• Minerva cardioangiologica · Dec 2020

    Caring for acute coronary syndrome and other time-sensitive medical emergencies during the coronavirus disease 2019 pandemic in Northern Italy: report from a hub centre.

    • Luca Cabrini, Walter Ageno, Sergio Balbi, Fabio Baruzzi, Elisa Candeloro, Carlo Capra, Federico Carimati, Battistina Castiglioni, Vinicio Conti, Roberto De Ponti, Dario Franchi, Giancarlo Gini, Andrea Giorgianni, Marianna Sartorelli, Giovanni Landoni, Davide Locatelli, Lorenzo Maffioli, Rita Pradella, Paolo Severgnini, Matteo Tozzi, Maurizio Versino, Giuliano Zocchi, and Alberto Zoli.
    • Università degli Studi dell'Insubria, Varese, Italy.
    • Minerva Cardioangiol. 2020 Dec 1.

    BackgroundThe Lombardy region, in Northern Italy, suffered a major outbreak of Coronavirus disease 2019 (COVID-19) at the end of February 2020. The health system was rapidly overwhelmed by the pandemic. It became evident that patients suffering from timesensitive medical emergencies like stroke, cerebral hemorrhage, trauma and acute myocardial infarction required timely, effective and safe pathways to be treated. The problem was addressed by a regional decree that created a hub-and-spoke system for time-sensitive medical emergencies.MethodsWe report the re-organizational changes adopted at a hub hospital (despite having already destined to COVID-19 patients most resources), and the number of emergent procedures for medical emergencies on the first 30-day of activity. These data were compared with the hospital activity in the same period of the previous year.ResultsOrganizational changes were implemented in few hours. Dedicated pathways for non-COVID-19 patients affected by a medical emergency were set up in the emergency department, in the labs and in the operating theater. Ten intensive beds were implemented from a high-dependency unit; two operating rooms were reserved 24h/day to neurosurgical or trauma emergencies. The number of emergent procedures was not different from that of the previous year, no admission refusal, no treatment delay and no viral transmission to the treated patients were recorded. No viral transmission to health care workers was observed.ConclusionsRe-organization of a hospital in order to adopt a hub-and-spoke model resulted feasible and allowed to face acute coronary syndrome and other time-sensitive medical emergencies timely and safely.

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