Characteristics and countermeasures of emergency patients in chest pain, stroke and trauma centers in tertiary hospital during epidemic of Coronavirus Disease 2019

  Objective  To explore the characteristic changes of emergency patients visiting chest pain, stroke, and trauma centers in Subei People's Hospital during the outbreak of the Coronavirus Disease 2019 (COVID-19) in Yangzhou, and to propose corresponding strategies.

  Methods  The materials of patients visiting three major centers in our emergency rescuing department from July 28 to August 27, 2021(during the outbreak of COVID-19 in Yangzhou), July 28 to August 27, 2019 (no outbreak of epidemic) and July 28 to August 27, 2020 (regular prevention and control stage) were analyzed. The clinical parameters of the patients in the above period were observed, including gender, age, disease, Acute Physiology and Chronic Health Status Scoring System Ⅱ(APACHE Ⅱ) score, and the main efficiency indicators such as the time from admission to receiving reperfusion therapy for patients with acute myocardial infarction, the time from admission to the start of intravenous thrombolysis for patients with ischemic stroke and the waiting time before surgery for patients with severe trauma were compared. The possible causes of changes were analyzed and countermeasures were put forward.

  Results  During the outbreak of the epidemic in Yangzhou, the proportions of patients with chest pain and severe trauma in the emergency department were lower than those in the same period of previous two years (P < 0.05). The proportion of patients with acute coronary syndrome in the chest pain center decreased significantly (P < 0.05). The ratio of patients aged 80 years and above and the APACHE Ⅱ score of patients were higher than those in the same period of the previous two years (P < 0.05). There were no significant differences in the main rescue efficiency indicators during the outbreak compared with those in the same period of the previous two years (P>0.05).

  Conclusion  During local outbreaks of COVID-19, the three major centers of the emergency department in the tertiary hospitals need to be more concerned about elderly and critically ill patients. At this stage, the emergency center can ensure the medical efficiency of three centers by adjusting the layout and optimizing the process.