Bader Mary Kay, Braun Annabelle, Fox Cherie, Dwinell Lauren, Cord Jennifer, Andersen Marne, Noakes Bryan, Ponticiello Daniel
Mary Kay Bader is a neuro/critical care clinical nurse specialist, Mission Hospital, Mission Viejo, California. She is the President of the Neurocritical Care Society.
Annabelle Braun is Executive Director of Critical Care and Emergency Services, Mission Hospital.
Crit Care Nurse. 2020 Dec 1;40(6):e1-e16. doi: 10.4037/ccn2020799.
The outbreak of coronavirus disease 2019 (COVID-19) rippled across the world from Wuhan, China, to the shores of the United States within a few months. Hospitals and intensive care units were suddenly faced with a "tsunami" warning requiring instantaneous implementation and escalation of disaster plans.
An evidence-based question was developed and an extensive review of the literature was completed, resulting in a structured plan for the intensive care units to manage a surge of patients critically ill with COVID-19 in March 2020. Twenty-five sources of evidence focusing on pandemic intensive care unit and COVID-19 management laid the foundation for the team to navigate the crisis.
The Critical Care Services task force adopted recommendations from the CHEST consensus statement on surge capacity principles and other sources, which served as the framework for the organized response. The 4 S's became the focus: space, staff, supplies, and systems. Development of algorithms, workflows, and new processes related to treating patients, staffing shortages, and limited supplies. New intensive care unit staffing solutions were adopted.
Using a framework based on the literature reviewed, the Critical Care Services task force controlled the surge of patients with COVID-19 in March through May 2020. Patients received excellent care, and the mortality rate was 0.008%. The intensive care unit team had the needed respiratory and general supplies but had to continually adapt to shortages of personal protective equipment, cleaning products, and some medications.
The intensive care unit pandemic response plan has been established and the team is prepared for the next wave of COVID-19.
2019年冠状病毒病（COVID-19）疫情在短短几个月内从中国武汉蔓延至全球，波及美国海岸。医院和重症监护病房突然面临“海啸”预警，需要立即实施并升级灾难应对计划。
提出了一个基于证据的问题，并完成了对文献的广泛审查，从而形成了一个结构化计划，供重症监护病房在2020年3月应对大量COVID-19重症患者。25个聚焦于大流行重症监护病房和COVID-19管理的证据来源为团队应对危机奠定了基础。
重症护理服务特别工作组采纳了CHEST关于应对能力原则的共识声明及其他来源的建议，这些建议成为有组织应对的框架。“4S”成为重点：空间、人员、物资和系统。制定了与治疗患者、人员短缺和物资有限相关的算法、工作流程和新流程。采用了新的重症监护病房人员配备解决方案。
基于所审查的文献框架，重症护理服务特别工作组在2020年3月至5月期间控制了COVID-19患者的激增情况。患者得到了优质护理，死亡率为0.008%。重症监护病房团队有所需的呼吸和常规物资，但不得不持续应对个人防护装备、清洁用品和一些药物的短缺问题。
已制定重症监护病房大流行应对计划，团队已为下一波COVID-19做好准备。
