Hackett Anna K, Wells Celia M, Gupta Rohit, Zhang Ziya, Brito Amy, Kirton Natalie B, Chan Christy C, Brown Kester, Wong Caitlin, Leonardi Kayla M, Shittu Atinuke, Lay Cappi, Kohli-Seth Roopa
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Disaster Med Public Health Prep. 2022 May 2:1-3. doi: 10.1017/dmp.2022.111.
The surge in critically ill patients has pressured hospitals to expand their intensive care unit capacities and critical care staff. This was difficult given the country's shortage of intensivists. This paper describes the implementation of a multidisciplinary central line placement team and its impact in reducing the vascular access workload of ICU physicians during the height of the COVID-19 pandemic.
Vascular surgeons, interventionalists, and anesthesiologists, were redeployed to the ICU Access team to place central and arterial lines. Nurses with expertise in vascular access were recruited to the team to streamline consultation and assist with line placement.
While 51 central and arterial lines were placed per 100 ICU patients in 2019, there were 87 central and arterial lines placed per 100 COVID-19 ICU patients in the sole month of April, 2020. The ICU Access Team placed 107 of the 226 vascular access devices in April 2020, reducing the procedure-related workload of ICU treating teams by 46%.
The ICU Access Team was able to complete a large proportion of vascular access insertions without reported complications. Given another mass casualty event, this ICU Access Team could be reassembled to rapidly meet the increased vascular access needs of patients.
重症患者数量的激增给医院带来压力,迫使其扩大重症监护病房的容量并增加重症护理人员。鉴于该国重症医学专家短缺,这一任务颇具难度。本文描述了一个多学科中心静脉置管团队的组建及其在新冠疫情高峰期对减轻重症监护病房医生血管通路工作负担的影响。
血管外科医生、介入科医生和麻醉科医生被重新调配至重症监护病房血管通路团队,负责放置中心静脉和动脉导管。招募了具有血管通路专业知识的护士加入该团队,以简化会诊流程并协助导管放置。
2019年每100例重症监护病房患者中有51根中心静脉和动脉导管被放置,而在2020年4月这一单独月份,每100例新冠重症监护病房患者中有87根中心静脉和动脉导管被放置。2020年4月,重症监护病房血管通路团队放置了226根血管通路装置中的107根,将重症监护病房治疗团队与操作相关的工作量减少了46%。
重症监护病房血管通路团队能够完成很大一部分血管通路置入操作,且未报告有并发症。若再发生大规模伤亡事件,该重症监护病房血管通路团队可重新组建,以迅速满足患者增加的血管通路需求。