Abstract
The current global spread of COVID-19, a highly contagious disease, has challenged healthcare systems, and placed immense burdens on medical staff globally. With a sharp increase in the number of newly confirmed cases and the rapid progression of the disease into a critically ill state, overstretched critical care units have had to contend with a shortage of beds, specialist personnel, and medical resources. Temporary intensive care units (ICUs) were therefore set up in isolated hospitals to provide the required standardized care for all severe cases. The current paper describes the authors' experience of setting up and managing such an ICU in Wuhan, Hubei Province, China, from the identification of critically ill COVID-19 patients through to the arranging and equipping of the unit, providing training and protection for staff, and standardizing all aspects of care.
Highlights
Coronavirus Disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is highly contagious
By July 22, 2020, the total officially confirmed cases in China reached 86,152 with 4,653(5.4%) having died since the outbreak began in December 2019
The first sector, containing 12 beds supplied with sufficient oxygen pressure to run ventilators, was designated for the management of severe critically ill patients, including those requiring invasive ventilator support or prone ventilation, exhibiting hemodynamic instability
Summary
Coronavirus Disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is highly contagious. The current paper shares best practices gleaned from the establishment and management of temporary ICUs in isolated hospitals during the epidemic in Wuhan; the centralization of severe confirmed cases enabled reintegration and maximum use of existing medical resources, facilitating effective professional treatments for COVID19 patients. The first sector, containing 12 beds supplied with sufficient oxygen pressure to run ventilators, was designated for the management of severe critically ill patients, including those requiring invasive ventilator support or prone ventilation, exhibiting hemodynamic instability. This sector was located close to the nurses’ and doctors’ workstations, enabling staff to monitor patients closely and provide immediate attention. If there is no improvement after 2 h, or the patient’s condition worsens, the team should consider early invasive ventilation [8], followed by lung-protective ventilation strategies and early prone positioning during mechanical ventilation for more than 12 hours per day (Figure 6)
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