Expanding ICU facilities in an epidemic: recommendations based on experience from the SARS epidemic in Hong Kong and Singapore.
Epidemics have the potential to severely strain intensive care resources and may require an increase in intensive care capability. Few intensivists have direct experience of rapidly expanding intensive care services in response to an epidemic. This contribution presents the recommendations of an expert group from Hong Kong and Singapore who had direct experience of expanding intensive care services in response to the epidemic of severe acute respiratory syndrome. These recommendations cover training, infection control, staffing, communication and ethical issues. The issue of what equipment to purchase is not addressed. Early preparations should include fit testing of negative pressure respirators, training of reserve staff, sourcing of material for physical modifications to the ICU, development of infection control policies and training programmes, and discussion of triage and quarantine issues.
Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Hong Kong, China. gomersall@cuhk.edu.hk
Charles D
CD
Gomersall
Dessmon Y H
DY
Tai
Shi
S
Loo
James L
JL
Derrick
Mia Siang
MS
Goh
Thomas A
TA
Buckley
Catherine
C
Chua
Ka Man
KM
Ho
Geeta P
GP
Raghavan
Oi Man
OM
Ho
Lay Beng
LB
Lee
Gavin M
GM
Joynt
D003376:Counseling; D004196:Disease Outbreaks; D004864:Equipment and Supplies; D004992:Ethics, Medical; D006723:Hong Kong / Q000453:epidemiology; D006742:Hospital Bed Capacity; D006749:Hospital Design and Construction; D006801:Humans; D017053:Infection Control; D007318:Inservice Training; D007362:Intensive Care Units / Q000458:organization & administration*; D010561:Personnel Staffing and Scheduling; D011481:Protective Clothing; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology*; D012846:Singapore / Q000453:epidemiology