An emergency department response to severe acute respiratory syndrome: a prototype response to bioterrorism

摘要: Abstract Study objective On March 13, 2003, Singapore physicians were alerted about an outbreak of atypical pneumonia that became known as severe acute respiratory syndrome (SARS). I describe the application emergency department (ED) disaster response plan to manage SARS outbreak. Methods The ED implemented protection for staff, patients, and facility; infection control measures; disaster-response workflow changes. Ministry Health, Singapore, centralized cases in hospital, national screening center. A questionnaire a set admission criteria applied after assessment clinical features chest radiograph findings. Results For duration ended on May 31, screened 11,461 persons SARS, whom 1,386 (12.9%) admitted rule out 235 (17%) confirmed have SARS. Among 10,075 discharged from ED, there 28 reattending patients who diagnosed with giving undertriage rate 0.3% (95% confidence interval [CI] 0.1% 0.4%). sensitivity was 89.4% CI 85.6% 93.1%), specificity 89.7% 89.2% 90.3%). positive predictive value 17% 15.7% 18.4%), negative 99.7% 99.6% 99.8%). No patient contracted result visit. After full implementation protective measures, 1 nurse undiagnosed diabetes mellitus treated suspected Conclusion Although not bioterrorism event, applicable outbreak's management. use enabled screen, treat, safely discharge majority patients.