Transforming ORs into ICUs

Peters, Alexander W.; Chawla, Kashmira S.; Turnbull, Zachary A.

doi:10.1056/nejmc2010853

Cited by 93 publications

(88 citation statements)

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“…In accordance with New York State Department of Health guidelines, residents were quarantined empirically if they developed symptoms, had known exposure to a patient who tested positive for COVID-19, or tested positive themselves, but after the March 31 guideline revision, essential personnel who had tested positive were permitted to return to work if they were asymptomatic, isolated for 7 days after illness onset, and afebrile for 72 hours. 12 An additional measure to limit exposure was abolishing the junior resident consult role. This was important because most consults were in the emergency department, which was inundated with patients with COVID-19.…”

Section: Phase 1: Prioritizing Reserve Pool and Limiting Resident Expmentioning

confidence: 99%

Restructuring of a General Surgery Residency Program in an Epicenter of the Coronavirus Disease 2019 Pandemic

et al. 2020

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n March 1, 2020, the first case of coronavirus disease 2019 (COVID-19) was confirmed in New York City (NYC) and rapidly emerged as the nation's epicenter with more than 366 000 (22% of the US) confirmed cases and 29 000 (30% of the US) deaths as of May 27, 2020 (Figure 1). 1,2 At the peak in mid-April, NewYork-Presbyterian Hospital/Weill Cornell Medicine (NYP-WC) was treating 474 patients who had tested positive for COVID-19, with 237 (50.0%) admitted to the intensive care unit (ICU) and 212 (44.7%) requiring mechanical ventilation. Owing to the exponential rise in critical care needs, 3-5 NYC hospitals sought to quickly restructure existing systems to expand critical care capacities while limiting clinical care in nones-sential areas. Plans to restructure surgery programs have been previously described, 6-8 but the experience of a region as profoundly affected as NYC has yet to be reported. This restructuring had a particularly pronounced effect on surgery departments and training as elective cases were suspended. 9,10 On March 16, 2020, in response to the US Centers for Disease Control and Prevention recommendations in consensus with multiple surgical societies such as the American College of Surgeons and an order from the New York State governor, NYP-WC announced that elective surgeries would be postponed. 11 General surgery training in NYC was uniquely affected by decreased operative training opportunities lost during the 2019-On March 1, 2020, the first case of coronavirus disease 2019 (COVID-19) was confirmed in New York, New York. Since then, the city has emerged as an epicenter for the ongoing pandemic in the US. To meet the anticipated demand caused by the predicted surge of patients with COVID-19, the Department of Surgery at NewYork-Presbyterian Hospital/Weill Cornell Medicine developed and executed an emergent restructuring of general surgery resident teams and educational infrastructure. The restructuring of surgical services described in this Special Communication details the methodology used to safely deploy the necessary amount of the resident workforce to support pandemic efforts while maintaining staffing for emergency surgical care, limiting unnecessary exposure of residents to infection risk, effectively placing residents in critical care units, and maintaining surgical education and board eligibility for the training program as a whole.

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Section: Phase 1: Prioritizing Reserve Pool and Limiting Resident Expmentioning

confidence: 99%

Restructuring of a General Surgery Residency Program in an Epicenter of the Coronavirus Disease 2019 Pandemic

et al. 2020

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“…Healthcare personnel were diverted to these units, replacing their usual duties with COVID-19 patient treatment and triage. 13 The consequence is a reduced capacity for diagnostic and therapeutic procedures of unrelated pathologies. 2,[7][8][9][10] This capacity was further decreased by the need to adapt procedures and provide adequate personal protection equipment to healthcare professionals, since these patients may be harbouring the disease and be contagious while remaining asymptomatic.…”

Section: York 11mentioning

confidence: 99%

“…2,[7][8][9][10] This capacity was further decreased by the need to adapt procedures and provide adequate personal protection equipment to healthcare professionals, since these patients may be harbouring the disease and be contagious while remaining asymptomatic. 13 Furthermore, patients themselves may be avoiding looking for healthcare even when in need, for fear of contracting COVID-19 infection. 14 Data show that this will invariably result in delays and increased waiting lists for diagnostic and therapeutic procedures of vital importance, which will be felt for years to come.…”

Section: York 11mentioning

confidence: 99%

The role of breast fine needle aspiration during and post‐COVID‐19 pandemic: A fast and safe alternative to needle core biopsy

Gomes

Schmitt

2020

Cytopathology

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“…A major New York medical center recently described their transformation of operating rooms and PACUs into ICU rooms. 23 According to recent media reports, two major car manufacturers, Ford Motor Company and General Motors, as well as GE Health, have collaborated with several ventilator companies to begin mass production of simple, but modern, ventilators that had previously been FDA approved but, to date, have been produced only in small quantities. [24][25][26][27] Local U.S. suppliers have been sought for other ventilator elements.…”

Section: Centers For Disease Control and Prevention (Cdc) Strategic Nmentioning

confidence: 99%

Supporting resilience

Brodrick¹,

O'Rourke²,

Angelo³

et al. 2020

Nursing Management

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With the onset of COVID-19 1 and the strong possibility of large percentages of the U.S. population being admitted to the hospital and intensive care unit (ICU), the Society of Critical Care Medicine (SCCM) has updated its statistics on critical care with this new document focusing resources available for COVID-19 in the United States. 2 Our goal is to provide information regarding the resources needed and available to care for a potentially overwhelming number of critically ill patients, many of whom may require mechanical ventilation. 1 In this report, we address the most current data and estimates on the number of acute care, ICU, and step-down (eg, observation, progressive) beds; ICU occupancy rates; mechanical ventilators; and staffing. We also seek to provide context to the data. Acute care hospitals; ICU, step-down, and burn beds: The American Hospital Association (AHA) maintains a proprietary dataset of most non-federal hospitals in the United States. Data is gathered by voluntary survey. In April 2019, a study published in Critical Care Medicine analyzed the 2015 AHA data. 3 For this current report, we extended the analysis from that publication using the most currently available 2018 AHA data while noting minimal changes from 2015. 4 The 2018 AHA data indicate that there are 5256 AHA-registered community hospitals in the United States. Of these, 2704 (51.4%) provide ICU services (Figure 3). These hospitals have 534,964 staffed (operational) acute care beds, including 96,596 ICU beds (Table 1), accounting for a median 16.7% of all hospital beds. The ICU beds are categorized as adult, pediatric, or neonatal.

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Transforming ORs into ICUs

Abstract: Covid-19 NotesTo rapidly communicate short reports of innovative responses to Covid-19 around the world, along with a range of current thinking on policy and strategy relevant to the pandemic, the Journal has initiated the Covid-19 Notes series.

Cited by 93 publications

References 0 publications

Restructuring of a General Surgery Residency Program in an Epicenter of the Coronavirus Disease 2019 Pandemic

Restructuring of a General Surgery Residency Program in an Epicenter of the Coronavirus Disease 2019 Pandemic

The role of breast fine needle aspiration during and post‐COVID‐19 pandemic: A fast and safe alternative to needle core biopsy

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