Divisions of Pulmonary Allergy and Critical Care Medicine and Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
Johns Hopkins Center for Health Security, Bloomberg School of Public Health, Baltimore, Maryland, USA.
Curr Opin Pulm Med. 2021 Mar 1;27(2):73-78. doi: 10.1097/MCP.0000000000000749.
The worldwide SARS-CoV-2 pandemic has taken a heavy toll on ICUs worldwide. This review expounds on lessons learned for ICU preparedness during the pandemic and for future mass casualty events.
In the 21st century, there have already been several outbreaks of infectious diseases that have led to mass casualties creating ICU strain, providing multiple opportunities for hospitals and hospital systems to prepare their ICUs for future events. Unfortunately, the sheer scale and rapidity of the SARS-CoV-2 pandemic led to overwhelming strain on every aspect of ICU disaster preparedness. Yet, by analyzing experiences of hospitals throughout the first 7 months of the current pandemic in the areas of infection control, equipment preparedness, staffing strategies, ICU spatial logistics as well as acute and postacute treatment, various important lessons have already emerged that will prove critical for successful future ICU preparedness.
Preemptive planning, beginning with the early identification of staffing resources, supply chains and alternative equipment sources, coupled with strong infection control practices that also provide for the flexibility for evolving evidence is of utmost importance. However, there is no single approach that can be applied to every health system.
全球范围内的 SARS-CoV-2 大流行给全球 ICU 带来了沉重的负担。这篇综述阐述了在大流行期间和未来大规模伤亡事件中 ICU 准备工作的经验教训。
在 21 世纪,已经发生了几次传染病暴发,导致大量伤亡,给 ICU 带来了压力,为医院和医院系统提供了多次机会,为未来的事件做好 ICU 准备。不幸的是,SARS-CoV-2 大流行的规模和速度之快,给 ICU 灾害准备的各个方面都带来了巨大的压力。然而,通过分析当前大流行前 7 个月期间医院在感染控制、设备准备、人员配备策略、ICU 空间后勤以及急性和后期治疗等方面的经验,已经出现了各种重要的经验教训,这些经验教训对于未来成功的 ICU 准备工作至关重要。
先发制人的规划,从早期确定人员配备资源、供应链和替代设备来源开始,再加上强大的感染控制措施,为不断发展的证据提供灵活性,这一点至关重要。然而,没有一种方法可以适用于每个医疗系统。