Objectives:
Discuss advantages and disadvantages of relocating IV pumps for coronavirus disease 2019 patients from bedside to outside the patient room and characterize reproducible details of an external infusion pump model.
Design:
Brief report.
Setting:
ICUs at a single-center teaching hospital.
Patients:
Critically ill coronavirus disease 2019 patients under contact and special droplet precautions.
Interventions:
Relocation of IV pumps for coronavirus disease 2019 patients from bedside to outside the patient room using extension tubing.
Measurements and Main Results:
Infusion pumps secured to a rolling IV pole are moved immediately outside the patient room with extension tubing, reaching the patient through a closed door. It is anticipated that this practice may reduce unnecessary coronavirus disease 2019 exposure for healthcare professionals, reduce the consumption of personal protective equipment, and promote patient safety by limiting delays of donning personal protective equipment to initiate or adjust medications.
Conclusions:
Risks of situating IV pumps outside the patient room must be carefully weighed against the benefits. Relocation of IV pumps outside the patient room may be considered given shortages of personal protective equipment and high risk of healthcare professional exposure. Institutional review-approved studies investigating the measured impact on decreased exposure, personal protective equipment usage, and patient safety are required.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–related hypercoagulability has been of great interest in the pathophysiology of coronavirus disease 2019 (COVID-19). Many patients have clinical findings of dead-space ventilation, similar to pulmonary embolism. Herein, a patient who presented with COVID-19 pneumonia and whose condition rapidly deteriorated to respiratory failure requiring intubation is described. Tissue plasminogen activator (tPA) was administered because of concern of pulmonary microemboli, with improvement of respiratory status and extubation within 24 hours. Patients with COVID-19 infection have an increased risk of thrombus formation,
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and the administration of tPA may benefit these patients by immediately lysing diffuse thrombi and improving gas exchange.
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