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Objective: Early during the coronavirus disease 2019 (COVID‐19) pandemic, Australian EDs experienced an unprecedented surge in patients seeking screening. Understanding what proportion of these patients require testing and who can be safely screened in community‐based models of care is critical for workforce and infrastructure planning across the healthcare system, as well as public messaging campaigns. Methods: In this cross‐sectional survey, we screened patients presenting to a COVID‐19 screening clinic in a tertiary ED. We assessed the proportion of patients who met testing criteria; self‐reported symptom severity; reasons why they came to the ED for screening and views on community‐based care. Results: We include findings from 1846 patients. Most patients (55.3%) did not meet contemporaneous criteria for testing and most (57.6%) had mild or no (13.4%) symptoms. The main reason for coming to the ED was being referred by a telephone health service (31.3%) and 136 (7.4%) said they tried to contact their general practitioner but could not get an appointment. Only 47 (2.6%) said they thought the disease was too specialised for their general practitioner to manage. Conclusions: While capacity building in acute care facilities is an important part of pandemic planning, it is also important that patients not needing hospital level of care can be assessed and treated elsewhere. We have identified a significant proportion of people at this early stage in the pandemic who have sought healthcare at hospital but who might have been assisted in the community had services been available and public health messaging structured to guide them there. [ABSTRACT FROM AUTHOR]

Introduction: The global pandemic of coronavirus disease 2019 (COVID-19) has caused significant worldwide disruption. Although Australia and New Zealand have not been affected as much as some other countries, resuscitation may still pose a risk to health care workers and necessitates a change to our traditional approach. This consensus statement for adult cardiac arrest in the setting of COVID-19 has been produced by the Australasian College for Emergency Medicine (ACEM) and aligns with national and international recommendations.Main Recommendations: In a setting of low community transmission, most cardiac arrests are not due to COVID-19. Early defibrillation saves lives and is not considered an aerosol generating procedure. Compression-only cardiopulmonary resuscitation is thought to be a low risk procedure and can be safely initiated with the patient's mouth and nose covered. All other resuscitative procedures are considered aerosol generating and require the use of airborne personal protective equipment (PPE). It is important to balance the appropriateness of resuscitation against the risk of infection. Methods to reduce nosocomial transmission of COVID-19 include a physical barrier such as a towel or mask over the patient's mouth and nose, appropriate use of PPE, minimising the staff involved in resuscitation, and use of mechanical chest compression devices when available. If COVID-19 significantly affects hospital resource availability, the ethics of resource allocation must be considered.Changes in Management: The changes outlined in this document require a significant adaptation for many doctors, nurses and paramedics. It is critically important that all health care workers have regular PPE and advanced life support training, are able to access in situ simulation sessions, and receive extensive debriefing after actual resuscitations. This will ensure safe, timely and effective management of the patients with cardiac arrest in the COVID-19 era. [ABSTRACT FROM AUTHOR]

The creation of hospitals safe from disaster is an area of increasing public policy. The vulnerability of hospitals to damage and destruction during an event has profound implications for the health of a community. Although hospital evacuations do occur in Australia, their prevalence is unknown and what leads to a successful evacuation is poorly understood. This article reviewed the worldwide hospital evacuation literature to determine the prevalence of hospital evacuations and common precipitants for evacuation. Factors leading to safe evacuation and areas of ongoing challenge were identified. The findings highlight the need for more structured and detailed reporting of hospital responses to disaster. A number of lessons can be learned from hospitals that have experienced evacuation. Most critically, all hospitals must have a practised, detailed hospital evacuation plan existing before an impending threat. There are also areas for improvement in the areas of assessing the risk to the facility, communications, leadership, logistics, staffing and planning. These lessons should be included into comprehensive, detailed evacuation plans for all Australian hospitals, supported by a national framework that standardises planning and response. [ABSTRACT FROM AUTHOR]