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 Table of Contents  
LETTER TO THE EDITOR
Year : 2021  |  Volume : 59  |  Issue : 1  |  Page : 114-116

Utilization of hospital car parking garage for COVID-19 triage and screening in a high-volume tertiary eye care center


1 Department of Glaucoma and Research, Mahathma Eye Hospital Private Limited, Tiruchirappalli, Tamil Nadu, India
2 Department of Cataract and Refractive Surgery, Mahathma Eye Hospital Private Limited, Tiruchirappalli, Tamil Nadu, India
3 Department of Paediatric Ophthalmology and Strabismus, Mahathma Eye Hospital Private Limited, Tiruchirappalli, Tamil Nadu, India

Date of Submission06-Aug-2020
Date of Decision09-Oct-2020
Date of Acceptance18-Sep-2020
Date of Web Publication27-Mar-2021

Correspondence Address:
Dr. Prasanna Venkatesh Ramesh
Mahathma Eye Hospital Private Limited, No 6, Tennur, Seshapuram, Trichy 620 017, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjosr.tjosr_106_20

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How to cite this article:
Ramesh PV, Ramesh SV, Ramesh MK, Rajasekaran R. Utilization of hospital car parking garage for COVID-19 triage and screening in a high-volume tertiary eye care center. TNOA J Ophthalmic Sci Res 2021;59:114-6

How to cite this URL:
Ramesh PV, Ramesh SV, Ramesh MK, Rajasekaran R. Utilization of hospital car parking garage for COVID-19 triage and screening in a high-volume tertiary eye care center. TNOA J Ophthalmic Sci Res [serial online] 2021 [cited 2021 May 6];59:114-6. Available from: https://www.tnoajosr.com/text.asp?2021/59/1/114/312269



As cities brace for a steep influx of patients suffering from or suspected to be infected from the novel coronavirus (COVID-19), the sprint is on as ophthalmic professionals to make up for a woeful dearth of available hospital space, to triage all outpatient department (OPD) patients. To ensure optimal screening for COVID-19, we propose a novel cost-effective means of accommodating a triaging strategy in the hospital car parking garage present outside the hospital premises.

The existing hospital parking garages are experiencing declines due to the cancellation of nonemergency treatments and the limitations of visiting inpatients. As a result, hospital parking structures may be suitable for nonparking uses, like sorting out and classifying outpatients to determine the priority of need and proper place of treatment. In this regard, we developed an underground car parking triage standard operating protocol for screening possible COVID-19 patients, which does not replace any routine clinical triage already in place in health-care facilities.[1] All OPD patients are received in the underground hospital car parking garage present outside the hospital premises [Figure 1] and [Figure 2] and are asked to inform health-care providers if they have symptoms of respiratory illness. Multiple audiovisual alerts through television are provided on proper donning of face masks and social distancing [Figure 3].[2] Once body temperature and pulse oximetry are assessed and if within normal limits, the patient's uncorrected visual acuity is tested [Figure 4] and then allowed to enter into the hospital. The triage area is cleaned at least twice a day with a focus on frequently touched surfaces [Figure 5]. Disinfection is done with 0.1% (1000 ppm) chlorine or 70% alcohol for surfaces that do not tolerate chlorine. For large blood and body fluid spills, 0.5% (5000 ppm) chlorine is utilized.[3] Also to avoid droplet transmission due to air-conditioning, usage of air conditioning devices were avoided and we have used cross ventilation [Figure 6] to supply fresh air.[4]
Figure 1: (a) Hospital underground car parking garage present outside the hospital premises (red arrow). (b) Pre-COVID car parking garage

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Figure 2: Pre-COVID car parking garage converted in a triage area with social distancing norms followed while sitting

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Figure 3: Audiovisual education and awareness on donning of face masks, social distancing, and precautions to take inside the hospital premises

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Figure 4: Snellen visual acuity assessment with good ambient lighting supported by additional task lighting

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Figure 5: Disinfecting frequently touched surfaces by sanitary worker

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Figure 6: Panoramic view depicting cross ventilation fresh air flow (red arrow)

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As we gear up for unlocking from lockdown, there is a growing need for triaging space and patient wait areas for catering patients resuming OPD services in high-volume tertiary eye care centers. The COVID-19 pandemic should be treated as an opportunity to explore new and innovative safety methods. One such method is the usage of existing parking structures for triaging, which might not only free up inhospital space but also minimize unwanted patient movement inside the hospital premises.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Sengupta S, Honavar SG, Sachdev MS, Sharma N, Kumar A, Ram J, et al. All India Ophthalmological Society-Indian Journal of Ophthalmology consensus statement on preferred practices during the COVID-19 pandemic. Indian J Ophthalmol 2020;68:711-24.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Qian M, Jiang J. COVID-19 and social distancing. Z Gesundh Wiss 2020;25:1-3.  Back to cited text no. 2
    
3.
Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect 2020;104:246-51.  Back to cited text no. 3
    
4.
Experts suggest fresh air, ventilation may avert Coronavirus infection - ET HealthWorld [Internet]. ETHealthworld.com. Available from: https://health.economictimes.indiatimes.com/news/diagnostics/experts-suggest-fresh-air-ventilation-may-avert-coronavirus-infection/74078415. [Last accessed on 2020 Aug 03].  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]



 

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