SCCM主席Lewis J. Kaplan近期致信广大会员朋友们
SCCM主席Lewis J. Kaplan近期致信广大会员朋友，介绍了美国重症领域的现状及应对疫情采取的措施。
应对 COVID-19 的挑战离不开团队的创新。Lewis介绍到，创造性的解决方案包括将静脉泵和呼吸机控制面板重新安置在病人护理室外，以限制ICU临床医生的接触，减少防护用品的损耗。由于ICU病房的设备在疫情严重的地方匮乏，一些团队已经开发出了一台呼吸机给两个病人使用的方法。虽然这是一个较为极端的措施，但在没有临床证明更安全的方法来护理急性呼吸衰竭患者时，两名患者共同使用一台呼吸机可能是一个合理的方法。
Lewis介绍到，COVID-19研究组已经迅速制定了新的科学研究策略，例如DiscoveryNetwork’s VIRUS 研究，主要针对COVID-19患者的护理和结果。SCCM邀请广大重症医护者指导并提供患者数据，以帮助制定有效的策略来挽救生命。
Acute inpatient care—and critical care in particular—has responded to the COVID-19 pandemic in unprecedented ways. Hospital entry screening, reduction or near-elimination of visitation, universal masks, and concerns regarding the supply of beds, medications, personal protective equipment (PPE), ventilators, and ICU team members are chief among the changes. But these are not the only changes that now characterize our daily work and workflow.
Novel ICU spaces are being set up in operating theaters, inpatient floors, clinic rooms, and education venues, as well as tents and other facilities outside of hospitals.Non-ICU clinicians are pressed into service to help augment the supply of skilled clinicians caring for the critically ill. SCCM has assistedmore than 300,000 of these clinicians in preparing for thistask. Volunteers travel the globe to help shore up the ranks of ICU teams in overwhelmed zones such as New York City. Hundreds of these volunteers flowed from SCCM’s ranks. We could not be prouder or more grateful.
Woven throughout the fabric of how critical care has met the COVID-19 challenge isteam-based care and team-based innovation. Creative solutions include relocating IV pumps and ventilator control panels outside patient care rooms tolimit ICU clinician exposure and preserve the threatened PPE supply. As crucial ICU equipment and supply shortages erupt in the hardest-hit areas, some have developed methodsfor ventilating two patients with a single ventilator.To address the pandemic, we enact inventive solutions to respond to the crisis.
Iparticipated in developing a protocol with a multiprofessional group at FEMA for what is now termed co-venting. While it is an extreme measure, two patients on a single ventilator may be areasonable approach when there are no more clinically proven and safe methodsof caring for patients with acute respiratory failure. Such an approach meritsstudy, and we intend—with your help—to do just that.
COVID-19 has launched scientific inquiry. Our colleagues rapidly formulated new studiessuch as the DiscoveryNetwork’s VIRUS study addressing COVID-19 patientcare and outcomes. It is within VIRUS that we invite you to direct yourco-venting patient data to help us learn how well such a rescue strategy works to preserve lives.
On the frontlines of care, each of you endures great stress. Remember that you are part of an ICU team of skilled professionals dedicated to patients and also to one another. While organizations such as SCCM offer resources to helpwith education, training, and preparation—including forums for group discussion—little is more powerful than a thoughtful word in an unbidden moment of kindness in support of one another. Know that,despite the struggles we now face, we are all one team—one professional family.Together we will get through this crisis. The result will be innovative therapies, better strategies, new colleagues, and improved care of thecritically ill and injured when life returns to normal.
Lewis J. Kaplan, MD, FACS, FCCP, FCCM
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