The emergency department is by its nature a place where we see all kind of patients coming in to get treated, when sick. The infections and its consequences to the human body are of the common occurring in the emergency department and the emergency physician has to act quick and think methodically to deal with patients presenting with any kind of infection.
Care in the emergency department affects the inpatient stay of the patients. Prevention and treating hospital acquired Infections(HAI) is challenging part of the emergency care. It is due to the fact that in the process of emergency care in the ED there are uncertainties regarding patients flow, unpredictable number of patients and lastly fluctuating disease occurrence. In the emergency department almost all infections can spread, but mostly it is the throat, nose, lung and skin related infections that are responsible for most of the infections spreading in the patients. These are mostly seasonal and includes usual infections like Flu, RSV, Rhinovirus and Adenovirus. Other infections that can also spread are bacterial infections especially of the lung origin and at times skin infections.
The patients coming to the ED are with common and overlapping presentations which cause at times multiple physicians and multiple interventions before a firm diagnosis can be established. Similarly, in order to decrease the spread of infections, consistent and expedient execution of infection control measures are needed. Infectious control measures start at the design of the emergency department and is always a continuum which includes ongoing education, developing competence, containment measures for the infection, treatment options, decontamination and isolation techniques to stop the flow of infection. There is no such thing as infection free emergency department, but we can create a safety culture and create a safe emergency department.
In order to outline infectious disease issues in the emergency department we need to look at the subject from various angles. Starting from the education of the patients coming to the emergency department to the types of infections and the ED design. Each aspect is equally important and should be studied on a continuous basis to always be ahead in the fight against the spread of infections. The community needs to be strong and knowledgeable to deal with this task. Individual patients and the community at large should always be in communication with the healthcare community through different ways and means. Whether it be a brochure or newsletter or a TV program, or it could be a group meeting or community function. These instances should always be guiding the community and the patients regarding the aspects of infectious disease where these a little time spent may produce great impact.
The next channel in the struggle to stop the spread of infection is the pre-hospital care. The infection control practices should be known and conveyed to the community with periodic educational efforts. It should be in the form of identification of infections, using personal protection, isolating the infected person, decontamination of the place and communicating the incidence to the stakeholders. As a different angle we need to categorize the type of infection based upon the source as it has the treatment implications and problems of resistance to antibiotics. Most of the organism in the community are presumed to be sensitive to common antibiotics but this pattern is changing at alarming pace and resistance is developing in the community forcing us to be vigilant as well as progressive in dealing with the infections and infected patients. Healthcare related infections are by resistant organism and pose a problematic encounter of physicians with the patients.
The emergency departments need to be designed thoughtfully as a better design have effects not only in treatment domain but also in the domain of preventive medicine. The better designed emergency department helps the patient flow in the ED. It helps deal with the patients load and improve the performance of the staff. It also prevent the cross contamination of infections among the patients, staff and other treating individuals. This ultimately results in safety of the patients and the staff as well as containment of the infections with limited exposure to unsuspecting patients as well as other staff.
The world that we live in is as good as we like to keep it, so improving the healthcare and preventing the disease is one of the ways to make it a better place and enrich our living. It is a combined task and a team approach will be the best way to achieve that goal.