COVID-19 experience from an Intensive Treatment Unit (ITU) in London

Abstract

This article will try to provide an insight into the CoViD – 19 situation in Barnet Hospital with regards to management of the hospital, disease pattern, ITU admission criteria & treatment plans, work pattern of doctors, staff safety, & a trainee doctor’s experience. Barnet Hospital is a District General Hospital (DGH) in North London, whereas, Chase Farm Hospital is an elective surgical Hospital in North East London. Overall management Barnet Hospital is a DGH with 450 beds which includes 2 wings of ITU consisting of 10 beds & 13 beds respectively. There are more than 100 confirmed cases, and they are increasing. During the emergency period, elective surgeries have been stopped. The only surgeries that are on are emergencies, trauma (directed to another dedicated trauma centre), cancer surgeries, and maternity. The high risk areas are Emergency dept., isolation wards (separate for confirmed cases and suspected cases), ITU, Theatres, & Maternity. These have been reasonably well stocked with Personal Protective Equipment (PPE). ITU expansion plan 2 extra beds have been setup in ITU North wing. Theatre recovery has been converted to an 8 bedded ITU with anaesthetic machines as ventilators. A ward adjacent to ITU South wing has been converted to an ITU wing with 6 beds with anaesthesia machine ventilators. That has expanded the ITU capacity to 39. If more beds are needed, 3 out of 5 Operation Theatres and Anaesthetic rooms will be converted to 9 beds with anaesthesia machines as ventilators. Anaesthesia machines have been transported from Chase Farm Hospital. There is also a plan to transfer acute patients, preferably with single organ failure, to other hospitals with less patient volume, and also a new facility (Nightingale Hospital, Excel Centre) with 4000 dedicated beds for CoViD-19 patients. Diagnosis Patients are coming in with a combination of any of the following symptoms : Fever, dry cough, sore throat, history of recent travel/contact, shortness of breath,