OSA COVID-19-Letter From The President
I am reaching out to offer encouragement as the State of Ohio enters a challenging time such that we have not faced before, at least during our careers. COVID-19 presents us with an iceberg where broad and sure navigation now, while it only appears to be a tiny speck, will keep our ship safe from the greater threat that lies beneath the surface. As guardians of the operating room and the ICU during this crisis, we hold a critical position from which we can protect patients who are previously beyond our reach. Leading our teams, from the administrators all the way to the patient care techs, sets in motion a unified effort that can identify and act upon factors that have a ripple effect throughout the hospitals and communities that we serve.
Let me implore you to immediately engage with your facility’s administration by having frank conversations about how to manage events as they may unfold. The presence of a plan now enhances the effectiveness of the team and avoids confusion in the face of chaos. Your local emergency departments have protocols in place to identify, sequester and evaluate patients who may be exhibiting signs and symptoms of COVID-19 infection. I urge you to consider having your facility apply that same process to every patient who arrives to the admitting area prior to surgery. The undetected admission of one person infected with COVID-19 may tragically expose scores of patients and caregivers to the virus needlessly.
Strongly consider discussing trigger events for curtailing or prohibiting elective surgeries. Adjusting too slowly to a significant uptick in the local infection rate may leave your facility short on beds, personal protective equipment, critical care drugs and ventilators when they are most needed. Balance this with the knowledge that hospitals may take a significant financial setback at some point and surgeons, especially those in independent practice, may be financially and professionally devastated.
Anesthesiologists hold the key to a significant expansion in the supply of ventilators in the event of a catastrophic outbreak. Recruitment of the anesthesia machines as ICU ventilators to save lives is a revelation for hospital administrators and critical care staff alike. Nursing and respiratory staff will need training to operate our equipment and we will be there to teach them should the unfortunate need arise. Indeed, this would be a worst case scenario that we hope never materializes but having a plan in place, should it come to that, puts you ahead of the game.
Keep abreast of recommendations and mandates from federal, state and local government. Lean on sources like the CDC, APSF, OSHA, AMA and the ASA to help guide your practice and manage your resources. Teach other healthcare providers, patients and members of your community about methods to best avoid contracting the disease. Dr. Giacomo Grasselli, the anesthesia/critical care physician directing northern Italy’s crisis – “…the most important thing is to avoid the spread of the disease through the education of the population, because no matter how good is your health-care system, if the tsunami arrives, sooner or later, you will be submerged.”
Be safe, be vigilant,
William Glenn MD
President, Ohio Society of Anesthesiology
ASA Committee on Trauma and Emergency Preparedness
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