key: cord-0738645-yvvwf8k6
authors: Thomas, Boban; Hassan, Imad
title: Cardiac intensive care unit during the coronavirus disease 2019 surge
date: 2020-11-26
journal: Am Heart J
DOI: 10.1016/j.ahj.2020.09.010
sha: 71c720f0c3708d60352674575f46b941d458863f
doc_id: 738645
cord_uid: yvvwf8k6

nan

We laud the efforts of Anstey et al 1 for a description of the reengineering of work and roles during the coronavirus disease 2019 pandemic, and some of the content will serve as a template for other centers throughout the world. As we have learned during this pandemic, where there are few treatments available, success revolves around the creative and innovative logistics that the situation demands.

To guarantee the health and safety of the personnel, we suggest 2 simple logistic points to consider. Doffing after a long shift is one of the most dangerous moments, and staff are often emotionally, psychologically, and physically exhausted. The intricate details required to avoid self-contamination may not be adhered to. We don personal protective equipment as a team and wait for the outgoing shift staff members to exit one at a time. Each one is doffed by the shift members about to enter in a carefully choreographed sequence where contamination is avoided. The riskiest moments are while taking off the mask and protective eye wear. Doffing one at a time ensures that outgoing staff members are not at different stages of doffing at any given moment, increasing risk.

Despite the overflow of patients, individual clinical trajectories need to be documented on a daily basis. To facilitate this, we pair a frontline clinician with a back office clinician reachable by phone, located remotely, to receive and document information, request imaging and laboratory studies, and document results. This avoids contamination of medical records, computer screens, and keyboards by staff who have been in contact with patients.

The cardiac intensive care unit and the cardiac intensivist during the COVID-19 surge in New York City

No financial disclosures and no conflicts of interest. Letters to the Editor