Emergency department : COVID-19 crisis and organizational aspects / Urgences hospitalieres : crise COVID-19 et aspects organisationnels

ABSTRACT

Emergency departments are on the front line in the management of COVID-19 cases, from screening to the initial management of the most severe cases. The clinical presentation of COVID-19 range from non-specific symptoms to adult acute respiratory distress syndrome (ARDS). Diagnosis is based on PCR from a nasopharyngeal swab and emergency treatment rely on oxygen therapy. Patient's orientation (home, hospitalization, admission in intensive care unit) is a central aspect of emergency management. The shift from a strategy of systematic recognition of potential cases to the one of epidemic mitigation required hospital emergency medicine services to implement crisis management measures, to guarantee admission and hospitalization capacity. Les services durgences sont en premiere ligne dans la gestion des cas de COVID-19, quil sagisse du depistage ou de la prise en charge des cas les plus severes. La clinique associee au COVID-19 va de symptomes non specifiques au syndrome de detresse respiratoire aigue de ladulte. Le diagnostic repose sur la PCR a partir dun frottis nasopharynge et le traitement durgence sur loxygenotherapie. Lorientation du patient (retour a domicile, hospitalisation, indication aux soins intensifs) est un aspect central de la prise en charge aux urgences. Le passage de la strategie de reconnaissance systematique des cas potentiels a celle de la mitigation de lepidemie a implique pour les services durgences hospitaliers la mise en place de mesures exceptionnelles afin de garantir une capacite daccueil et dhospitalisation.