In normal times in ICUs, airborne precautions are instituted in a negative pressure room with an anteroom in which caregivers mask with a n95, gown, glove, hat, booties, etc so that no part of one's clothes is exposed. (Most ICUs have one of these rooms.) Two people will often check each other for fit and any possible exposure. Vent and Xray, IVs and procedural equipment are supplies are dedicated to the room. In addition to the vent, central lines and arterial lines, multiple IV machines to carry fluids and blood products, if necessary. Some IV and medication drips. The Art line for blood draws for labs and blood gases. After three days, IV nutrition with separate access. Sometimes cardiac meds and catheters in the heart chambers to monitor optimal blood flow. RT goes in to check vent settings and meds to loosen pulmonary secretions. Patient needs turning every 1-2 hours often with four people and keeping all these lines secure. Cardiac monitor. Patients bodily functions do not stop. Exiting through the door back into the anteroom where all the covering are disposed off with the consideration that they are all infected. At least all is done every two hours, usually more often. For CPR, quickly all must do this to enter the room, possibly turning from the prone position. Then there is contact with the anxious, worried family. Some patients are not 250-300 pounds, in severe distress, in need of dialysis, or ECMO. Down the road, decsions are made when to trach the patient to prevent damage to the trachea over the long term. ICU stays for Covid patients are 5-19 days.
Other diseases requiring airborne precautions include, but are not limited to: Measles, Severe Acute Respiratory Syndrome (SARS), Varicella (chickenpox), and Mycobacterium tuberculosis. Airborne precautions apply to patients known or suspected to be infected with microorganisms transmitted by airborne droplet nuclei.
Now imagine each ICU nurse has two Covid patients for a twelve hour shift in rooms without negative pressure and no anteroom. Are they getting more with the ICU full and overwhelmed and staffing is short? For staffing in normal times, an assignment of two of these is never done. Then home to one's family. In normal times, three twelve hour shifts a week. Every patient waiting in hallways, or any areas in the hospital until a bed is available is not on a cardiac monitor. If ambulances are stacked up outside of ER and because ER staff and management are in communication with all other hospitals in the area, that means no one has rooms. Rural hospitals without critical care rooms or staff trained and experienced for 6-12 months can't send their patients there.
Wear a mask. Get the vaccine.
Other diseases requiring airborne precautions include, but are not limited to: Measles, Severe Acute Respiratory Syndrome (SARS), Varicella (chickenpox), and Mycobacterium tuberculosis. Airborne precautions apply to patients known or suspected to be infected with microorganisms transmitted by airborne droplet nuclei.
Now imagine each ICU nurse has two Covid patients for a twelve hour shift in rooms without negative pressure and no anteroom. Are they getting more with the ICU full and overwhelmed and staffing is short? For staffing in normal times, an assignment of two of these is never done. Then home to one's family. In normal times, three twelve hour shifts a week. Every patient waiting in hallways, or any areas in the hospital until a bed is available is not on a cardiac monitor. If ambulances are stacked up outside of ER and because ER staff and management are in communication with all other hospitals in the area, that means no one has rooms. Rural hospitals without critical care rooms or staff trained and experienced for 6-12 months can't send their patients there.
Wear a mask. Get the vaccine.
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