Original Articles Open access

COVID-19 pandemic management at the Emergency Department: the changing scenario at the University Hospital of Pisa

Authors

Published
9 September 2020
Section
Original Articles
DOI
10.4081/ecj.2020.9146

Abstract

Starting from 1st case in Italy, on February 20th, 2020, CO-rona VI-rus D-isease 2019 (COVID-19) pandemic spread to whole Italian territory, with different regional distribution. Tuscany has been classified as medium diffusion area (40-100 cases/100000 inhabitants). In this context, all healthcare structures reviewed their organization to meet new needs. Our study’s objectives were description of organizational model outlined to safely manage Emergency Department (ED) and analysis of patients’ flows within Hospital of Pisa during pandemic. The ED has been reorganized with dedicated areas for examination and waiting for tests results. A similar reduction (-62%) of ED accesses comparing to the same period of 2019 and the previous months of 2020 was observed. Hospital Task Force arranged for progressive activation of Units by modules, according to territorial needs. From the beginning of March to the end of April 2020, 315 COVID-19 patients were hospitalized. Overall, a 45% reduction in hospital admissions compared to the same period of 2019 was observed, with increased mortality (4% versus 2%). The University Hospital of Pisa efficiently managed COVID-19 emergency with a logistical reorganization of ED.

Keywords

References

  1. World Health Organization. General's opening remarks at the media briefing on COVID-19 :11 March2020. 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-themedia-briefing-on-covid-19---11-march-2020.
  2. Coronavirus COVID-19 global cases by the Center for Systems Science and Engineering (CSSE)at JohnsHopkins. . 2020. https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
  3. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. DOI: https://doi.org/10.1016/S0140-6736(20)30183-5
  4. Italian Ministry of Health. Covid-19. Situazione in Italia. 2020. www.salute.gov.it/portale/nuovocoronavirus/dettaglioContenutiNuovoCoronavirus.jsp?lingua=italiano&id=5351&area=nuovoCoronavirus&menu=vuoto.
  5. Italian Ministry of Health. Covid-19, Decreto #Iorestoacasa.
  6. Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020. DOI: https://doi.org/10.1001/jama.2020.5394
  7. Grasselli G, Pesenti A, Cecconi M. Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response. JAMA. 2020. DOI: https://doi.org/10.1001/jama.2020.4031
  8. Italian National Institute of Statistics. Impatto dell’epidemia covid-19 sulla mortalità totale della popolazione residente primo trimestre 2020 2020.
  9. Istituto Superiore di Sanità. Sorveglianza integrata COVID-19 in Italia. 2020. www.iss.it/documents/20126/0/Infografica_09marzo.pdf/1f62ad0a-e156-cf27-309d-26adcb1b52b4?t=1583782049035.
  10. Rhodes A, Ferdinande P, Flaatten H, Guidet B, Metnitz PG, Moreno RP. The variability of critical care bed numbers in Europe. Intensive Care Med. 2012;38(10):1647-53. DOI: https://doi.org/10.1007/s00134-012-2627-8
  11. Regione Toscana. Linee di indirizzo per la gestione del percorso COVID-19 in ambito ospedaliero e peri-ospedaliero. 2020. http://www301.regione.toscana.it/bancadati/atti/Contenuto.xml?id=5247300&nomeFile=Ordinanza_del_Presidente_n.14_del_17-03-2020-Allegato-A.
  12. Rosenbaum L. Facing Covid-19 in Italy - Ethics, Logistics, and Therapeutics on the Epidemic's Front Line. N Engl J Med. 2020;382(20):1873-5. DOI: https://doi.org/10.1056/NEJMp2005492
  13. Kokkinakis I, Selby K, Favrat B, Genton B, Cornuz J. [Covid-19 diagnosis : clinical recommendations and performance of nasopharyngeal swab-PCR]. Rev Med Suisse. 2020;16(689):699-701.
  14. Erika P, Andrea V, Cillis MG, Ioannilli E, Iannicelli T, Andrea M. Triage decision-making at the time of COVID-19 infection: the Piacenza strategy. Intern Emerg Med. 2020. DOI: https://doi.org/10.1007/s11739-020-02350-y
  15. Gargani L, Soliman-Aboumarie H, Volpicelli G, Corradi F, Pastore MC, Cameli M. Why, when, and how to use lung ultrasound during the COVID-19 pandemic: enthusiasm and caution. Eur Heart J Cardiovasc Imaging. 2020. DOI: https://doi.org/10.1093/ehjci/jeaa163
  16. De Filippo O, D'Ascenzo F, Angelini F, Bocchino PP, Conrotto F, Saglietto A, et al. Reduced Rate of Hospital Admissions for ACS during Covid-19 Outbreak in Northern Italy. N Engl J Med. 2020. DOI: https://doi.org/10.1056/NEJMc2009166
  17. La Nazione. A Viareggio Passeggiata e negozi strapieni. "L’incoscienza ci ha spaventati". 2020. https://www.lanazione.it/viareggio/cronaca/versilia-coronavirus-1.5062393.
  18. Italian Civil Protection Department. Decreto ministeriale del 13 febbraio 2001: criteri di massima per i soccorsi sanitari nelle catastrofi. 2001. http://www.protezionecivile.gov.it/amministrazione-trasparente/provvedimenti/dettaglio/-/asset_publisher/default/content/decreto-ministeriale-del-13-febbraio-2001-criteri-di-massima-per-i-soccorsi-sanitari-nelle-catastrofi.
  19. Decreto Legislativo 9 Aprile 2008, n. 81. Testo Unico sulla salute e sicurezza sul lavoro. 2008.
  20. Remuzzi A, Remuzzi G. COVID-19 and Italy: what next? Lancet. 2020;395(10231):1225-8. DOI: https://doi.org/10.1016/S0140-6736(20)30627-9

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