Filière ambulatoire COVID-19 aux urgences : retour d’expérience et perspectives()

AIMS: SARS-CoV2 has caused a pandemic in 2020. We describe the creation of an ambulatory sector dedicated to COVID-19 in an emergency department (ED). PROCEDURE: Patients on stretcher or with emergency signs were managed in an ED dedicated area by emergency physicians. The other COVID-19-suspect patients were managed in another area, under a tent, by physicians with another specialty. Paper files were used to save time. Following the national recommendations at that time [Haut Conseil de la santé Publique], nasopharyngeal swabs for SARS-CoV-2 RT-PCR were performed for patients being at risk of severe disease, patients being inhospitalized, healthworkers, and first cases of a new cluster. RESULTS: From March 16th to May 7th 2020, 57 physicians representing 17 medical or surgical specialties different from emergency medicine realized 224 shifts of 5 h. During that period of time, 2039 consultations in the ED were related to COVID-19, of which 1542 took place in the ambulatory care area under the tent. Eventually, 1819 (93 %) consultations led to discharge from hospital, 114 (6 %) to hospitalization in a medical ward, and 23 (1 %) in intensive care unit. CONCLUSION: Creating dedicated area because of contagiousness, and the large number of patients attending the ED in a short period of time, require caregiver reinforcement. Integration of the reinforcements is easier when a precise procedure has been established and when they are provided with initial teaching and mentoring. Respect of the ED organization allows to provide effective care to all patients.