Notfall Rettungsmed
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Notfall Rettungsmed · Jan 2020
Review[Algorithm for flexible decision-making in the intra-hospital management of patients with the changing requirements of the SARS-CoV-2 pandemic].
After the initial fulminant outbreak, the SARS-CoV‑2 pandemic has now taken a more protracted course which, nevertheless, challenges hospitals in returning to a "normal" mode and in preparing for a worst-case scenario of a second wave. Not only the organization of the first contact with the patient and the admission in the emergency department but also the admission as an in-patient and the subsequent management requires both flexibility and clear directions of action for the medical personnel involved. ⋯ The algorithm covers some key points of decision making such as clinical signs, first contact, admission for in-patient treatment, consequences of swab and computed tomography (CT) results, and allocation and isolation measures within the hospital. The algorithm is not intended to guide diagnostics, decisions and treatment in the narrower medical sense but to provide more general instructions for the management of in-patients considering specific aspects of SARS-CoV‑2.
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After taking a patient's history and physical examination, lung ultrasound can immediately reveal numerous causes and complications in patients suffering from respiratory tract infection and/or dyspnea. It can thus facilitate decisions on further diagnostic and first therapeutic procedures, even in patients with a SARS-CoV‑2 infection who present to the emergency room. This review article highlights the typical findings of lung ultrasound in patients with COVID-19 and discusses its value compared to other imaging methods.
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Notfall Rettungsmed · Jan 2020
Review[Strategy for university emergency room management at the beginning of an epidemic using COVID-19 as an example].
Due to the increasing number of COVID-19 infections worldwide, all hospitals are faced with the challenge associated with the pandemic. In particular, emergency rooms must prepare and implement completely new workflows. ⋯ In addition, communication and quality and risk management are highly relevant in addition to the clinical aspects. This article uses COVID-19 as an example to describe how emergency rooms can prepare for a pandemic.
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The increasing introduction of standardized emergency call systems in German-speaking countries follows the recommendations of the European Resuscitation Council (ERC) and German Resuscitation Council (GRC), according to which the emergency call shall be queried using specified protocols. Although there may be a need for improvement in terms of sensitivity and specificity with regard to the detection of special clinical pictures, standardized products are preferred for emergency call inquiries, which can enable constant call processing regardless of user, time and situation during the day. This increases both patient safety and the legal security of the control center staff and the company management. ⋯ There is a need for optimization of the establish standards for the use of the structured and protocol-based systems and in improving user training.