While initially deployed to increase Emergency Department surge capacity, the MSED was repurposed to cohort and treat COVID patients with the monoclonal antibody, Bamlanivimab, who were expected to be discharged after treatment. rapidly deployable Mobile Satellite Emergency Department (MSED) with scalable capability from prompt care to resuscitation level allowed the emergency care team to optimize patient care and throughput. The MSED was strategically located adjacent to the ambulance entrance. While initially deployed to increase Emergency Department surge capacity, the MSED was repurposed to cohort and treat COVID patients with the monoclonal antibody, Bamlanivimab, who were expected to be discharged after treatment. This allowed for more efficient use of Emergency Department resources, including physical space and staffing. strong class=”kwd-title” Keywords: COVID-19, Mobile Satellite Naringin (Naringoside) Emergency Department, COVID monoclonal antibody treatment, Bamlanivimab, COVID-19 patient isolation, COVID-19 patient treatment area 1. Introduction This communication explains the use of a unique mobile medical asset to improve patient care Naringin (Naringoside) and optimize the use of Emergency Department (ED) resources during the COVID-19 pandemic. The location of use is the Hackensack Meridian HealthJersey Shore University Medical Center in Neptune, New Jersey. The Jersey Shore University Medical Center is usually a 630-bed academic medical center in the Eastern Central part of the state. The Emergency Department volume is usually approximately 88,300 patients per year, with 20,000 being pediatric (2019 pre-COVID). The specific innovation addressed in this communication is the treatment of patients diagnosed with COVID-19 with the monoclonal antibody Bamlanivimab in a unique alternate care area. Naringin (Naringoside) These are generally patients who are scheduled to present for treatment and whose discharge is anticipated after treatment. The process can take several hours, since it involves evaluation, intravenous infusion, and re-evaluation post-treatment. Coupled with the required isolation, a significant amount of Emergency Department resources can be consumed. The availability of a unique trailer based mobile medical asset, coupled with patients being scheduled well in advance, has allowed the implementation of a specialized patient flow pathway to optimize care and throughput. Patients receiving the antibody were treated in a dedicated Mobile Satellite Emergency Department (MSED) located outside the ambulance entrance of the normal Emergency Department. Naringin (Naringoside) This communication will discuss details and considerations of staffing, supply, patient flow, and the unique Mobile Satellite Emergency Department. 2. Materials and Methods The Mobile Satellite Emergency Department (MSED) is usually part of a unique fleet of mobile medical assets originally developed by Hackensack University Medical Center, Hackensack, New Jersey, with federal government funding, circa 2010. The intent of the program was to provide a capability for an individual hospital to deploy mobile rapid response hospital-level medical care. Three prototype medical models and support vehicles were designed and built collaborating with vehicle manufacturers. There were also various research efforts related to the fleet development [1,2]. The prototype program and associated research projects were successful. When federal government funding ended a non-profit consortium of multiple Naringin (Naringoside) hospitals and health care organizations were formed to continue the program. The program is known as the the Advanced Mobile Emergency Resource Coalition (AMERCO); http://www.amercousa.org/, accessed on 26 May 2020. Five categories of missions were anticipated, including disaster response where local resources were overwhelmed or transport to them impaired, providing surge capacity during occasions of high patient volume, community outreach to the underserved, providing alternate clinical space during hospital repairs or construction and a clinical treatment area for patients requiring special isolation precautions. Over the years, the models have been deployed for all of these missions, including, in 2018, to St Croix, USVI, post-hurricane. The models are nominally 50 foot trailers with expandable sides that are compatible with commercial tractors. They are highly mobile and are driven as standard tractor trailers. When open, the nominal footprint is usually 25 50 feet. Two are configured to function as well-equipped Emergency Departments or Intensive Care Rabbit polyclonal to HMGN3 models. One is configured as a formal operating suite, complete with a hospital grade sterilizer. Models can function individually or be connected with enclosed climate controlled connectors. If necessary, all three models can function alone, with no external utilities required. Each has an on-board electrical power generator, heating-ventilation-air conditioning (HVAC) systems, water tank, wastewater tank, oxygen supply, satellite and cellular communications links. During extended deployments, the models can be connected to external sources; detailed requirements for this are listed in Appendix A. The MSED deployed for COVID-19 monoclonal antibody treatment was one of the Emergency Department/Intensive Care Models. The unit is usually configured with seven stretchers with bedside cardiorespiratory monitors connected to a central monitoring/alarm station, portable digital X-Ray, medical gas.
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