key: cord-0983401-wx01e94i
authors: Camus, Marine; Becq, Aymeric; Jaïs, Benedicte; Dray, Xavier
title: Resource-sparing urgent endoscopies by a mobile on-call team in the Paris area during the COVID-19 outbreak
date: 2020-04-16
journal: Gastrointest Endosc
DOI: 10.1016/j.gie.2020.04.021
sha: 550f8d3100bc49e0e51ee7659b8693ee55723546
doc_id: 983401
cord_uid: wx01e94i

nan

We have read with interest the article by Repici et al. 1 Our institution, Assistance Publique -Hôpitaux de Paris (APHP) brings together 39 university hospitals in the Greater Paris area, comprising 16 endoscopy units. In the context of the COVID-19 outbreak, only urgent endoscopy acts are performed, whereas COVID-19 dedicated medical and critical care units are mobilized. We report herein on how a mobile Parisian on-call endoscopy team (POET) performs urgent endoscopy acts outside regular hours, by means of a portable equipment, in a dense urban area (6.7 million inhabitants within 762 km 2 ), hence allowing the most effective use of manpower where and when needed.

There are 3 such on-call teams operating in Paris and its suburbs. We decided to extend the outreach of POET (usually within the Paris city limits) to the whole Greater Paris area. POET is based in the Saint-Antoine Hospital located in Paris where reprocessing and equipment storage take place. The team comprises, for each round of interventions, a senior physician and a paramedic, both specialized in endoscopy. These caregivers are used in one of the APHP hospitals and have clearance to perform urgent acts in all the critical care units of these hospitals. Therefore, patients from outside hospitals or clinics in the greater Paris area are transferred for endoscopy in one of these APHP sites. The mobile team is equipped with a 7kg portable processor (Telepack X GI, Karl Storz, Tuttlingen, Germany), 3 endoscopes (GI Silver Scope Series, Karl Storz), a 4-kg portable power source (Vio 100C, Erbe, Tuebingen, Germany), and ancillary tools (Fig. 1) , carried on a foldable moving cart (Fig. 2) .

POET relies on transportation by taxicab, from one hospital to another to perform urgent acts.

All necessary precautions and procedures are those described in the recent publication by Repici et al. 1 This new organization allows a more optimal deployment of caregivers in other departments.

A mobile team reduces the need for patients' transportation at a time when the ambulance system and logistics are saturated. We expect that it also probably reduces the risk of dissemination of the virus. Further, traffic is virtually nonexistent due to the confinement, hence allowing rapid transit between hospitals. We believe that this system simplifies how urgent endoscopies are performed at a time of crisis when smart protocols and logistics procedures are critical. 

COVID-19) outbreak: what the department of endoscopy should know