Containment of critically ill patients in the emergency department during the pandemic

To the Editor—Early measures of infection prevention and control (IPC) when patients enter a healthcare facility during a pandemic are important in avoiding nosocomial spread as well as protecting healthcare workers.1 Severe acute respiratory coronavirus virus 2 (SARS-CoV-2), for example, is transmitted through close contact, droplets, or airborne particles formed by aerosol generation in the hospital setting. Resuscitation of the critically ill patients may generate infectious aerosol during endotracheal intubation or chest compression.2 Therefore, the critically ill patients with possibility of undergoing aerosol-generating procedures are recommended to receive treatment in negative pressure isolation rooms (NPIRs).3 To prevent nosocomial infections, lessons learned from the 2003 severe acute respiratory syndrome (SARS) outbreak were early cataloguing of and then isolating suspected cases.4,5 The specific protocol adopted by our ED during the current COVID-19 pandemic for containing critically ill patients was the establishment of screening point at the corridor in front of the main ED entrance. A specific route for critically ill patients to be admitted to the NPIR without entering the main ED reduces the risk of nosocomial spread during management and resuscitation.