Hospital surge capacity in a tertiary emergency referral centre during the COVID-19 outbreak in Italy.
COVID-19
coronavirus
hospital preparedness
respiratory failure
surge capacity
Journal
Anaesthesia
ISSN: 1365-2044
Titre abrégé: Anaesthesia
Pays: England
ID NLM: 0370524
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
accepted:
01
04
2020
pubmed:
5
4
2020
medline:
18
6
2020
entrez:
5
4
2020
Statut:
ppublish
Résumé
The first person-to-person transmission of the 2019 novel coronavirus in Italy on 21 February 2020 led to an infection chain that represents one of the largest known COVID-19 outbreaks outside Asia. In northern Italy in particular, we rapidly experienced a critical care crisis due to a shortage of intensive care beds, as we expected according to data reported in China. Based on our experience of managing this surge, we produced this review to support other healthcare services in preparedness and training of hospitals during the current coronavirus outbreak. We had a dedicated task force that identified a response plan, which included: (1) establishment of dedicated, cohorted intensive care units for COVID-19-positive patients; (2) design of appropriate procedures for pre-triage, diagnosis and isolation of suspected and confirmed cases; and (3) training of all staff to work in the dedicated intensive care unit, in personal protective equipment usage and patient management. Hospital multidisciplinary and departmental collaboration was needed to work on all principles of surge capacity, including: space definition; supplies provision; staff recruitment; and ad hoc training. Dedicated protocols were applied where full isolation of spaces, staff and patients was implemented. Opening the unit and the whole hospital emergency process required the multidisciplinary, multi-level involvement of healthcare providers and hospital managers all working towards a common goal: patient care and hospital safety. Hospitals should be prepared to face severe disruptions to their routine and it is very likely that protocols and procedures might require re-discussion and updating on a daily basis.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
928-934Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2020 Association of Anaesthetists.
Références
http://opendatadpc.maps.arcgis.com/apps/opsdashboard/index.html#/b0c68bce2cce478eaac82fe38d4138b1(accessed 12/04/2020).
Carinci F. Covid-19: preparedness, decentralisation, and the hunt for patient zero. British Medical Journal 2020. Epub ahead of print 28 February. https://doi.org/10.1136/bmj.m799
Xie J, Tong Z, Guan X, Du B, Qiu H, Slutsky AS. Critical care crisis and some recommendations during the COVID-19 epidemic in China. Intensive Care Medicine 2020. Epub ahead of print 2 March. https://doi.org/10.1007/s00134-020-05979-7
Arabi YM, Murthy S, Webb S. COVID-19: a novel coronavirus and a novel challenge for critical care. Intensive Care Medicine 2020. Epub ahead of print 3 March. https://doi.org/10.1007/s00134-020-05955-1
Grasselli G, Pesenti A, Cecconi M. Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: early experience and forecast during an emergency response. Journal of the American Medical Association 2020. Epub ahead of print 13 March. https://doi.org/10.1001/jama.2020.4031
Spina S, Marrazzo F, Migliari M, Stucchi R, Sforza A, Fumagalli R. The response of Milan's Emergency Medical System to the COVID-19 outbreak in Italy. Lancet 2020; 395: e49-50.
Hick JL, Christian MD, Sprung CL. European Society of Intensive Care Medicine's Task Force for intensive care unit triage during an influenza epidemic or mass disaster. Chapter 2. Surge capacity and infrastructure considerations for mass critical care. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster. Intensive Care Medicine 2010; 36 (Suppl 1): S11-20.
European Center for Disease Control (ECDC). COVID-19 Checklist for hospital preparing for the reception and care of coronavirus 2019 (COVID-19) patients. https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-checklist-hospitals-preparing-reception-care-coronavirus-patients.pdf (accessed 08/03/2020).
Sprung CL, Zimmerman JL, Christian MD, et al. Recommendations for intensive care unit and hospital preparations for an influenza epidemic or mass disaster: summary report of the European Society of Intensive Care Medicine's Task Force for intensive care unit triage during an influenza epidemic or mass disaster. Intensive Care Medicine 2010; 36: 428-43.
Liao X, Wang B, Kang Y. Novel coronavirus infection during the 2019-2020 epidemic: preparing intensive care units-the experience in Sichuan Province, China. Intensive Care Medicine 2020; 46: 357-60.
Maves RC, Jamros CM, Smith AG. Intensive care unit preparedness during pandemics and other biological threats. Critical Care Clinics 2019; 35: 609-18.
Wong ATY, Chen H, Liu SH, et al. From SARS to Avian influenza preparedness in Hong Kong. Clinical Infectious Diseases 2017; 64: S98-104.
Bouadma L, Lescure FX, Lucet JC, Yazdanpanah Y, Timsit JF. Severe SARS-CoV-2 infections: practical considerations and management strategy for intensivists. Intensive Care Medicine 2020; 46: 579-82.
Kurihara H, Bisagni P, Faccincani R, Zago M. COVID-19 outbreak in northern Italy. Viewpoint of the Milan surgical area community. Journal of Trauma and Acute Care Surgery 2020. Epub ahead of print 20 March. https://doi.org/10.1097/ta.0000000000002695
Abrahamson SD, Canzian S, Brunet F. Using simulation for training and to change protocol during the outbreak of severe acute respiratory syndrome. Critical Care 2006; 10: R3.
Ragazzoni L, Ingrassia PL, Echeverri L, et al. Virtual reality simulation training for Ebola deployment. Disaster Medicine and Public Health Preparedness 2015; 9: 543-6.