Anaesthesia. Hospital surge capacity in a tertiary emergency referral centre during the COVID-19 outbreak in Italy

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Anaesthesia. 2020 Apr 4. doi: 10.1111/anae.15072. [Epub ahead of print]
Hospital surge capacity in a tertiary emergency referral centre during the COVID-19 outbreak in Italy.


Carenzo L¹, Costantini E¹, Greco M^1,2, Barra FL¹, Rendiniello V¹, Mainetti M¹, Bui R³, Zanella A^4,5, Grasselli G^4,5, Lagioia M³, Protti A^1,2, Cecconi M^1,2.

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Abstract

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 unit(s) (ICU) 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 ICU in personal protective equipment use 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 a multidisciplinary, multilevel 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 update on a daily basis.
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PMID:32246838DOI:10.1111/anae.15072