Infection control protocol of the Fujigaoka Hospital Emergency Room during the COVID-19 crisis

Abstract

Several medical institutions fumbled while establishing countermeasures to ensure the safety of patients and medical professionals during the coronavirus disease 2019 （COVID-19） pandemic. Herein, we introduce the COVID-19 infection countermeasures practiced at the Fujigaoka Hospital emergency room （ER）. Triaging, personal protection, and infrastructure improvement are the main countermeasures practiced. Sometimes, the data obtained from emergency service, patients, and family members may be inadequate, and even asymptomatic patients may have COVID-19. Therefore, nurses initiated triaging in June 2020 for all emergency patients. This enabled the stratification of examination order, examination location, and COVID-19 risk. In July 2020, regardless of the COVID-19 pandemic, all ER staff at our hospital mandatorily started using N95 masks and eyeguards as standard personal protective equipments because aerosol-generating procedures, such as performing suction, may be required unexpectedly. Earlier, there was only one examination room for negative-pressure ventilation. Therefore, all examination booths were converted into ventilated private rooms with a window, a bed, and a ventilation fan in each booth. An airborne isolation unit was installed in examination rooms without a window. In December 2020, two automatic negative-pressure boosts were installed in the recovery room for infection control. Patients with COVID-19 could be examined at all booths. Although all emergency patients were suspected to have COVID-19, changes in the ER improved medical care efficiency. No COVID-19 infections occurred among the nurses and critical care physicians working in ERs by practicing these infection control measures. We hope that the infection control protocol practiced at the Showa University Fujigaoka Hospital ER will be helpful for other institutions.