[Challenges in visceral medicine during COVID-19]. / Herausforderungen der Viszeralmedizin bei COVID-19: Erfahrungen aus einem Krankenhaus der Grund- und Regelversorgung.

ABSTRACT

BACKGROUND: The worldwide dissemination of the coronavirus disease 2019 (COVID-19) pandemic has become a relevant problem for the German healthcare system and the whole of society within only a few weeks. Because visceral medicine is at the focal point many adjustments in procedures are necessary. MATERIAL AND METHODS: Necessary organizational structures and challenges in visceral medicine are described for urgent abdominal surgery after screening and for patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Therefore, an analysis of the current and relevant literature was performed and changes in the procedures in a hospital for basic and standard healthcare in Lower Rhine are described. RESULTS: This article describes the organizational structures and changes in a German hospital facing the crisis and management during the pandemic. These include establishment of a corona screening center at the hospital's main entrance and a multidisciplinary crisis management team. Specific internal guidelines were formulated for the management, confirmed by international experience and studies and regularly changed due to the requirements of the situation. CONCLUSION: In comparison to other countries the crisis reached hospitals in Germany with a clear delay and a relatively mild course. In order to be prepared for severely ill patients, adequate preparations could be made to meet the challenges on intensive care units, isolation wards, operating theaters and in endoscopy. The primary goal was the safeguarding of patients and employees. In the light of the pandemic medical rituals and habits need to be reconsidered.