Electronic personal protective equipment: A strategy to protect emergency department providers in the age of COVID-19

Abstract Emergent policy changes related to telemedicine and the Emergency Medical Treatment and Labor Act during the novel coronavirus disease 2019 (COVID-19) pandemic have created opportunities for technology-based clinical evaluation, which serves to conserve personal protective equipment (PPE) and protect emergency providers. We define electronic PPE as an approach using telemedicine tools to perform electronic medical screening exams while satisfying the Emergency Medical Treatment and Labor Act. We discuss the safety, legal, and technical factors necessary for implementing such a pathway. This approach has the potential to conserve PPE and protect providers while maintaining safe standards for medical screening exams in the emergency department for low-risk patients in whom COVID-19 is suspected.

[1]  D. Eitel,et al.  Reliability and validity of a new five-level triage instrument. , 2000, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[2]  T. Nesbitt,et al.  Pediatric Critical Care Telemedicine Program: A Single Institution Review. , 2016, Telemedicine journal and e-health.

[3]  J. Hollander,et al.  Virtually Perfect? Telemedicine for Covid-19. , 2020, The New England journal of medicine.

[4]  J. Zibulewsky The Emergency Medical Treatment and Active Labor Act (Emtala): What It Is and What It Means for Physicians , 2001, Proceedings.

[5]  Mirou Jaana,et al.  Systematic review of telemedicine applications in emergency rooms , 2015, Int. J. Medical Informatics.

[6]  R. Body,et al.  Auscultating to diagnose pneumonia , 2007, Emergency Medicine Journal.

[7]  G. Kelen,et al.  Use of Telemedicine to Screen Patients in the Emergency Department: Matched Cohort Study Evaluating Efficiency and Patient Safety of Telemedicine , 2019, JMIR medical informatics.

[8]  F. Buckner Emergency Medical Treatment and Labor Act (EMTALA). , 2002, ED management : the monthly update on emergency department management.

[9]  A. Agthe,et al.  Telemedicine: A Reliable Tool to Assess the Severity of Respiratory Distress in Children. , 2016, Hospital pediatrics.

[10]  Benjamin A Lipsky,et al.  Diagnosing pneumonia by physical examination: relevant or relic? , 1999, Archives of internal medicine.

[11]  K. L. Rockwell,et al.  Emergency Telemedicine: Achieving and Maintaining Compliance with the Emergency Medical Treatment and Labor Act. , 2018, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[12]  T. Greenhalgh,et al.  Covid-19: a remote assessment in primary care , 2020, BMJ.

[13]  W T Haeck,et al.  American College of Emergency Physicians. , 1970, The Journal of the Florida Medical Association.

[14]  R. Hopstaken,et al.  Diagnostic value of signs, symptoms and diagnostic tests for diagnosing pneumonia in ambulant children in developed countries: a systematic review , 2018, npj Primary Care Respiratory Medicine.

[15]  J. Pang,et al.  Clinical features for diagnosis of pneumonia among adults in primary care setting: A systematic and meta-review , 2019, Scientific Reports.

[16]  J. Benger,et al.  The safety and effectiveness of minor injuries telemedicine. , 2004, Emergency medicine journal : EMJ.

[17]  Len Gray,et al.  The application of telemedicine to geriatric medicine. , 2007, Age and ageing.