Division of Cardiology, Duke University, Durham, North Carolina.
Inova Heart and Vascular Institute, Inova Fairfax Medical Center, Falls Church, Virginia. Electronic address: https://twitter.com/ShashankSinhaMD.
J Am Coll Cardiol. 2020 Jul 7;76(1):72-84. doi: 10.1016/j.jacc.2020.04.029. Epub 2020 Apr 16.
The COVID-19 pandemic has presented a major unanticipated stress on the workforce, organizational structure, systems of care, and critical resource supplies. To ensure provider safety, to maximize efficiency, and to optimize patient outcomes, health systems need to be agile. Critical care cardiologists may be uniquely positioned to treat the numerous respiratory and cardiovascular complications of the SARS-CoV-2 and support clinicians without critical care training who may be suddenly asked to care for critically ill patients. This review draws upon the experiences of colleagues from heavily impacted regions of the United States and Europe, as well as lessons learned from military mass casualty medicine. This review offers pragmatic suggestions on how to implement scalable models for critical care delivery, cultivate educational tools for team training, and embrace technologies (e.g., telemedicine) to enable effective collaboration despite social distancing imperatives.
COVID-19 大流行给劳动力、组织结构、医疗体系和关键资源供应带来了重大的意外压力。为了确保医护人员的安全、提高效率和优化患者的治疗效果，医疗体系需要具有灵活性。重症监护心脏病专家可能在治疗 SARS-CoV-2 的众多呼吸道和心血管并发症以及支持没有重症监护培训的临床医生方面具有独特的优势，这些医生可能会突然被要求照顾重症患者。这篇综述借鉴了来自美国和欧洲受疫情影响严重地区的同事的经验，以及从军事大规模伤亡医学中吸取的经验教训。这篇综述提供了一些切实可行的建议，介绍如何实施可扩展的重症监护模式，培养团队培训的教育工具，并采用技术（如远程医疗），以便在保持社交距离的要求下进行有效的协作。
