State Government has advised the District Collectors to strengthen the Critical Care facilities for Management of COVID-19 at district level instead sending them to Bhubaneswar and Cuttack.
Issuing a Detailed Protocol for strengthening of critical care for management of COVID-19 cases, ACS Health & Family Welfare, Pradipta Kumar Mohapatra has advised the District authorities advised to provide critical care in available Intensive Care Unit (ICU)s and High Dependable Unit (HDU) at district level.
Accordingly, more training should be imparted at grass root level and district level hospitals, so that patient management is accurate and referral should be reduced, said he.
All facilities should follow the notified referral policy to enable seamless coordination between the sending and receiving hospitals, said he adding the cluster district concept must be followed.
Patients insisting on being referred to Bhubaneswar and Cuttack should be counseled and dissuaded, as there is life risk in transport.
Patients in transit should be accompanied by Emergency Medical Technician so that the patients do not develop hypoxia during transport, he said adding unless stable, the patients should not be transported.
Close monitoring and timely early stage treatment should be given to cases in wards so that fewer patients become serious to be put in ICUs.
In order to decrease the load on ICU, there should be Step Down ICUs and the patients, who become stable in ICU, there should be shifted to Step Down ICU or HDU or Semi ICU beds, said he.
The concept of Virtual ICU may be started so that appropriate care can be given by expert advice from remote tertiary hospital level.
More number of dialysis beds, maternity beds, Oncology beds, trauma beds may be created for COVID patients, especially in peripheral facilities.
Diagnostic facilities such as CT Scan, Ultrasound of lungs should be strengthened in peripheral hospitals, advised Mr.Mohapatra, adding peripheral doctors can be trained in these diagnostic procedures.
Wherever possible, trained manpower can be mobilized from low burden districts to high burden districts.
Treating Teams should be provided with timely required support in terms of equipments and drugs.
The Teams working in Covid facilities and especially in ICUs should be regularly encouraged and their efforts appreciated to keep up their morale in these difficult times.
There should be continued structured discussions amongst the treating teams and State level experts through online meeting and seminars so that latest protocols can be discussed and there is cross learning and mentoring across the teams, pointed out ACS Health and family Welfare in a detailed guideline.