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Emergency medicine doctors note improved ED situation but stress importance of social distancing

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The Irish Association of Emergency Medicine (IAEM) has noted a decrease in attendances to emergency departments (EDs) during the current Covid-19 crisis, but has stated that the key to tackling the pandemic is for the public to follow guidance on social distancing.

In a statement on Friday 20 March, the IAEM said: “The Association cannot emphasise too much just how important it is to lessen the impact on the finite capacity of our healthcare system by reducing the number of patients requiring acute hospital care simultaneously and reiterates strongly the need for the public to follow the clear guidance on social distancing, cough etiquette and the importance of repeated, prolonged hand washing to help achieve this goal.”

The Association referred to “much speculation and some ill-informed commentary” on the impact that the presence of Covid-19 in the community and the measures taken to combat it are having on Ireland’s EDs.

The IAEM stated: “Our view as the experts in emergency medicine is that the flow of patients through EDs has improved greatly as a result of a number of main factors. These include: i) a reduced number of ED attendances due to there being fewer episodes of injury, infection and the exacerbations of chronic conditions in the community as a result of the cancellation of mass gatherings, the closure of venues and social distancing; ii) the cancellation of scheduled non-emergency work in the healthcare system resulting in the dedication of the entire bed stock to emergency care, and iii) the hard work of staff in all areas of the health system to concentrate on and optimise patient flow.

“Many of those whose acute hospital care had been completed but who remained in an acute hospital pending the provision of services or resources in the community (the so called delayed discharges) have now been moved to where they should have been. While these reduced rates of attendance have allowed time for staff to concentrate on the extra training required to ensure optimum preparedness, the Association is keen to reassure the public that the management of all time critical emergency presentations e.g. stroke, heart attack, severe breathing difficulties and injury requiring hospital attendance etc continues without interruption.

“Optimum preparedness in many EDs has included early diversion of patients into separate streams of those with suspected Covid-19 infection and all other ED patients. We have some concerns that patients, in particular the elderly, may be minded not to seek medical attention for conditions which genuinely require urgent medical intervention so it is important to emphasise that while facing the undeniable challenge of the Covid-19 pandemic, consultants in emergency medicine, doctors training to be consultants in emergency medicine, other doctors working in emergency departments (EDs), our ED nursing two colleagues and other staff working in Irish EDs will continue to deliver care to the sick and injured as best they can on an on-going basis.

“The enormous efforts being made by colleagues in very many other medical specialties and by hospital management to ensure that hospitals are as well prepared as they can be to deal with the expected onslaught must also be acknowledged.”

The IAEM said it will be the actions of the public at large that will ultimately determine whether these preparations have been successful or not.

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