Over the course of these past several weeks, the Emergency Department (ED) at Sierra View Medical Center (SVMC) has been on the forefront of safety implementation and crafting a set of rapidly evolving protocols to help combat the spread of COVID-19 and keeping patients safe.
To ensure the utmost safety for patients, the community, and staff, all hands were on deck to make essential transformations within the ED in preparation and as a result of the pandemic. “The entire re-structure of our processes involved many persons and departments,” said Kevin Dooms, SVMC Emergency Department RN Interim Clinical Manager. “From Engineering, Information Technology, Bio-Engineering, Infection Prevention Control, Environmental Services, Security, Risk Management, and the ED staff who adapted to almost daily changes in processes, were all an integral part of being prepared for any COVID-19 cases to a potential surge.”
Within the ED, the SVMC Engineering Team created a four bed, negative air pressure treatment area with the ability to safely treat COVID-19 positive or potential positive patients. Patients of all severities can be treated in this area that is equipped with cardiac and respiratory monitors, oxygen, video conferencing capabilities, equipment available to handle emergencies including the ability to utilize ventilators in that area. The engineering team created anterooms so that there is never direct access between a COVID-19 patient area and the remainder of the ED. In the anterooms, there is a staff changing area allowing staff to safely remove CDC recommended protective gear (PPE) and to store it when not in use.
“All ED staff has been trained in wearing PPE and have adapted to swiftly changing equipment as CDC guidelines evolve,” Dooms added. “Nursing and support staff rotate through the designated isolation area in approximately six hour shifts.
What began in preparation within the ED, outside measures also took precedence in mid-March when a temporary tent was erected in the circle driveway at the ED entrance. In accordance with CDC’s recommendations, the tent was installed to provide a place to screen persons for possible respiratory illness, as well as other potential COVID-19 cases, prior to their entering the building. Dooms explained that this was done to protect the staff and patients from persons who have few to no symptoms but are carriers of the virus.
The temporary tent was replaced with a larger, climate controlled tent structure in the same week that the initial tent was installed. The new tent structure is designed to be a pre-screening area for patients, visitors and staff. It also provides as a comfortable, climate controlled, High Efficiency Particulate Air (HEPA) filtered waiting area for potential COVID-19 patients at all times that meets the CDC social separation requirements.
“During this time, contingency plans have been made to utilize the tent structure as a treatment area should the ED become overwhelmed with patients,” Dooms explained. “On standby for deployment are cots, boxed supplies, internet and intranet wireless access points for documentation and communication. At this time, we have not provided patient care in the tent – however a plan is in place should the need arise.”
The preparation and keeping up with ever-changing mandates being placed around COVID-19 kept the SVMC ED busier than ever. Although the ED team have tirelessly put much work into preparing for COVID-19, they are still hard at work and are diligent about their practices and protocols to keep our community safe.