To the Editor:
By late April 2020, greater than 2.6 million coronavirus disease 2019 (COVID-19) cases had been recorded worldwide. Emergency physicians and nurses face the challenge of safely evaluating patients and collecting respiratory and blood specimens. After the severe acute respiratory syndrome (SARS) outbreak in 2003, most emergency departments (EDs) in Taiwan developed isolation rooms for patients with possible infectious diseases. We describe an outdoor single-person isolation chamber with negative pressure now used in our ED to reduce COVID-19 exposure risk.
After triage, each person under investigation is directed to chest radiography examination and then an isolation chamber along a route outside the hospital. The provider interviews the patient through an intercom located at the front window. The provider collects upper airway specimens by using holes in the acrylic panel windows, which have a mounted pair of plastic gloves (Figure 1 ). Blood specimens are obtained through a small window on the side of the chamber (Figure 2 ). The chamber is maintained under negative-pressure ventilation through high-efficiency particulate air filters, so even if the window is opened, aerosols and droplets remain inside, thereby reducing the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission (Figure 2, red box on the left side). When the patient leaves the chamber, the room is sanitized by spraying alcohol and using an ultraviolet lamp, decreasing downtime for subsequent patient evaluation. Each cabin measures only 20 ft2, can be moved on wheels, and can be easily replicated. Our outdoor isolation chamber may be useful in reducing the risk of nosocomial COVID-19 infection and protecting ED staff.
Figure 1.
The image shows the isolation chambers with an intercom on the front. The doctor collects the specimen through the gloves. Then a swab is passed through a small hole between the 2 gloves.
Figure 2.
A small window is on the lateral side of the chamber. After opening the window, the patient extends his or her arm from the negative pressure chamber, and nurses can safely collect blood samples.
Footnotes
Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist.