PMC:7029610 / 2492-4423
Annnotations
{"target":"http://pubannotation.org/docs/sourcedb/PMC/sourceid/7029610","sourcedb":"PMC","sourceid":"7029610","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7029610","text":"Critical care response at the hospital and city level\n\nCity level\nCritical care response to the outbreak of coronavirus should happen not only at the level of hospital, but also at the level of the city which is dominated by the government. At the early stage, the size of the patients’ population is not beyond the capability of local infectious diseases hospital (IDH). The general hospital is responsible for fever triage, identifying suspected cases, and transferring to the local IDH. Such a plan is mandatory for every hospital. Shenzhen city has established a preexisting Infectious Disease Epidemic Plan (IDEP), which has facilitated managing and containing local outbreak of the 2019-nCoV. In case the patient load exceeds the hospital capability of the IDH, new IDHs should be considered either by building a temporary new IDH or reconstructing an existing hospital. Wuhan, the epicenter of the outbreak, is racing against time to build two specialized hospitals for nCoV patients, namely Huoshenshan and Leishenshan hospital, whereas a different strategy has been undertaken in Shenzhen city by reconstructing an existing hospital to become an IDH with capability of 800 beds.\n\nHospital level\n2019-nCoV patients should be admitted to single-bedded, negative pressure rooms in isolated units with intensive care and monitoring [2]. Clinical engineering should have plans to reconstruct standard rooms [2]. Retrofitting the rooms with externally exhausted HEPA filters may be an expedient solution. Also, the general hospital may consider procedures such as suspending elective surgeries, canceling ambulatory clinics and outpatient diagnostic procedures, transferring patients to other institutions, and restricting hospital visitors [2]. More importantly, because the hospitals’ ability to respond to the outbreak largely depends on their available ICU beds, the plan to increase ICU bed capacity needs to be 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