As the community spread of COVID-19 grows, Emory Healthcare, like many hospitals, is expanding critical care services throughout its hospitals to accommodate its sickest patients. That means repurposing intensive care units (ICUs) to create specialty ICUs for patients with confirmed or suspected COVID-19.
“We have been consolidating some of our non-COVID ICUs to create additional ICU space for our patients with confirmed or suspected COVID-19,” says Craig Coopersmith, MD, professor of surgery, Emory University School of Medicine and interim director of the Emory Critical Care Center. “As we continue to open additional COVID ICUs, our greatest needs focus on staffing, equipment and technology and personal protective equipment (PPE).”
Emory has been redeploying advanced practice providers, nurses, residents, fellows (physicians who are completing specialty training) and attending physicians in other specialties to care for patients in COVID-ICUs, and to support critical care physicians and nurses and respiratory therapists who already staff the units. Nurse anesthetists and anesthesiology assistants working in surgical and procedural areas of Emory Healthcare have also been moved to these ICUs to assist.
“We are finding solutions for other providers with complementary skill sets to care for our sickest COVID patients, so our current teams won’t be as stretched,” says Coopersmith.
Equipment and technology are also being carefully monitored during the coronavirus outbreak. Ventilators and dialysis machines are in high demand for COVID patients in the ICU.
“We are learning that 70 to 80 percent of ICU patients who are COVID positive need to be on ventilators to assist with breathing, with 75 percent developing single organ failure of the lungs,” says Coopersmith. “Of those patients, 20 to 25 percent have multi-organ failure and also need dialysis. So, technology is extremely important in caring for these patients.”
Health care providers must also wear full PPE when treating COVID patients in ICU rooms to protect themselves and other patients. In-room PPE consists of N95 face masks, face shields or goggles for eye protection, gloves and isolation gowns, consistent with Centers for Disease Control and Prevention (CDC) guidelines. Having these resources available to the care team is critical.
“Throughout our health care system, our ICU nurses, providers and care team members are rising to the call in caring for this high-acuity patient population with compassion,” says Bob Dent, DNP, MBA, RN, vice president for patient care services and chief nursing officer, Emory Decatur Hospital, Emory Hillandale Hospital and Emory Long Term Acute Care Hospital. “We are drawing on each other each day to stay ahead of the curve, so we can support our patients in need.”
Emory hospitals continue to also operate non-COVID ICUs to care for many other patients who need a higher level of care.