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Preparing for the Maximum Emergency with a Simulation: A Table-Top Test to Evaluate Bed Surge Capacity and Staff Compliance with Training
INTRODUCTION: The sudden increase in the number of critically ill patients following a disaster can be overwhelming. STUDY OBJECTIVE: The main objective of this study was to assess the real number of available and readily freeable beds (“bed surge capacity”) and the availability of emergency operati...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7678714/ https://www.ncbi.nlm.nih.gov/pubmed/33235525 http://dx.doi.org/10.2147/OAEM.S267069 |
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author | Ceresa, Iride Francesca Savioli, Gabriele Angeli, Valentina Novelli, Viola Muzzi, Alba Grugnetti, Giuseppina Cobianchi, Lorenzo Manzoni, Federica Klersy, Catherine Lago, Paolo Marchese, Pierantonio Marena, Carlo Ricevuti, Giovanni Bressan, Maria Antonietta |
author_facet | Ceresa, Iride Francesca Savioli, Gabriele Angeli, Valentina Novelli, Viola Muzzi, Alba Grugnetti, Giuseppina Cobianchi, Lorenzo Manzoni, Federica Klersy, Catherine Lago, Paolo Marchese, Pierantonio Marena, Carlo Ricevuti, Giovanni Bressan, Maria Antonietta |
author_sort | Ceresa, Iride Francesca |
collection | PubMed |
description | INTRODUCTION: The sudden increase in the number of critically ill patients following a disaster can be overwhelming. STUDY OBJECTIVE: The main objective of this study was to assess the real number of available and readily freeable beds (“bed surge capacity”) and the availability of emergency operating rooms (OR) in a maximum emergency using a theoretical simulation. PATIENTS AND METHODS: The proportion of dismissible patients in four areas (Medical Area, Surgical Area, Sub-intensive Care Units, Intensive Care Units) and three emergency OR was assessed at 2 and 24 hours after a simulated maximum emergency. Four scenarios were modeled. Hospitalization and surgical capacities were assessed on weekdays and holidays. The creation of new beds was presumed by the possibility of moving patients to a lower level of care than that provided at the time of detection, of dislocation of patients to a discharge room, with care transferred to lower-intensity hospitals, rehabilitation, or discharge facilities. The Phase 1 table-top simulations were conducted during the weekday morning hours. In particular, the 24-hour table-top simulations of a hypothetical event lasted about 150 minutes compared to those conducted at 2 hours, which were found to be longer (about 195 minutes). Phase 2 was conducted on two public holidays and a quick response time was observed within the first 40 minutes of the start of the test (about 45% of departments). RESULTS: The availability of simulated beds was greater than that indicated in the maximum emergency plans (which was based solely on the census of beds). Patients admitted to Intensive Care and The Sub-Intensive Area may be more difficult to move than those in low-intensity care. The availability of emergency OR was not problematic. Age influenced the possibility of remitting/transferring patients. CONCLUSION: Simulation in advance of a maximum emergency is helpful in designing an efficient response plan. |
format | Online Article Text |
id | pubmed-7678714 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-76787142020-11-23 Preparing for the Maximum Emergency with a Simulation: A Table-Top Test to Evaluate Bed Surge Capacity and Staff Compliance with Training Ceresa, Iride Francesca Savioli, Gabriele Angeli, Valentina Novelli, Viola Muzzi, Alba Grugnetti, Giuseppina Cobianchi, Lorenzo Manzoni, Federica Klersy, Catherine Lago, Paolo Marchese, Pierantonio Marena, Carlo Ricevuti, Giovanni Bressan, Maria Antonietta Open Access Emerg Med Original Research INTRODUCTION: The sudden increase in the number of critically ill patients following a disaster can be overwhelming. STUDY OBJECTIVE: The main objective of this study was to assess the real number of available and readily freeable beds (“bed surge capacity”) and the availability of emergency operating rooms (OR) in a maximum emergency using a theoretical simulation. PATIENTS AND METHODS: The proportion of dismissible patients in four areas (Medical Area, Surgical Area, Sub-intensive Care Units, Intensive Care Units) and three emergency OR was assessed at 2 and 24 hours after a simulated maximum emergency. Four scenarios were modeled. Hospitalization and surgical capacities were assessed on weekdays and holidays. The creation of new beds was presumed by the possibility of moving patients to a lower level of care than that provided at the time of detection, of dislocation of patients to a discharge room, with care transferred to lower-intensity hospitals, rehabilitation, or discharge facilities. The Phase 1 table-top simulations were conducted during the weekday morning hours. In particular, the 24-hour table-top simulations of a hypothetical event lasted about 150 minutes compared to those conducted at 2 hours, which were found to be longer (about 195 minutes). Phase 2 was conducted on two public holidays and a quick response time was observed within the first 40 minutes of the start of the test (about 45% of departments). RESULTS: The availability of simulated beds was greater than that indicated in the maximum emergency plans (which was based solely on the census of beds). Patients admitted to Intensive Care and The Sub-Intensive Area may be more difficult to move than those in low-intensity care. The availability of emergency OR was not problematic. Age influenced the possibility of remitting/transferring patients. CONCLUSION: Simulation in advance of a maximum emergency is helpful in designing an efficient response plan. Dove 2020-11-16 /pmc/articles/PMC7678714/ /pubmed/33235525 http://dx.doi.org/10.2147/OAEM.S267069 Text en © 2020 Ceresa et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Ceresa, Iride Francesca Savioli, Gabriele Angeli, Valentina Novelli, Viola Muzzi, Alba Grugnetti, Giuseppina Cobianchi, Lorenzo Manzoni, Federica Klersy, Catherine Lago, Paolo Marchese, Pierantonio Marena, Carlo Ricevuti, Giovanni Bressan, Maria Antonietta Preparing for the Maximum Emergency with a Simulation: A Table-Top Test to Evaluate Bed Surge Capacity and Staff Compliance with Training |
title | Preparing for the Maximum Emergency with a Simulation: A Table-Top Test to Evaluate Bed Surge Capacity and Staff Compliance with Training |
title_full | Preparing for the Maximum Emergency with a Simulation: A Table-Top Test to Evaluate Bed Surge Capacity and Staff Compliance with Training |
title_fullStr | Preparing for the Maximum Emergency with a Simulation: A Table-Top Test to Evaluate Bed Surge Capacity and Staff Compliance with Training |
title_full_unstemmed | Preparing for the Maximum Emergency with a Simulation: A Table-Top Test to Evaluate Bed Surge Capacity and Staff Compliance with Training |
title_short | Preparing for the Maximum Emergency with a Simulation: A Table-Top Test to Evaluate Bed Surge Capacity and Staff Compliance with Training |
title_sort | preparing for the maximum emergency with a simulation: a table-top test to evaluate bed surge capacity and staff compliance with training |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7678714/ https://www.ncbi.nlm.nih.gov/pubmed/33235525 http://dx.doi.org/10.2147/OAEM.S267069 |
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