NC hospitals use tents, diagnostic centers to keep COVID patients out of emergency rooms
If you have a respiratory illness and go to the emergency departments at UNC Medical Center in Chapel Hill or Duke University Hospital in Durham, your first stop may be to a tent outside the building.
The tents are part of a strategy by both hospitals to keep potential coronavirus patients separated from the rest of their patients and staff, to reduce the chance of spreading the disease.
So-called triage tents are becoming common at hospitals across the country that are preparing for an onslaught of patients who have COVID-19 or who think they do. Several hospitals in the UNC Health system are working to erect triage tents, including Onslow Memorial Hospital. Novant Health has set up tents outside emergency rooms at its hospitals in Charlotte, Salisbury and Winston-Salem.
Duke and UNC are using the tents in different ways. At Duke, two tents that extend from the hospital’s enclosed ambulance bay are equipped with all the beds and equipment needed to treat up to 40 patients with respiratory illness at a time, says Chad Seastrunk, vice president for emergency services.
“It’s like a mini emergency department,” Seastrunk said in an interview. “You’re able to take this particular patient population and screen them and treat them appropriately.”
Duke’s tented emergency room should be completed Wednesday but is not yet being used. Seastrunk said Duke wanted to have the facility ready before it’s needed, so there won’t be any snags when coronavirus patients begin arriving in significant numbers.
UNC began using the triage tent outside its emergency department on Wednesday, in part because it plays a different role in how the hospital manages coronavirus patients.
Instead of a place to treat patients, the UNC tent is designed for screening them, apart from the regular emergency room. Patients with serious respiratory illness who need hospitalization can be admitted; the emergency department can safely treat up to 21 respiratory patients suspected of having COVID-19 in negative pressure areas to prevent the virus’ spread, said Christian Lawson, director of emergency preparedness and planning.
Less serious cases are being referred to a respiratory diagnostic center nearby, Lawson said. UNC has set up respiratory centers near eight of the 11 hospitals in its system, where potential COVID-19 patients can be evaluated, tested and treated before being sent home.
“If we sent everybody to the emergency department, that would just obliterate our ability to see those patients that need to be seen,” Lawson said in an interview.
UNC has not publicized the locations of its respiratory diagnostic centers, because it doesn’t want patients to show up unannounced. If a UNC Health patient develops coronavirus symptoms or has been exposed to a confirmed coronavirus patient, UNC says they should call their primary care provider or the UNC Health Helpline, 1-888-850-2684, where someone will determine whether they should visit one of the diagnostic centers.
Emergency rooms are for the critically ill
WakeMed has not erected any tents outside its hospitals, but opened its first respiratory diagnostic center on Monday. Like the UNC centers, WakeMed’s is an appointment-only site.
The respiratory diagnostic centers, like the tents, are strategies for keeping emergency departments from being overrun with potentially contagious people. Hospitals say that unless someone is critically ill, they should first try a physician, clinic or helpline if they think they need a coronavirus test.
“We’ve seen hospitals in other countries and other states get flooded with symptomatic patients,” Jose Cabanas, an emergency physician and Wake County EMS director/medical director, said in a written statement. “It created an environment ripe for COVID-19 transmission and negatively impacted the hospitals’ ability to treat seriously ill patients.”
“We don’t want that to happen here,” Cabanas continued, “so we’re working with the hospitals to route people to the right resources for testing.”
Frank DeMarco has worked at Duke University Hospital for 25 years and says the hospital has set up tents outside before. But DeMarco, the associate chief nursing officer for emergency services, says those tents were set up for drills.
“We do quite a few disaster drills,” DeMarco said in an interview. “But we’ve never set it up to actually take care of emergency department patients coming in.”
This story was originally published March 18, 2020 at 12:38 PM with the headline "NC hospitals use tents, diagnostic centers to keep COVID patients out of emergency rooms."
