Physician Response Unit, Barts Health NHS Trust, London, UK.
London's Air Ambulance Charity, London, UK.
Emerg Med J. 2021 May;38(5):371-372. doi: 10.1136/emermed-2020-210112.
The COVID-19 pandemic has presented significant challenges to services providing emergency care, in both the community and hospital setting. The Physician Response Unit (PRU) is a Community Emergency Medicine model, working closely with community, hospital and pre-hospital services. In response to the pandemic, the PRU has been able to rapidly introduce novel pathways designed to support local emergency departments (EDs) and local emergency patients. The pathways are (1) supporting discharge from acute medical and older people's services wards into the community; (2) supporting acute oncology services; (3) supporting EDs; (4) supporting palliative care services. Establishing these pathways have facilitated a number of vulnerable patients to access patient-focussed and holistic definitive emergency care. The pathways have also allowed EDs to safely discharge patients to the community, and also mitigate some of the problems associated with trying to maintain isolation for vulnerable patients within the ED. Community Emergency Medicine models are able to reduce ED attendances and hospital admissions, and hence risk of crowding, as well as reducing nosocomial risks for patients who can have high-quality emergency care brought to them. This model may also provide various alternative solutions in the delivery of safe emergency care in the postpandemic healthcare landscape.
在社区和医院环境中，COVID-19 大流行给提供紧急护理的服务带来了重大挑战。医师反应小组（PRU）是一种社区急诊医学模式，与社区、医院和院前服务密切合作。为应对大流行，PRU 能够迅速引入旨在支持当地急诊部（ED）和当地急诊患者的新途径。这些途径是：（1）支持从急性内科和老年人服务病房出院到社区；（2）支持急性肿瘤服务；（3）支持 ED；（4）支持姑息治疗服务。建立这些途径使许多弱势患者能够获得以患者为中心和全面的紧急护理。这些途径还使 ED 能够安全地将患者出院到社区，并减轻在 ED 中试图为弱势患者保持隔离所带来的一些问题。社区急诊医学模式能够减少 ED 就诊人数和住院人数，从而降低拥挤的风险，并且减少对那些可以获得高质量急诊护理的患者的医院感染风险。这种模式在大流行后医疗保健环境中提供安全的紧急护理时也可能提供各种替代解决方案。
