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Review
. 2022 Mar;53(1):159-166.
doi: 10.1016/j.jmir.2021.12.007. Epub 2021 Dec 30.

A review of the effectiveness of fever tent setup in COVID-19 pandemic from a radiology perspective

Liang Meishi Melissa  1 , Chua Sze Ting  2 , Chan Man Fung Manful  2 , Chionh Hui Li  2 , Chooi Chi Yuen Clara  2 , Clare Louise Jones  2 , Sarah Li Hui Tan  2 , Soong Si Min Veronica  2 , Tan Yi Xuan  2 , Low Xi Zhen  2
Affiliations
Review

A review of the effectiveness of fever tent setup in COVID-19 pandemic from a radiology perspective

Liang Meishi Melissa et al. J Med Imaging Radiat Sci. 2022 Mar.

Abstract
in English, French

Introduction: This paper describes our experience in setting up a dedicated imaging facility within a temporary fever tentage in an acute tertiary hospital in Singapore during the coronavirus disease 2019 (COVID-19) pandemic. We review the effectiveness of the setup and its role from the radiological perspective in detail.

Methods: The dedicated imaging facility within the temporary fever tentage was equipped with a computer-on-wheels (COWs) to access patients' medical records and a portable x-ray machine to allow for a smooth workflow. Radiation dose measurements were acquired around the imaging facility using phantoms and dosimeters to ensure radiation safety.

Results: Due to its rapid nature and availability as a screening tool, chest x-ray (CXR) is the most widely used imaging modality during the COVID-19 pandemic. Our dedicated fever tent setup minimizes possible in-hospital transmission between both patients and staff and provides a more streamlined workflow to tackle the high workload. It allowed us to reduce the time required for each radiograph, providing timely imaging services and radiological reports for expedient clinical screening.

Discussion: The close collaboration between Radiology and Emergency Departments in setting up the fever tentage is a crucial tool in managing the COVID-19 pandemic. The fever tentage imaging facility is a highly effective tool, providing the means to handle the increased patient load in a streamlined and safe manner during a pandemic.

Conclusion: This paper provides insights and guidelines in setting up a dedicated imaging service within the fever tent for future infectious disease outbreak contingency plans.

Introduction: Cet article décrit notre expérience dans la mise en place d’une installation d’imagerie dédiée dans une tente temporaire pour la fièvre dans un hôpital tertiaire de Singapour pendant la pandémie de coronavirus 2019 (COVID-19). Nous examinons en détail l’efficacité de cette installation et son rôle du point de vue radiologique.

Méthodologie: L’installation d’imagerie dédiée dans la tente temporaire pour la fièvre comprenait un ordinateur sur roues pour accéder aux dossiers médicaux des patients et une machine à rayons X portable pour permettre un flux de travail fluide. Des mesures de la dose de rayonnement ont été effectuées autour de l’installation d’imagerie en utilisant des fantômes et des dosimètres pour garantir la sécurité radiologique.

Résultats: En raison de sa rapidité et de sa disponibilité en tant qu’outil de dépistage, la radiographie pulmonaire est la modalité d’imagerie la plus utilisée pendant la pandémie de COVID-19. Notre installation de tente réservée à la fièvre minimise les risques de transmission à l’hôpital entre les patients et le personnel, et permet un flux de travail plus rationnel pour faire face à la charge de travail élevée. Elle nous a permis de réduire le temps nécessaire à chaque radiographie, en fournissant des services d’imagerie et des rapports radiologiques opportuns pour un dépistage clinique rapide.

Discussion: L’étroite collaboration entre la radiologie et le service des urgences pour la mise en place de la tente pour la fièvre est un outil crucial pour nous permettre de gérer la pandémie de COVID-19. L’installation d’imagerie de la tente pour la fièvre est un outil très efficace, fournissant les moyens de gérer l’augmentation du nombre de patients d’une manière rationnelle et sûre pendant une pandémie.

Conclusion: Cet article fournit des indications et des lignes directrices pour la mise en place d’un service d’imagerie dédié dans la tente pour la fièvre pour les futurs plans d’urgence en cas d’épidémie de maladie infectieuse.

Keywords: COVID-19; Chest X-ray; Effectiveness; Fever tent; Radiology.

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Figures

Fig. 1
Fig. 1
The situational update in Singapore from 29 March 2020 to 7 July 2020. Circuit Breaker (CB) started on 7 Apr 2020 shown by the red arrow, followed by Phase 1 and Phase 2 shown by the green arrows. During CB period, an elevated set of safe distancing measures were implemented to pre-empt the trend of increasing local transmission of COVID-19. Phases of reopening were implemented, phase 1 (Safe reopening) and phase 2 (Safe transition) with measures progressively lifted. The daily new cases gradually iincreased from the end of March and spiked in mid-April. After that, the graph shows a decreasing trend of daily new cases.
Fig. 2
Fig. 2
Shows the overall layout of the fever tent with dedicated x-ray area, consultation rooms, nurse station, swab area, ECG station and patient holding area. The perimeter of the fever tent area is demarcated by wooden planks.
Fig. 3
Fig. 3
The layout of the fully functional fever tent x-ray area, with portable machine (radiation sign), computer-on-wheels (C.O.W). changing area, changing area and industrial cooler. The x-ray area was lined with multiple lead shields in an overlay fashion for radiation protection. The x-ray tube was positioned 180cm away from the imaging plate for consistency of chest x-rays.
Fig. 4
Fig. 4
The average radiation survey meter (RSM) readings, 0.31μSv/hr, 0.41μSv/hr, 0.38μSv/hr and 0.54μSv/hr at four regions. The readings were taken with the primary x-ray beam (blue arrow) directed at a phantom with chest x-ray exposures (66kVp, 6mAs).
Fig. 5
Fig. 5
Shows an chest x-ray with multiple horizontal linear artefacts which were caused by overheating of x-ray detector.
Fig. 6
Fig. 6
It is a chest x-ray image with radiopaque speckled appearance as shown by the blue arrows.
See this image and copyright information in PMC

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