key: cord-1010352-47stp4ig
authors: Villalonga Vadell, R. M.; Sala Blanch, X.; Roigé Solé, J.; Garcia Eroles, X.; Morros Viñoles, C.; Valero Castell, R.; Bausili Ribera, M.; Pedregosa Sanz, A.; Sergi Angeles Fite, G.; Abreu Paradell, S.; Adalia Bartolomé, R.; Álvarez Pérez, A.; Amigó Bonet, N.; Asbert Sagasti, R.; Barbal Badia, F.; Carramiñana Dominguez, A.; Castellnou Ferré, J.; Bernia Gil, J. A.; Carol Boeris, F.; Colomina Soler, M. J.; Chamero Pastilla, A.; del Moral García, M. V.; del Pozo, D.; Escolano Villén, F.; Esquius Jofre, P.; Ferrando Ortolá, C.; García Marqueta, C.; Hernández Aguado, C.; Hernando Pastor, D.; Isach Comallonga, N.; Isern Domingo, X.; Cesar Jaramillo Carrión, L.; Koo García, M.; Lacambra Basil, M.; Lázaro Alcay, J. J.; Mailan Bello, J.; Manrique Muñoz, S.; Martínez Palli, G.; Martínez Jérez, L.; Masdeu Castellví, J.; Mercadal Mercadal, J.; Montero Matamala, A.; Morales Torres, O.; Moret Ferron, M. L.; Moret Ruiz, E.; Muñoz Falcón, L.; de Nadal Clanchet, M.; Miquel Ortells Nebot, P.; Prat Vallribera, A.; Remartinez Fernandez, F.; Roca Campos, P.; Roldan Osuna, J.; Sabaté Pes, A.; Sala Francino, P.; Saludes Serra, J.; Samsó Sabe, E.; Sarmiento Meneses, E.; Soto Ejarque, J. M.; Tomas Torrelles, A.; Tomás Esteban, A.; Yuste Graupera, M.
title: Involvement of the Anaesthesiology and Resuscitation Services in Catalonia in the SARS-CoV-2 pandemic. A real, cost-effective solution to an unprecedented health crisis
date: 2021-02-15
journal: nan
DOI: 10.1016/j.redare.2020.05.016
sha: 3a013f7d17939cd1df39acecd4ae23fa16716104
doc_id: 1010352
cord_uid: 47stp4ig

nan

To the Editor,

The SARS-CoV-2 coronavirus pandemic has tested the capacity of the entire healthcare system to the limit. This is particularly true of critical care units, which have had to double or triple their capacity to cater for demand. Post anaesthesia care units and other units in the surgical suite have played a fundamental role in preventing the collapse of critical care units. These units, which include certain Reanimation units, Post Anaesthesia Care Units (PACU) and operating rooms managed by the Anaesthesiology and Reanimation Service, are overlooked by hospital management and health services because they are not part of the critical care bed management system in many hospitals, even though they have all the intensive care units resources recommended by anaesthesiology scientific societies. 1 The transition in recent years from acute care hospitals to institutions aimed primarily at surgical patients has made Anaesthesiology and Resuscitation Services one of the largest hospital departments. A crisis such as the current pandemic inevitably involves suspending a large proportion of elective surgeries, and this has freed up expert personnel such as qualified anaesthesiologists and allowed them to be reassigned to critical care units. 2 At the beginning of the pandemic, the Catalan Society of Anaesthesiology, Reanimation and Pain Therapy (SCARTD) contacted the service managers in Catalan hospitals to ask how many care units they had available. Once the stage of surgery cut-backs had been reached, a 12-item online survey was designed to evaluate the real participation of personnel from the Anaesthesiology Services. The questionnaire was sent to all the heads of Anaesthesiology and Reanimation Services in tertiary, secondary and regional public and private hospitals in Catalonia. A total of 41 completed questionnaires were received between 30 April and 6 May 2020.

The main conclusions that can be drawn from this survey are as follows: (1) The hospitals polled had, in aggregate, 796 critical care beds officially available before the COVID-19 pandemic. Of these, 199 (25%) were administratively assigned to the Anaesthesiology Services of these hospitals. (2) During the COVID-19 pandemic, the number of beds assigned to critical patients increased from 796 to 1674 (210%), of which 729 (43% of the total) were managed and staffed by Anaesthesiology Services. This is an increase of over 350% compared to the number of pre-pandemic beds available (from 199 to 729 critical beds). (3) All the hospitals polled reported that a large number of anaesthesiologists have been involved in the care of critical COVID-19 patients. In 53.7% of hospitals, anaesthesiologists have been in charge of the medical care of critical patients, and in the remaining hospitals anaesthesiologists have formed part of multidisciplinary teams. (4) To take on these responsibilities, members of the Anaesthesiology Services have had to change their work schedules and have been responsible for airway management in COVID-19 patients. (5) A total of 732 anaesthesiologists, 67% of the entire staff of anaesthesiologists, were assigned to the direct care of COVID-19 patients. The remaining 33% were assigned to urgent and/or nondeferrable surgery, with occasional contact with COVID-19 patients.

The survey shows that successful management of future health crises will depend on the availability of clinical structures that can be effectively and efficiently adapted to care needs arising at any given moment. Another key component is qualified personnel, such as anaesthesiologists, who have the technical know-how and clinical expertise required to care for critically ill patients. 2 It is essential to factor in the beds and staff available in the Surgical Suite when the 

need arises to increase the capacity of critical care units. Including these multipurpose spaces attended by anaesthesiologists in bed management systems would allow hospitals to maintain their quality of care and would provide a costeffective solution to the problem of increased demand in future crises, such as COVID-19 or other pandemics, mass casualty incidents, etc. 

Cuidados Intensivos de Anestesia: recomendaciones de la Sección de Cuidados Intensivos de la Sociedad Espan˜ola de Anestesiología

Medical training in anaesthesiology. Updated European requirements

Villalonga Vadell a , X. Sala Blanch a, * , J. Roigé Solé a,b