Critical Care with Covid-19: You packed that, right?
We’ve relocated to the old A+E department so that if a second peak comes we’ve got a better area for Covid patients. It comes with some downsides, the area we’re in at the moment is seriously lacking in storage so everything is on various trollies. It’s not the biggest space and then fill it with patients and all the equipment that goes along with them, plus a bunch of extra trollies… there isn’t space to swing a cat. Geographically, ITU and the old A+E (now affectionately known as ITU2) are literally opposite end of the hospital. This is a bit of a pain in the bum, but I’m getting my steps in (Who am I kidding? I never miss my steps on a work day!). The major upside is that once we expand into the whole area there are 21 beds all in one area. It’s much easier to manage that way. Staffing is easier because you don’t have to spread your senior nurses out so far and covering breaks is easier because one nurse can see more beds at a time.
I was in charge on moving day which was interesting…Take four ITU/Anaesthetic consultants and two matrons who are all used to being ‘In charge’(and all vastly more senior than me), plus me whose job title is literally the nurse in charge (Hah!) and try to coordinate! I mostly ran between people going ‘Ready? Good! Now don’t move until I find out if the others are!’
The thing is, ITU patients come with a lot of clobber. When we transfer patients, we have to bring the stuff keeping them alive i.e. ventilator, monitoring, drug infusions (in the pumps that keep them running) plus all the emergency stuff in case your first set of stuff gives up on you. In place of the ventilator, you bring a hand ventilation circuit. You bring back up syringes of all your medications in case one of your drugs runs out or there’s a problem with the infusion en route. Then you pack up your emergency kit. Emergency drugs like adrenaline, fluid and yet more drugs in case your blood pressure drops drastically, a suction unit and the accompanying kit to clear your airway should it become blocked. Then the transfer bag (for reference think jammed full sports holdall) which has all the emergency airway and lines (for intravenous access) kit for if things really go tits up. It’s a lot. And it takes a certain amount of time to get it all ready. Plus, you need to make sure your patient is established on the transfer vent (not the same as the one we use in the unit), in case they don’t like it and have a wobble.
Once your packing up teams got all that ready (generally speaking think minimum 45 mins) and in between all the usual important stuff that happens routinely…then your transfer team are ready and your receiving team are ready…final check on your patient and you can go! Oh, and this is the Covid era, so everyone needs full PPE and we have to run crowd control in the corridors to make sure we don’t expose anyone. We transferred 6 people. It went nice and smoothly and everyone arrived safely. The far end was a bit chaotic initially, just in terms of everything being everywhere but it’s closer to resembling order now we’ve been in a couple of weeks.
I hope that the second wave doesn’t happen. Not everyone thinks it will, so fingers crossed. The donations at work have slowed to a trickle, which I understand (people have lives and with businesses restarting much more on their plates). But between that and the gowns being provided now strongly resembling the type of weed suppressing fabric you get from the garden centre (the full surgical gowns ran out weeks ago) you can’t help but worry that we are slowly being forgotten.
A word on the current Government advice: Just because Boris says you can go out, doesn’t mean you have to. Keep washing your hands, keep your distance, keep people safe.