Emergency Department Changes to Combat COVID-19 in Oman

Area of Science:

• Emergency Medicine
• Infectious Disease Control
• Hospital Management

Background:

• Tertiary care hospitals faced challenges managing the surge of coronavirus disease (COVID-19) patients.
• Initial modifications to the emergency department (ED) included a COVID suspect room and separate resuscitation area, but capacity was limited.
• Overcrowding in COVID-19 wards and intensive care units posed a significant challenge.

Purpose of the Study:

• To describe the adaptive strategies implemented in an Omani tertiary care hospital's emergency department to manage COVID-19 patient influx.
• To detail the evolution of patient flow and capacity building measures within the ED.
• To address the specific challenges of symptom concealment and cross-contamination in the ED setting.

Main Methods:

• Phased implementation of structural changes within the main ED.
• Establishment of a separate COVID emergency department (CED).
• Re-routing of all acute respiratory patients, regardless of suspected COVID-19 status, to a designated area.

Main Results:

• Initial ED modifications had limited patient throughput capacity.
• A separate CED resolved pending admission issues with central command support.
• Designating a specific area for all acute respiratory patients mitigated exposure risks in the main ED.

Conclusions:

• Adaptive strategies, including dedicated facilities and revised patient flow, are crucial for managing infectious disease outbreaks in emergency departments.
• Effective patient management and containment of infectious diseases require flexible infrastructure and coordinated command systems.
• Protecting healthcare staff and non-COVID patients from exposure is paramount during pandemics.