On the Front Line: Manitoba’s Busiest Emergency Department and the COVID-19 Pandemic
“There’s been some talk that emergency departments don’t appear to be that busy, but I can assure you that we are very busy. We are responding to the needs of COVID-19 patients but we still have the same volume of other very serious health emergencies that we are dealing with.” – Dr. Shelly Zubert, Assistant Director, Adult Emergency Department, HSC
In HSC’s adult emergency department, Dr. Shelly Zubert, the emergency department’s Assistant Director and Chad Chapman, Acting Director of Patient Care, momentarily find themselves in a room without patients. On this day, members of the media have been granted a rare peak inside the walls of Manitoba’s Provincial Hospital, and the space is being used to address false claims spreading on social media about how busy Manitoba EDs are during COVID-19.
“We are still seeing the same number of acute resuscitations that we normally see in pre-COVID-19 times that can be between 15 and 30 major resuscitations of very sick individuals every single day,” says Zubert. “In addition, we are seeing many critically ill patients with COVID-19 every day. Many of those patients will require admission to hospital. With COVID-19 precautions in place, those patients are staying with us in the emergency department for a longer time.”
On any given day, between 16-27 patients may spend prolonged periods of time in the emergency department as they wait for COVID-19 test results, Chapman explains.
“We put patients in treatment areas as quickly as possible so they can be isolated appropriately,” says Chapman. “We have rapid testing in place for all patients being admitted through emergency and once those swabs are sent off, the patient has to stay in emergency until those test results come back before we can safely transfer them to the appropriate unit.”
The requirement to test patients being admitted is just one of many changes COVID-19 has brought to this department. Planning, preparation and simulations have allowed staff to adapt to the adjustments that have had to be made in order to keep staff – and other patients – safe from the deadly virus.
In the main unit, every patient treatment area has become a dedicated space, with plastic curtains installed to create a barrier between patients and additional equipment has been installed in the resuscitation areas. The area is loud and staff are wearing respirators or masks, gowns and other personal protective equipment (PPE), necessary precautions that have added to the workload and risk faced by the department’s physicians and staff.
“With the community spread, we have to assume a lot of the patients coming in have COVID-19 exposures,” says Zubert. “For those patients where we have to rapidly respond or where we do not have a history for them, we assemble a team, prepare before the ambulance arrives and approach the patient wearing PPE. It’s important that we make sure everything is ready and that all members of the team know who is doing what.”
As Zubert answers a question about emergency department volumes, a page sounds overhead summoning two resuscitation teams to prepare for incoming patients.
“All of the staff are rising to the occasion,” says Zubert, adding, “We have an outstanding team of health care workers who are experts in delivering care and connecting with patients, working tirelessly to find solutions and to advocate for their patients and always finding a way to bring humanity to the bedside, even when the demands on them are relentless.”
There is a heightened level of urgency as the teams prepare for the impending arrivals. Within seconds, staff are assembled, PPE is donned and preparations are underway.
“There’s been some talk that emergency departments don’t appear to be that busy, but I can assure you that we are very busy. We are responding to the needs of COVID-19 patients but we still have the same volume of other very serious health emergencies that we are dealing with,” concludes Zubert.