ENCOVUR-2 study: Analysis of the protocols of action, management and availability of intensive care resources for patients with severe COVID-19 attended in Spanish Emergency Departments during the first peak of the pandemic
Por:
Miro, O, Alquezar-Arbe, A, Pinera, P, Jacob, J, Martin, A, Llorens, P, Jimenez, S, del Castillo, J, Garcia-Lamberechts, E, Martin-Sanchez, F, Burillo-Putze, G and Representacion Red Invest SIESTA
Publicada:
11 ago 2021
Ahead of Print:
11 ago 2021
Resumen:
Background: During the first wave of the COVID-19 pandemic, the availability of a critical care bed was insufficient. The aim of this work was to evaluate the presence of protocols, management in the emergency department (ED) and the availability of intensive care unit (ICU) beds for severe COVID-19 patients attended in Spanish hospital EDs during the first peak of the 2020 pandemic.
Methods: Questionnaire collecting data regarding ED care in March-April 2020 aimed at all Spanish public health care EDs. The respondents were the Chiefs of EDs. The variables of interest were: 1) Presence and of compliance with ED protocols for decision making and adequacy of therapeutic effort; 2) management of COVID-19 patients with non-invasive mechanical ventilation (NIMV) or high flow nasal cannula (HFNC) in the ED; and 3) ICU bed accessibility for ED patients. The results were compared based on the characteristics of the hospital, impact of the pandemic and autonomous community. A descriptive and inferential analysis of the variables studied was performed using the chi-square test and analysis of variance.
Results: A total of 246 questionnaires (89%) were received. Protocols were available in 136 EDs (57.1%). Globally, the protocol was applied in >95% of the EDs, although this was less frequent (76%) in EDs with high impact of the pandemic. 53% of the EDs managed patients with severe COVID-19 with NIMV/HFNC in the ED itself, and 19.4% suffered from lack of ICU beds. The lack of ICU beds for severe COVID-19 patients in the ED significantly differed among periods, and more marked in hospitals with ICC and with high pandemic impact.
Conclusions: it is needed to generalize the implementation of protocols in EDs for the management of severe COVID-19 patients and improve the capacity of the ICUs to homogeneously adjust to the needs.
Filiaciones:
Miro, O:
Univ Barcelona, Hosp Clin, IDIBAPS, Serv Urgencias, Barcelona, Spain
Alquezar-Arbe, A:
Hosp Santa Creu & Sant Pau, Serv Urgencias, Barcelona, Spain
Pinera, P:
Hosp Gen Univ Reina Sofia, Serv Urgencias, Murcia, Spain
Jacob, J:
Hosp Univ Bellvitge, Serv Urgencias, Lhospitalet De Llobregat, Barcelona, Spain
Martin, A:
Hosp Univ Mostoles, Serv Urgencias, Mostoles, Madrid, Spain
:
Univ Miguel Hernandez Elche, Hosp Gen Univ Alicante, Inst Invest Sanitaria & Biomed Alicante ISABIAL, Serv Urgencias, Elche, Spain
Jimenez, S:
Univ Barcelona, Hosp Clin, IDIBAPS, Serv Urgencias, Barcelona, Spain
del Castillo, J:
Univ Complutense, Hosp Clin San Carlos, Serv Urgencias, IDISSC, Madrid, Spain
Garcia-Lamberechts, E:
Univ Complutense, Hosp Clin San Carlos, Serv Urgencias, IDISSC, Madrid, Spain
Martin-Sanchez, F:
Univ Complutense, Hosp Clin San Carlos, Serv Urgencias, IDISSC, Madrid, Spain
Burillo-Putze, G:
Hosp Univ Canarias, Serv Urgencias, Tenerife, Spain
Open Access
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