ABSTRACT
Summary This article summarizes the work carried out within the framework of the NO-FEAR project during the COVID-19 pandemic. Remote seminars, organized during each of the waves, enabled the challenges faced by clinicians in each of the project's partner countries, to be confronted. These rich exchanges sometimes served as a wake-up call by highlighting challenges to be anticipated. The retrospective analysis of shared experiences makes it possible to make proposals to better understand the next health crisis, in terms of human resources and logistics, particularly with regard to oxygen requirements. The response to pandemics requires coordination and cooperation between practitioners, suppliers, researchers and policy makers. Résumé Cet article résume les travaux menés dans le cadre du projet NO-FEAR pendant la pandémie COVID-19. Des séminaires distanciels, organisés pendant chacune des vagues ont permis de confronter les enjeux auxquels les cliniciens de chaque pays partenaire du projet devaient faire face. Ces échanges riches ont parfois servi de lanceurs d’alerte en mettant l’accent sur des défis à anticiper. L’analyse rétrospective des expériences partagées permet de faire des propositions pour mieux appréhender la prochaine crise sanitaire, au plan humain et logistique, notamment au regard des besoins en oxygène. La réponse aux pandémies nécessite une coordination et une coopération entre les praticiens, les fournisseurs, les chercheurs et les décideurs politiques.
ABSTRACT
This article summarizes the work carried out within the framework of the NO-FEAR project during the COVID-19 pandemic. Remote seminars, organized during each of the waves, enabled the challenges faced by clinicians in each of the project's partner countries, to be confronted. These rich exchanges sometimes served as a wake-up call by highlighting challenges to be anticipated. The retrospective analysis of shared experiences makes it possible to make proposals to better understand the next health crisis, in terms of human resources and logistics, particularly with regard to oxygen requirements. The response to pandemics requires coordination and cooperation between practitioners, suppliers, researchers and policy makers.
ABSTRACT
OBJECTIVES: We aimed to determine the impact of a dedicated medical team (DMT) on ambulatory care for patients requiring oxygen. METHODS: The DMT selected patients requiring oxygen for less than 5 l/min in the emergency department (ED). The rate of ED readmission was compared in patients managed by the DMT and those managed by the ED physicians (EDPs). Consensual treatment for COVID-19 pneumonia with oxygen requirement was steroids + preventive anticoagulation. RESULTS: A total of 1397 patients with COVID-19 came to our ED from the first to the 31st of August, 2021, among whom 580 (41%) had ambulatory care. A total of 82 (14.1%) patients were managed by the DMT, with a rate of ED readmission of 4.8% (4/82), compared with 13.6% (68/498) for those managed by EDPs (P <0.001). Focusing on the 45/498 (9.0%) patients requiring oxygen and managed by EDPs, the rate of ED readmission was 20%, P = 0.017. Prescription of the consensual treatment concerned 96% versus 40% for those patients requiring oxygen for the DMT and the EDP, respectively (P <0.001). CONCLUSION: A DMT for ambulatory care of patients with COVID-19 requiring oxygen was associated with less return to the ED than usual practices.
Subject(s)
COVID-19 , Patient Readmission , Ambulatory Care , Anticoagulants , COVID-19/therapy , Emergency Service, Hospital , Humans , Oxygen , Retrospective StudiesABSTRACT
Résumé La mission Résilience Dixmude des Armées a réalisé 12 transferts inter-hospitaliers durant la première vague de la crise COVID-19 en 25 jours de patrouilles actives dans l’arc antillais permettant de réduire les pertes de chances des patients COVID+ et non COVID hospitalisés dans les îles du nord et les îles du sud de la Guadeloupe. Le principe de délestage des patients des établissements en double insularité en cas de situation sanitaire exceptionnel doit être retenu et opéré avec des moyens opérationnels adaptés. Summary The Resilience Dixmude mission of the Armed Forces carried out 12 inter-hospital transfers during the first wave of the COVID-19 crisis in 25 days of active patrols in the French West Indian region, making it possible to reduce the loss of chances of COVID+ patients and not COVID hospitalized in the northern islands and the southern islands of Guadeloupe. The principle of offloading patients from establishments with double insularity in the event of an exceptional health situation must be retained and operated with suitable operational resources.