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Effectiveness of the Middle East respiratory syndrome-coronavirus protocol in enhancing the function of an Emergency Department in Qatar.
Eur J Emerg Med. 2015 Oct; 22(5):316-20.EJ

Abstract

OBJECTIVE

This study aimed to investigate the effectiveness of a Middle East respiratory syndrome coronavirus (MERS-CoV) surveillance protocol in the Emergency Department (ED) at Hamad General Hospital. Effectiveness was measured by: (a) reduction in the number of patients admitted into the MERS-CoV tracking system; (b) identification of positive MERS-CoV cases; (c) containment of cross infectivity; and (d) increased efficiency in ED functioning.

METHODS

A retrospective chart review was carried out of all ED patients suspected of MERS-CoV during the height of the epidemic (August to October 2013). An algorithm was created on the basis of international guidelines to screen and triage suspected MERS-CoV patients. Once identified, patients were isolated, had a chest roentgenogram [chest radiography (CXR)] taken, and a nasopharyngeal swab for polymerase chain reaction (PCR) was sent with sputum samples for testing. Patients with normal CXR and mild respiratory symptoms were discharged with home isolation instructions until nasopharyngeal and sputum PCR results were available. Patients with fever and acute respiratory distress, with or without abnormal CXR, were treated in the hospital until tests proved negative for MERS-CoV.

RESULTS

The protocol successfully reduced the number of patients who needed to be tested for MERS-CoV from 12,563 to 514, identified seven positive cases, and did not lead to apparent cross infectivity that resulted in serious illness or death. The protocol also increased the efficiency of ED and cut the turnaround time for nasopharyngeal swab and sputum results from 3 days to 1 day.

CONCLUSION

A highly protocolized surveillance system limited the impact of MERS-CoV on ED functioning by identifying and prioritizing high-risk patients. The emergence of new infectious diseases requires constant monitoring of interventions to reduce the impact of epidemics on population health and health services.

Authors+Show Affiliations

aEmergency Medicine bHealth Services Research cInfectious Diseases, Hamad Medical Corporation, Doha, Qatar dDepartment of Sociology and Global Health, Duke University, Durham, North Carolina, USA eDepartment of Emergency Medicine, Monash University, Melbourne, Victoria, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26035278

Citation

Varughese, Shinu, et al. "Effectiveness of the Middle East Respiratory Syndrome-coronavirus Protocol in Enhancing the Function of an Emergency Department in Qatar." European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine, vol. 22, no. 5, 2015, pp. 316-20.
Varughese S, Read JG, Al-Khal A, et al. Effectiveness of the Middle East respiratory syndrome-coronavirus protocol in enhancing the function of an Emergency Department in Qatar. Eur J Emerg Med. 2015;22(5):316-20.
Varughese, S., Read, J. G., Al-Khal, A., Abo Salah, S., El Deeb, Y., & Cameron, P. A. (2015). Effectiveness of the Middle East respiratory syndrome-coronavirus protocol in enhancing the function of an Emergency Department in Qatar. European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine, 22(5), 316-20. https://doi.org/10.1097/MEJ.0000000000000285
Varughese S, et al. Effectiveness of the Middle East Respiratory Syndrome-coronavirus Protocol in Enhancing the Function of an Emergency Department in Qatar. Eur J Emerg Med. 2015;22(5):316-20. PubMed PMID: 26035278.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of the Middle East respiratory syndrome-coronavirus protocol in enhancing the function of an Emergency Department in Qatar. AU - Varughese,Shinu, AU - Read,Jennan G, AU - Al-Khal,Abdullatif, AU - Abo Salah,Salem, AU - El Deeb,Yasser, AU - Cameron,Peter A, PY - 2015/6/3/entrez PY - 2015/6/3/pubmed PY - 2016/6/1/medline SP - 316 EP - 20 JF - European journal of emergency medicine : official journal of the European Society for Emergency Medicine JO - Eur J Emerg Med VL - 22 IS - 5 N2 - OBJECTIVE: This study aimed to investigate the effectiveness of a Middle East respiratory syndrome coronavirus (MERS-CoV) surveillance protocol in the Emergency Department (ED) at Hamad General Hospital. Effectiveness was measured by: (a) reduction in the number of patients admitted into the MERS-CoV tracking system; (b) identification of positive MERS-CoV cases; (c) containment of cross infectivity; and (d) increased efficiency in ED functioning. METHODS: A retrospective chart review was carried out of all ED patients suspected of MERS-CoV during the height of the epidemic (August to October 2013). An algorithm was created on the basis of international guidelines to screen and triage suspected MERS-CoV patients. Once identified, patients were isolated, had a chest roentgenogram [chest radiography (CXR)] taken, and a nasopharyngeal swab for polymerase chain reaction (PCR) was sent with sputum samples for testing. Patients with normal CXR and mild respiratory symptoms were discharged with home isolation instructions until nasopharyngeal and sputum PCR results were available. Patients with fever and acute respiratory distress, with or without abnormal CXR, were treated in the hospital until tests proved negative for MERS-CoV. RESULTS: The protocol successfully reduced the number of patients who needed to be tested for MERS-CoV from 12,563 to 514, identified seven positive cases, and did not lead to apparent cross infectivity that resulted in serious illness or death. The protocol also increased the efficiency of ED and cut the turnaround time for nasopharyngeal swab and sputum results from 3 days to 1 day. CONCLUSION: A highly protocolized surveillance system limited the impact of MERS-CoV on ED functioning by identifying and prioritizing high-risk patients. The emergence of new infectious diseases requires constant monitoring of interventions to reduce the impact of epidemics on population health and health services. SN - 1473-5695 UR - https://www.unboundmedicine.com/medline/citation/26035278/Effectiveness_of_the_Middle_East_respiratory_syndrome_coronavirus_protocol_in_enhancing_the_function_of_an_Emergency_Department_in_Qatar_ L2 - https://doi.org/10.1097/MEJ.0000000000000285 DB - PRIME DP - Unbound Medicine ER -