St. John's Riverside Hospital, Department of Emergency Medicine, Yonkers, New York.
West J Emerg Med. 2022 Jan 17;23(2):129-133. doi: 10.5811/westjem.2021.9.52294.
Since early 2020, the world has been living through coronavirus disease 2019 (COVID-19). Westchester County, New York, was one of the hardest and earliest hit places in the United States. Working within a community emergency department amid the rise of a highly infectious disease such as COVID-19 presented many challenges, including appropriate isolation, adequate testing, personnel shortages, supply shortfalls, facility changes, and resource allocation. Here we discuss our process in navigating these complexities, including the practice changes implemented within our institution to counter these unprecedented issues. These adjustments included establishing three outdoor tents to serve as triage areas; creating overflow intensive care units through conversion of areas that had previously served as the ambulatory surgery unit, post-anesthesia care unit, and endoscopy suite; increasing critical care staff to meet unprecedented need; anticipating and adapting to medical supply shortages; and adjusting resident physician roles to meet workflow requirements. By analyzing and improving upon the processes delineated below, our healthcare system should be better prepared for future pandemics.
自 2020 年初以来，世界一直在经历 2019 年冠状病毒病（COVID-19）。纽约州威彻斯特县是美国受灾最严重和最早的地区之一。在像 COVID-19 这样具有高度传染性的疾病爆发期间，在社区急诊部门工作面临着许多挑战，包括适当的隔离、充分的检测、人员短缺、供应短缺、设施变化和资源分配。在这里，我们讨论了我们在应对这些复杂性方面的过程，包括我们机构内部为应对这些前所未有的问题而实施的实践改变。这些调整包括建立三个户外帐篷作为分诊区；通过将以前用作门诊手术单元、麻醉后护理单元和内窥镜套房的区域转换为重症监护病房来增加重症监护人员以满足前所未有的需求；预测和适应医疗用品短缺；并调整住院医师的角色以满足工作流程要求。通过分析和改进下面阐述的流程，我们的医疗保健系统应该为未来的大流行做好更好的准备。
