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Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV)
Randy S Wax1,2,3, Michael D Christian4
1Department of Critical Care Medicine, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada. randy.wax@queensu.ca.
Abstract:
A global health emergency has been declared by the World Health Organization as the 2019-nCoV outbreak spreads across the world, with confirmed patients in Canada. Patients infected with 2019-nCoV are at risk for developing respiratory failure and requiring admission to critical care units. While providing optimal treatment for these patients, careful execution of infection control measures is necessary to prevent nosocomial transmission to other patients and to healthcare workers providing care. Although the exact mechanisms of transmission are currently unclear, human-to-human transmission can occur, and the risk of airborne spread during aerosol-generating medical procedures remains a concern in specific circumstances. This paper summarizes important considerations regarding patient screening, environmental controls, personal protective equipment, resuscitation measures (including intubation), and critical care unit operations planning as we prepare for the possibility of new imported cases or local outbreaks of 2019-nCoV. Although understanding of the 2019-nCoV virus is evolving, lessons learned from prior infectious disease challenges such as Severe Acute Respiratory Syndrome will hopefully improve our state of readiness regardless of the number of cases we eventually manage in Canada.
Insights
The 2019 novel coronavirus (2019-nCoV) outbreak requires critical care units to implement strict infection control measures. This includes patient screening, personal protective equipment, and operational planning to prevent nosocomial transmission.
Area of Science:
- Public Health
- Infectious Diseases
- Critical Care Medicine
Background:
- The World Health Organization declared a global health emergency due to the 2019 novel coronavirus (2019-nCoV) outbreak.
- Patients infected with 2019-nCoV face risks of respiratory failure and require critical care.
- Nosocomial transmission of 2019-nCoV to patients and healthcare workers is a significant concern.
Purpose of the Study:
- To outline essential considerations for managing 2019-nCoV patients in critical care settings.
- To emphasize the importance of infection control measures during the outbreak.
- To prepare Canadian healthcare facilities for potential imported cases or local outbreaks.
Main Methods:
- Summarizing key strategies for patient screening and environmental controls.
- Detailing personal protective equipment (PPE) requirements.
- Discussing resuscitation measures, including intubation, and critical care unit (CCU) operations planning.
Main Results:
- Human-to-human transmission of 2019-nCoV is possible.
- Airborne spread during aerosol-generating procedures is a concern.
- Lessons from previous outbreaks like Severe Acute Respiratory Syndrome (SARS) can inform readiness.
Conclusions:
- Proactive planning and adherence to infection control protocols are crucial for managing 2019-nCoV in critical care.
- Effective strategies involve a multi-faceted approach encompassing screening, PPE, and operational preparedness.
- Leveraging past experiences with infectious diseases enhances preparedness for the evolving 2019-nCoV situation.
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