. doi: 10.3906/sag-2106-169.
Emergency departments have always been the first point of contact for hospitals in many situations, including man-made and natural disasters. The first places where patients with symptoms of COVID-19 were met in health institutions were also emergency departments. Emergency departments play an important role in diagnosing the disease and isolating patients (by hospitalization if necessary). The process, which starts with the triage of outpatients admitted to the emergency department and brought by ambulance, continues as isolation of the patients in appropriate areas including physical evaluation, management of laboratory and scanning processes and, if necessary, providing cardiopulmonary resuscitation with airway support. Afterwards, patients can be treated as an outpatient, or hospitalized, or treated at the intensive care unit in line with their preliminary diagnosis and clinical conditions. Disruptions that may occur in one or more of these stages can lead to crowds and lengthy queues in the emergency department by prolonging the follow-up period of the patients. One of the strengths of Turkey at this point is that emergency departments are accustomed to the heavy patient load. The experiences gained from these conditions have facilitated the organization of pre-hospital emergency medical services, pandemic hospitals, and their emergency departments. In this organization, the main goal should be to provide uninterrupted and high-quality patient care through personnel training, personal protection measures, and the creation of physical conditions. Turkey’s emergency departments are accustomed to managing the intensive patient flow, as they work at full capacity during normal times. Thanks to the experiences of emergency healthcare workers, health service was provided without any patient being turned away from the door of the emergency departments during the COVID-19 pandemic. In this review, we aimed to present the organization of pandemic hospitals and emergency departments during the COVID-19 pandemic. We made a schematic representation of the architectural areas through the emergency department of Ankara City Hospital, which has a bed capacity of 4200 with 256 beds in emergency department.
急诊科在许多情况下一直是医院的第一接触点，包括人为和自然灾害。在医疗机构中遇到 COVID-19 症状的患者的第一站也是急诊科。急诊科在诊断疾病和隔离患者（如有必要，通过住院治疗）方面发挥着重要作用。该过程从分诊急诊科门诊和救护车送来的患者开始，继续对包括体格评估、实验室和扫描过程管理以及必要时提供心肺复苏和气道支持在内的适当区域的患者进行隔离。之后，患者可以作为门诊患者进行治疗，或者根据初步诊断和临床情况住院或在重症监护病房治疗。在这些阶段中的一个或多个阶段中可能发生的中断可能会导致急诊部门的人群和长时间的排队，从而延长患者的随访期。土耳其在这方面的优势之一是急诊科习惯于应对大量的患者。从这些情况下获得的经验有助于组织院前急救医疗服务、大流行医院及其急诊科。在这种组织中，主要目标应该是通过人员培训、个人保护措施和创造物理条件来提供不间断和高质量的患者护理。土耳其的急诊科习惯于管理密集的患者流量，因为它们在正常情况下都处于满负荷运转状态。得益于急诊医护人员的经验，在 COVID-19 大流行期间，没有任何患者被急诊科拒之门外。在本次综述中，我们旨在介绍 COVID-19 大流行期间大流行医院和急诊科的组织情况。我们通过安卡拉市立医院的急诊科制作了一个示意性的建筑区域图，该医院的病床容量为 4200 张，其中急诊科有 256 张病床。
