"I am an ER nurse in San Jose. I feel underprepared and unprotected. Just one PUI takes at least 4 staff members to help don and monitor PPE, isolate and place into a negative pressure room (we only have 4 of these rooms in the ED). The number of PUIs increase each day, my last shift we had 5. This slowed the flow of the department down significantly! I heard some hospitals are utilizing tents outside? This was two days ago and I hear that number is multiplying each day. I have a few questions: What can HCW on the front line do better to protect ourselves and the patients we care for? If we aren’t utilizing the right PPE in the department we run the risk of unknowingly being exposed and exposing others. Especially if PPE is limited.
Obviously working in the ED places me at higher risks for exposures to Infectious diseases- not just covid19 and I have always implemented standard precautions and good hand hygiene. Is this still sufficient to keep nurses safe as the epidemic rises in Santa Clara? Should I be using an N95 and a face shield/googles throughout my entire shift? Or only when I’m caring for a PUI and persons who are confirmed? What did your nurses do? The ER still has non-Covid related patients to care for but I’m worried because I’m still expected to screen and triage patients. Because masks are now limited for HCWs. am I to wear this 1 PPE throughout my entire 12 hour shift? ( I know I would have to be meticulous and correctly remove the face shield and n95. ) If I am suppose to reuse these items how do I sanitize them properly? "
Британский и американский доктор согласны в ожиданиях:
"American icu doctor here. Also being anonymous since we represent an organization. Our two countries overall response is relatively weak and heavy in denial. Hospitals have came up with their own mass casualty contingency plans.
Are you starting to see signals of the surge? We have some admissions in ICUs and hospitals in this country so far but no one seems to be seeing a lot of cases, even in the Washington state area because they are distributing patients to different hospitals. Of course we are about 1–2 weeks “behind” the situation in Italy.
Are you guys starting to feel the heat and in what way? Just gathering info because we will cancel elective procedures to open up beds and units if the surge is to be expected. We have prepared more in 5 days than we have in 6 weeks."
"Have things gotten to a point in your facility where normal operations have ceased or been impacted by the volume of COVID patients? Are the ORs still performing elective surgery? Have you had supply issues?I provide anesthesia at several facilities in my area (US, California). Some of the surgery centers are experiencing supply issues. On Friday I was told to save my mask for next week, as we have 3 boxes left and they are on "indefinite backorder."
".. My wife is a nurse at a hospital in the US, where little has been done to prepare for the spread of this disease apart from a few posters by the elevators and an email applicable only to staff members having recently travelled internationally.Last night we had a discussion, and I asked her if the lack of information and preparedness is intended to keep staff members from quitting in advance to protect themselves and their families.
What was your experience with staff members calling in sick or quitting over the course of the past week?"
В других странах тоже, похоже, не особо шевелятся:
"Critical care doctor working in Portugal here. Are you seeing a lot of patients with ARDS criteria? Are you using corticosteroids (early chinese data suggested possible higher viral shedding)? Are you using NIPPV/HFOT on some patients in isolation? Are you seeing more cases of VAP or bacterial superinfection? Knowing the extent of knowledge on respiratory failure the italians possess and seeing the high mortality they are reporting makes me fearful for the coming months."