An Intensive Care Unit (ICU) is an organized system for the provision of care to critically ill patients that provides intensive and specialized medical and nursing care, an enhanced capacity for monitoring, and multiple modalities of physiologic organ support to sustain life during a period of life-threatening organ system insufficiency. While this availability of trained manpower and specialized equipment makes it possible to care for critically ill patients, it also presents singular challenges in the form of man and material management, design concerns, budgetary concerns, and protocolization of treatment. Consequently, the establishment of an ICU requires rigorous design and planning, a process that can take months to years. However, the Coronavirus disease-19 (COVID-19) Epidemic has required the significant capacity building to accommodate the increased number of critically ill patients. At the peak of the pandemic, many countries were forced to resort to the building of temporary structures to house critically ill patients, to help tide over the crisis. This narrative review describes the challenges and lessons learned while establishing a 250 bedded ICU in a temporary structure and achieving functionality within a period of a fortnight.
The anesthetic management of a pregnant patient with coronavirus disease 2019 (COVID-19) presents various unique challenges in terms of patient preparation, intraoperative management, and postoperative concerns, all while taking concurrent measures to prevent the spread of the virus from the patient to the healthcare workers. Anesthetic management of parturient in the era of the COVID-19 pandemic is further complicated by the fact that intubation and extubation are highly aerosol-generating procedures, and are generally advised to be avoided. While various organizations have come up with guidelines on the management of pregnant patients with COVID-19, definitive evidence-based guidelines for the same are lacking. This article aims to consolidate the available literature on the management of pregnant patients with COVID-19, with special impetus on the anesthetic management of these patients.
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