Coronavirus: Quebec hospital guidelines will help protect patients and staff, says ER specialist

The Quebec government announced new guidelines on Thursday to protect frontline workers in hospital emergency rooms from COVID-19.

“The protocol was completely reviewed yesterday and we have given out new instructions across the province,” said Quebec Health Minister Danielle McCann.

The new measures will allow healthcare workers to apply COVID-19 criteria to every patient showing symptoms of an infectious disease.

“Any person who goes to an emergency room with infectious symptoms, such as a sore throat or gastro, will be given a mask to wear and will be required to wash their hands,” McCann said.

The news was welcomed by health care workers who had been pushing for new guidelines.

“Staff were quite worried,” said Gilbert Boucher, president of the Quebec association of emergency medicine specialists.

“As of last evening, if you were coming in coughing in the emergency with a bit of fever but no other reason, all you had is a mask, ” he said of the protection allowed to health workers.

Boucher explained that full protective gear was reserved for specific cases only and is thankful for the changes.

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“They lifted the criteria for needing epidemiological reasons,” he said.

Prior to the new directives, Boucher explained that to be considered a possible COVID-19 patient, you needed to have been travelling in the past three weeks, needed to be in contact with someone who had been travelling or have been in contact with a person who tested positive for the illness.

Now, doctors in the emergency room will be able to suit up for anyone showing infectious symptoms offering them more protection.

“The people in front of you will be properly protected, and if they’re properly protected, the chance of them being infectious to you is much less.”

Last week, two emergency room doctors became sick and around 500 specialists and some 300 nurses were in quarantine, according to Boucher.

“Now is the time to protect our workers because as everyone is saying this is going to be a  marathon, not a sprint,” Boucher said.

“We need all the health care workers we can to be lasting as long as we can.”

Patients arriving at emergency rooms across the province will be going through preliminary triage outside the hospital where tents have been, or are being, set up.

The idea is to divide patients and the emergency room into three zones or categories: positive patients, negative patients and in-betweens.

“If you come to emergency and we don’t know if you’re positive or negative, we don’t want to put you in the cold zone with the healthy patients because you might infect them,” Boucher said. “We don’t want to put you in the hot zone with the infected ones because you’ll be infected.”

The goal is to only bring in patients that need to be admitted to the hospital and reduce the risk of contagion.

The new measures also have the added benefit of cutting down on the amount of protective gear used on a daily basis.

“If you gown in and gown out with every patient, you can use 20-25 gears per day,” Boucher said.

“Whereas if things are zoned, they gear in in the morning, get in the zone and stay there all day. Then you use one or two gears for the entire day. So that decreases the usage by 90, 95 per cent.”

The Quebec college of physicians also announced Thursday that it will be making an exception for resident doctors to allow them to help during the pandemic.

As final exams have been pushed back, those who have completed their training, but not taken final examinations required for licensing, will be given special permits valid until June 2021.

— With files from Global’s Dan Spector

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