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QUEENS WEEKLY, APRIL 12, 2020
An inside look at Elmhurst Hospital as told by
the director of the emergency department
BY JENNA BAGCAL
Since the end of last month,
Elmhurst Hospital has been the
center of the COVID-19 crisis in
Queens, admitting about 200 patients
who tested positive for the
virus as of March 30.
Elmhurst’s Emergency Department
Director, Dr. Stuart Kessler,
described the experience as “challenging”
and added that “no hospital
in the country was prepared” to
deal with a pandemic of these proportions.
Kessler praised the hospital and
its healthcare staff, including attending
physicians, residents, midlevel
practitioners and nurses and
said in the past, they have trained
for “disaster and mass casualties.”
“It’s a totally different experience.
I’ve been doing emergency
medicine for more than 20 years
and none of us could have imagined
what we’re seeing,” said Kessler.
“I still sometimes have a hard
a time getting my head around the
fact of what we’re seeing today. It’s
something very different than anything
we’ve ever thought would
happen or could happen.”
Making adjustments
According to Kessler, the early
parts of March brought “huge volumes
of patients that we never expected
to see.” The doctor estimated
that during that time, Elmhurst
admitted more than double the patients
that would come on any other
given day.
“It started with a few patients
that I don’t think anyone would
recognize would likely turn out to
be patients infected with coronavirus.
We then gradually saw a huge
increase in our volume of patients
that were coming to the emergency
department,” he said.
The dramatic increase in
patients required the staff at
Elmhurst to make changes in the
way they staffed their employees
and in treating patients diagnosed
with the virus.
“We had to figure out who of all
those patients was really sick and
who needed the most intense care
or who could get a medical screening
exam, be given good discharge
instructions and told that they
could go home fairly rapidly after a
thorough evaluation,” Kessler said.
According to Kessler, the issue
wasn’t the amount of patients admitted
to the hospital but rather
People wait in line to be tested for coronavirus disease (COVID-19) while wearing protective gear outside Elmhurst Hospital Center on March 25, 2020.
REUTERS/Stefan Jeremiah
their acuity, or severity of their illness.
The doctor said that over the
past few weeks, Elmhurst saw an
increase in those patients who became
seriously ill from COVID-19.
“Now, it wasn’t so much that
there was a huge volume of patients
walking in, there was just a large
number of really sick patients.
We’ve intubated more patients in
two or three days than we would in
two or three months,” Kessler said.
To offer an alternative to going
inside the hospital for testing,
Elmhurst set up an outdoor tent
next to the emergency department.
“Some people were just coming
to the emergency department because
they wanted to get tested. So
we were able to give them an option
that didn’t require them to come to
the emergency department, they
had the option, if they chose, to get
tested,” said Kessler.
A need for more supplies
Prior to the COVID-19 outbreak,
Kessler said that Elmhurst had
enough resources, including ventilators,
for “any day of the week.”
“But when people began to realize
what the need was, it was something
that was sort of extraordinary.
It required us to work really
hard to try and get the resources
we needed,” Kessler said. “So, I’m
sure there was some concern on
everybody’s part about how many
patients are going to come in tomorrow
that need to be intubated
and put on vents and can we get
enough vents to manage all the patients
that need them.”
What he and other hospital staff
try to do is to manage their needs
on a daily basis and determine if
they’ll have enough resources to
last for the next two to five days and
beyond that.
“We’ve managed to keep up and
that’s great. So the fear is just, will
we be able to keep up today and
will we have enough for tomorrow,”
he said. “We’re always concerned
and we’re always looking to get
more because we know if we have
enough today, that doesn’t necessarily
mean we’ll have enough
tomorrow. We always have to be
looking to get more tomorrow and
more the next day and more the
next day.”
Fortunately, the doctor said that
leadership, including Vice President
of NYC Health + Hospitals
Israel Rocha Jr., hospital administrators
and the government have
provided “great support” in providing
enough supplies for Elmhurst’s
needs.
So far, Kessler said that they
have not run out of supplies and
added that a lot of people have
“stepped up” to donate PPE to the
hospital.
“I think in hospitals that haven’t
experienced this yet, they’re gonna
go through the same kind of learning
experience that we have as to
what’s the extent of PPE how should
you wear it, how much do you need,
how often do you need to change it.
Those are all things we’re learning
as we go,” said Kessler.
Healthcare heroes
In terms of handling a health
situation that no one could have
prepared for, Kessler said that the
whole hospital and the emergency
department has “done a great job,”
volunteering for extra shifts, coming
in when they are not scheduled
to work and going above and beyond
their normal roles.
“They’ve stepped up in amazing
ways, they’re doing things that
they’ve never imagined they would
have to do. In our department and
throughout the hospital but everybody
in the ED has just been more
than I could have ever asked for,”
said Kessler. “There’s been no one
that’s said no to any request or requirements,
they’ve all in fact volunteered
to do more. They’ve all
spent time learning how to best
treat these patients.
“Everybody in my department
knows how to work a vent, they
know the different types of vents
and they know how to use them in
a very short period of time,” Kessler
continued. “We have a really strong
residency program and our nurses
and everybody have stepped up
in exceptional ways.”
Reach reporter Jenna Bagcal
by e-mail at jbagcal@qns.com or by
phone at (718) 260-2583.
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