Practical Considerations for Converting Operating Rooms and Post-anaesthesia Care Units into Intensive Care Units in the COVID-19 Pandemic - Experience from a Large Singapore Tertiary Hospital.
10.47102/annals-acadmedsg.2020220
- Author:
Zihui TAN
1
;
Priscilla Hui Yi PHOON
;
Claudia Jong-Chie TIEN
;
Johari KATIJO
;
Shin Yi NG
;
Meng Huat GOH
Author Information
1. Division of Anaesthesiology, Singapore General Hospital, Singapore.
- Publication Type:Journal Article
- MeSH:
COVID-19/therapy*;
Critical Care/organization & administration*;
Critical Illness;
Health Care Rationing/organization & administration*;
Health Resources/organization & administration*;
Health Services Accessibility/organization & administration*;
Humans;
Intensive Care Units/organization & administration*;
Operating Rooms/organization & administration*;
Pandemics;
Respiration, Artificial;
Singapore/epidemiology*;
Tertiary Care Centers/organization & administration*
- From:Annals of the Academy of Medicine, Singapore
2020;49(12):1009-1012
- CountrySingapore
- Language:English
-
Abstract:
COVID-19 has spread globally, infecting and killing millions of people worldwide. The use of operating rooms (ORs) and the post-anaesthesia care unit (PACU) for intensive care is part of surge response planning. We aim to describe and discuss some of the practical considerations involved in a large tertiary hospital in Singapore. Firstly, considerations for setting up a level III intensive care unit (ICU) include that of space, staff, supplies and standards. Secondly, oxygen supply of the entire hospital is a major determinant of the number of ventilators it can support, including those on non-invasive forms of oxygen therapy. Thirdly, air flows due to positive pressure systems within the OR complex need to be addressed. In addition, due to the worldwide shortage of ICU ventilators, the US Food and Drug Administration has granted temporary approval for the use of anaesthesia gas machines for patients requiring mechanical ventilation. Lastly, planning of logistics and staff deployment needs to be carefully considered during a crisis. Although OR and PACU are not designed for long-term care of critically ill patients, they may be adapted for ICU use with careful planning in the current pandemic.
