Board of the Portuguese College of Anaesthesiology. Portuguese Medical Association. Lisbon. Portugal.
Acta Med Port. 2023 Jan 2;36(1):42-48. doi: 10.20344/amp.18453. Epub 2022 Jul 29.
The dissemination of the COVID-19 pandemic in Europe, namely in Portugal, demanded an organizational and clinical reaction from the Portuguese National Health Service. With the unpredictable impact of COVID-19 infected patients redefining hospital logistics, reducing non-priority elective care and extending the hospital capacity for critical care patients made mobilizing a significant part of human resources a priority. We conducted a national survey to monitor the contribution and the role of anaesthesiologists belonging to the 53 Portuguese National Health Service hospitals in the first wave fight against the pandemic.
This prospective cross-sectional observational study used a weekly survey sent to the Directors of the Anaesthesiology Departments of all Portuguese National Health Service hospitals, between the period of 13th April and 21st June 2020. Directors were asked about human resources, hospital logistics, anaesthetic activity and residency programs in their departments as well as contingency plans facing the impact of the pandemic growth in the PNHS.
Contingency strategy for all Portuguese National Health Service hospitals planned for a total of 1524 level III critical care beds during the initial phases of the pandemic, an increase of 151% from the existing 607 level III critical care beds in Portugal in January 2020. This re-configuration effort of the Portuguese National Health Service was only possible due to the partial or total suspension of non-urgent elective activity that reached over 90% of these institutions in the first pandemic months (March and April) and the deployment of anaesthesiologists from their normal activities to the treatment of critical care patients. During the peak of the first pandemic wave, 209 anaesthesiology specialists and 170 trainees (22.9% of the total anaesthesiologist's staff in the Portuguese National Health Service) were deployed in critical care. There was an almost complete interruption of the residency program rotation in 70.4% of hospitals with anaesthesiology residents, between March and April 2020.
During the first pandemic wave there was an effective and fast reorganisation of the Portuguese National Health Service in order to increase level III critical care beds, which might have contributed to the low mortality rates in Portugal. We believe that this could have also been a result of the contribution given by all public anaesthesiology departments.
新冠疫情在欧洲（尤其是葡萄牙）的传播，要求葡萄牙国家卫生服务机构做出组织和临床反应。由于新冠感染患者的不可预测影响重新定义了医院后勤，减少了非优先选择性护理，并为重症监护患者扩展了医院容量，因此调动大量人力资源成为当务之急。我们进行了一项全国性调查，以监测在抗击疫情的第一波中，隶属于葡萄牙 53 家国家卫生服务机构的麻醉师的贡献和作用。
这是一项前瞻性的横断面观察性研究，使用每周向所有葡萄牙国家卫生服务机构麻醉科主任发送的调查，时间为 2020 年 4 月 13 日至 6 月 21 日。主任们被问及人力资源、医院后勤、麻醉活动以及所在部门的住院医师计划，以及面对国家卫生服务机构中疫情增长的应急计划。
所有葡萄牙国家卫生服务机构的应急战略计划在疫情的初始阶段总共设置 1524 张三级重症监护病床，比 2020 年 1 月葡萄牙现有的 607 张三级重症监护病床增加了 151%。葡萄牙国家卫生服务机构的这种重新配置工作仅得益于部分或全部暂停非紧急选择性活动，在头几个月（3 月和 4 月），这些机构中有超过 90%的机构暂停了这种活动，以及麻醉师从正常活动中部署到重症监护患者的治疗中。在第一波疫情高峰期间，共有 209 名麻醉专家和 170 名学员（占葡萄牙国家卫生服务机构麻醉师总数的 22.9%）被部署在重症监护病房。2020 年 3 月至 4 月，70.4%有麻醉住院医师的医院几乎完全中断了住院医师轮转。
在第一波疫情期间，葡萄牙国家卫生服务机构进行了有效的快速重组，以增加三级重症监护病床，这可能有助于葡萄牙的低死亡率。我们认为，这也可能是所有公共麻醉部门贡献的结果。
