Hospital surge capacity in a tertiary emergency referral centre during the COVID ‐19 outbreak in Italy
Open accessAbstract
Summary: The first person‐to‐person transmission of the 2019 novel coronavirus in Italy on 21 February 2020 led to an infection chain that represents one of the largest known COVID ‐19 outbreaks outside Asia. In northern Italy in particular, we rapidly experienced a critical care crisis due to a shortage of intensive care beds, as we expected according to data reported in China. Based on our experience of managing this surge, we produced this review to support other healthcare services in preparedness and training of hospitals during the current coronavirus outbreak. We had a dedicated task force that identified a response plan, which included: (1) establishment of dedicated, cohorted intensive care units for COVID ‐19–positive patients; (2) design of appropriate procedures for pre‐triage, diagnosis and isolation of suspected and confirmed cases; and (3) training of all staff to work in the dedicated intensive care unit, in personal protective equipment usage and patient management. Hospital multidisciplinary and departmental collaboration was needed to work on all principles of surge capacity, including: space definition; supplies provision; staff recruitment; and ad hoc training. Dedicated protocols were applied where full isolation of spaces, staff and patients was implemented. Opening the unit and the whole hospital emergency process required the multidisciplinary, multi‐level involvement of healthcare providers and hospital managers all working towards a common goal: patient care and hospital safety. Hospitals should be prepared to face severe disruptions to their routine and it is very likely that protocols and procedures might require re‐discussion and updating on a daily basis.
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HICs and UMICs are likely to be able to put in place surge capacity to limit any impact on mortality.
“However, as has been observed, HICs and UMICs are likely to be able to put in place surge capacity to limit any impact on mortality (19–21).”
From The impact of COVID-19 and strategies for mitigation and suppression in low- and middle-income countries (2020) · cites this paper as [19]
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- Authors
- Carenzo, L., Costantini, E., Greco, M., Barra, F. L., Rendiniello, V., Mainetti, M., Bui, R., Zanella, A., Grasselli, G., Lagioia, M., Protti, A., & Cecconi, M.
- Affiliations
- Department of Anesthesia and Intensive Care Medicine Humanitas Clinical and Research Center Milan Italy
- Humanitas University (IT)
- Humanitas Clinical and Research Center Milan Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- Corresponding author
- Protti, A.
- Venue
- Anaesthesia
- Publisher
- Wiley
- Published
- 2020-04-22
- Volume
- 75
- Issue
- 7
- Pages
- 928-934
- ISSN
- 0003-2409 (ISSN-L)
- 1365-2044
- OpenAlex
- W3014734765
- Cited by
- 311
- References
- 14
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 21 · 2023: 28 · 2022: 54 · 2021: 107 · 2020: 84
- FWCI
- 63.94
- Type
- journal article
- Language
- en
- Update notices
- correction (2020-10-11)
- Open access
- bronze
- doi.org
- Locations
- Anaesthesia (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Disaster Response and Management
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Keywords
- hospital surge capacity, COVID-19 pandemic, personal protective equipment, employee training, patient isolation, hospital preparedness, multidisciplinary collaboration, healthcare disruption, emergency planning
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Disease Outbreaks, Emergency Service, Hospital, Humans, Italy, Pneumonia, Viral, Referral and Consultation, Coronavirus Infections, Surge Capacity, Pandemics, Tertiary Care Centers
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