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SPECIAL ARTICLE  COVID-19 SECTION Open accessopen access

Italian Journal of Emergency Medicine 2021 August;10(2):67-73

DOI: 10.23736/S2532-1285.21.00089-6

Copyright © 2021 THE AUTHORS

This is an open access article under the CC BY-NC-ND license

language: English

A solution to increase the surge capability in the Emergency Department in Vercelli during the second wave of COVID-19: the OBOE (OBI extended)

Roberta PETRINO 1 , Valeria ASARO 1, Michela GHISIO 1, Emanuela PASTORELLI 2

1 Emergency Department (MECAU), S. Andrea Hospital, ASL VC, Vercelli, Italy; 2 Andrea Hospital, ASL VC, Vercelli, Italy



The Emergency Department (ED) is the first like of the response to COVID-19 patients and during the peaks of pandemic waves has accepted many critical patients needing for immediate treatment and oxygen. The need of keeping separated pathways for COVID and non-COVID patients, the need of increasing the number of beds for COVID patients during the waives and the necessary latency, can put the ED in serious threat of great gatherings and lack of oxygen plugs. During the second wave (from November 2, 2020 to February 2, 2021) have faced the need to increase the ED surge capability by opening a 18 bed ward used as an Observation Unit Extended: the OBOE. It was staffed by emergency physicians and internists and by ED nurses and surgical department nurses. In the OBOE in 3 months, we transferred to the OBOE 424 patients of any severity, except the most critical ones. Two hundred eighty-five patients were admitted to hospital while the resto was discharged or transferred to lower care facilities, 29 patients died. In the ascending part of the wave the patients transferred to the OBOE were COVID patients and 188 were then admitted. In January we reduced the number of beds to 9 and accepted suspect patients with negative swab and then 97 were admitted. The OBOE permitted the conversion to and reconversion of wards from clean to COVID-19 and vice versa in a safe way by permitting to increase surge capability of the ED thanks to the collaboration of other departments and a close training process of personnel.


KEY WORDS: COVID-19; Surge capacity, Emergency service, hospital

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