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新冠肺炎三級照護延伸之加強版集中檢疫所

Medicalized Quarantine Centers as Outposts of a Three-Tiered Hospital Care System in COVID-19 Pandemic

摘要


2021年5月全台新冠肺炎(COVID-19)疫情緊繃,雙北染疫病人數目遽增,新北市政府協請亞東醫院籌劃板橋、三重2家集中檢疫所,以收治無症狀與輕度症狀之確診者,本文分享集中檢疫所設計與收治過程,作為未來參考。集中檢疫所由亞東醫院、保安大隊、飯店管理3單位偕同,進行資源盤點,設置流程,包括:建置「檢疫所收治前檢傷篩檢」機制;救護車在集中檢疫所前等待病人檢傷,病情嚴重者直接後送;建置雲端全方位照護模式,確保居隔者在檢疫所身、心、靈安全,實現全人照護。集中檢疫所共檢傷評估881人,有61位(6.92%)經檢傷後直接轉送醫院治療,820位(93.08%)收治隔離,95位(11.59%)收治檢疫所後轉院治療,其中22位病人入住加護病房,重症比例2.68%,2人轉住院治療後死亡,死亡率0.24%,725名留所病人均健康出所,沒有任何人在所死亡,所有醫護同仁與後勤團隊零感染。檢疫所收治確診者發病至確診之平均天數、確診至入住檢疫所之平均天數,與發病至入住檢疫所之平均天數,隨著時問較檢疫所開設之初均有下降趨勢。面臨COVID-19疫情,措施都是滾動式調整,藉由這次面對疫情之經驗,有助於建立未來收治COVID-19病人集中檢疫所收治流程,強化醫院三級照顧模式,保存醫療量能。

並列摘要


Far-Eastern Memorial Hospital (FEMH) launched two quarantine centers in New Taipei City to treat asymptomatic or mildly symptomatic COVID-19 patients in May 2021 due to an outbreak. The teams who were responsible for the quarantine centers included medical staffs for medical care, and nonmedical staffs for guarding and logistic support. The processes to establish these centers included resources management, protocol design, triage principle setup, ambulance control for patient transfer, and online virtual reality wards for the holistic care of patients. A total of 881 patients were sent to the quarantine centers. Among them, 820 (93.08%) patients were admitted to the center and 61 (6.92%) patients were transferred to the base hospital directly according to the triage criteria. Ninety-five (11.59%) patients were transferred to the hospital after admission due to clinical deterioration and 22 (2.68%) of these patients required intensive care. There were 725 patients discharged from the centers smoothly and the mortality of patients admitted to the quarantine centers was 0.24% (2/820). No in-center mortality of patients and none of the medical and nonmedical staffs had any infectious complications. It is feasible and safe to transform hotels into quarantine centers which play as the outposts of a three-tiered care system of hospital in COVID-19 pandemic. It can reduce the workload of hospital staffs and prevent burnout during the pandemic.

參考文獻


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