Preventing SARS-CoV-2 transmission in the emergency department by implementing a separate pathway for patients with respiratory conditions.

Fulwah Alqahtani,Muna Aljahany,Fadilah Sfouq Aleanizy,Mohammad Alraye,Wajdan Alassaf,Mercy Joseph,Marzouqah Alanazi

doi:10.1515/jcim-2020-0422

Abstract

This study aimed to describe the development and implementation of a separated pathway to check and treat patients with a suspected/confirmed coronavirus disease 2019 (COVID-19) in the emergency department (ED) at King Abdullah bin Abdulaziz University Hospital in Riyadh. We conducted a retrospective, descriptive longitudinal study from March to July 2020by analyzing data of all confirmed cases of COVID-19 among ED visitors and healthcare workers in King Abdullah bin Abdulaziz University Hospital. During the study period, a total of 1,182 swab samples were collected for testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), of which 285 (24.1%) tested positive. Of the 285 cases of confirmed SARS-CoV-2 infection, 18 were healthcare workers and 267 were patients. As a result of using the respiratory pathway for COVID-19 patients, the hospital managed to limit transmission of SARS-CoV-2 not only between patients but also between patients and healthcare workers, while also containing the pandemic. There were no cases of nosocomial SARS-CoV-2 infection recorded among the patients who visited the ED or the flu clinic. All confirmed cases were community acquired and patients were cared for under constrained measures. Implementing infection control measures and restricting those with respiratory symptoms to the ED pathway prevented nosocomial spread of SARS-CoV-2 infection in the ED.

Highlights

Most healthcare facilities provide services to patients with suspected or confirmed coronavirus disease 2019 (COVID-19) during COVID-19 pandemic [1]
This study aimed to describe the development and implementation of a separated pathway to check and treat patients with a suspected/confirmed coronavirus disease 2019 (COVID-19) in the emergency department (ED) at King Abdullah bin Abdulaziz University Hospital in Riyadh
During the COVID-19 epidemic in Saudi Arabia, a respiratory pathway was created in King Abdullah bin Abdulaziz University Hospital (KAAUH) that accepted patients and healthcare workers (HCWs) with suspected or confirmed COVID-19/

Summary

Introduction

Most healthcare facilities provide services to patients with suspected or confirmed coronavirus disease 2019 (COVID-19) during COVID-19 pandemic [1]. Healthcare facility managers should implement infection control procedures in emergency departments (EDs) to prevent the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to patients and healthcare workers (HCWs) [1]. Isolation, and management of suspected cases are vital, while limiting the number of contacts and hospital visits is important, to the prevention of SARS-CoV-2 transmission. It is preferable to restrict the movement of patients with suspected COVID-19 to a separate pathway to prevent the spread of SARS-CoV2 among other patients and HCWs [2]. EDs in healthcare facilities are an important source of cases, as they provide care to patients who present without prior appointment, either as walk-ins or by an ambulance. Most hospital EDs operate 24 h a day, 7 days a week, staffing levels may vary according to the patient volume [4]

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