When Torrance Memorial Medical Center’s expert team of health care
professionals began planning the hospital’s COVID-19 response in
February, they knew that the Emergency Department (ED) would likely be
the first stop for people who were seriously ill as a result of the coronavirus.
“In emergency medicine, we are used to being the ‘front door,’
so we have lots of experience with triage and making decisions with limited
information,” says Zachary Gray, MD, MPH, co-medical director of
the Torrance Memorial Melanie and Richard Lundquist ED. “We used
every stream of information we could find to develop our COVID-19 response
plan, and we were able to draw from our disaster management training and
our experience with other highly infectious diseases such as Ebola, H1N1
One of the team’s first steps was to set up a large outdoor triage
area for the ED and develop specialized triage procedures to assess the
likelihood each patient may be infected with COVID-19. Based on the results
of this initial assessment, people who had a potential COVID-19 infection
and those who were not potentially infectious were sent to separate waiting
and treatment areas within the ED.
Next, the ED team developed guidelines for the use of personal protective
equipment (PPE) to safeguard staff and patients. In the COVID-19 area
of the ED, which is sealed off from the rest of the department, staff
wear eye protection, masks, gloves and gowns. When an airway procedure
is performed, staff follow more stringent guidelines and use additional
PPE. Although there was initial concern about having sufficient PPE to
handle the expected number of COVID-19 patients, the overwhelming surge
never occurred at Torrance Memorial and PPE remains in ample supply.
In the non-COVID-19 area of the ED, staff wear eye protection, gloves and
masks. In both areas, patients are asked to wear masks.
The safety measures implemented at Torrance Memorial’s ED—
including specialized triage procedures, isolation of COVID-19 patients
and PPE protocols—proved to be effective during the initial stages
of the pandemic and continue to remain in place. Torrance Memorial has
also implemented mandatory daily screening and temperature checks for
everyone who enters the facility, physical distancing protocols, enhanced
cleaning and a “no visitor” policy with limited exceptions.
If necessary, the outdoor triage area, which has since been taken down,
can be easily restored to serve the patient community.
“All of our COVID-19 response plans remain in place, so there is
no reason to delay emergency care” says Dr. Gray. “We've
combined what we’ve learned about COVID-19 so far with our experience
and training to ensure our staff and patients are cared for and protected.
Our team is constantly analyzing community risks and remains ready to
meet the community’s needs.”