Cardio-Vascular Unit in COVID
The cardiovascular team always involve a lot of health workers involved
in the team including the doctors, paramedical staffs and the house
keeping. There are several ways COVID can affect the unit
- Intensive care beds & ventilator : Complex vascular and cardiac
cases may occupy ICU beds for a longer time. This may curb the need
for more beds and ventilators in the near future during the COVID era.
- Selection of cases : It is difficult to draw a line between
elective and urgent cases in cardiac surgery. Patient who can survive
more than 4 weeks can be categorised as elective at the moment thought
no guidelines define the same (Doug E. Wood, Chair of Surgery at the
University of Washington). The American college of surgeons has
proposed a COVID-19 guideline for triage of vascular surgery patients
(4). They have advised not to postpone acute aortic dissection,
rupture aneurysm, any symptomatic aneurysm or any aneurysm associated
with infection. It has been recommended to postpone any asymptomatic
aneurysm.
- Cardiovascular Patients: Complex cardiac and vascular patients
are likely to have additional comorbidities. They may develop COVID 19
during the hospital stay or after surgery. A COVID19 patient may need
an emergency cardiac or vascular procedure. A cardiovascular surgeon
need to present when the situation of ECMO arises.
- Team work : It necessitate a close working environment in a
cardiovascular unit, which theoretically may increase the chance of
infectious spread, hence advisable to reduce the staff members and
follow all the necessary precautions.
- Blood and blood products: Cardiac and vascular procedures
invariably need the support of blood banks. There is drought of donors
which makes the operation of blood bank difficult.