Medical Journal of Dr. D.Y. Patil Vidyapeeth

COMMENTARY
Year
: 2020  |  Volume : 13  |  Issue : 3  |  Page : 195--196

“There's a first time for everything:” Our coronavirus disease intensive care unit experience


K Hema Sri Laxmi, Prashant Sirohiya 
 Department of Anaesthesia, ABVIMS and Dr. RML Hospital, New Delhi, India

Correspondence Address:
Prashant Sirohiya
Department of Anaesthesia, ABVIMS and Dr RML Hospital, New Delhi
India




How to cite this article:
Laxmi K H, Sirohiya P. “There's a first time for everything:” Our coronavirus disease intensive care unit experience.Med J DY Patil Vidyapeeth 2020;13:195-196


How to cite this URL:
Laxmi K H, Sirohiya P. “There's a first time for everything:” Our coronavirus disease intensive care unit experience. Med J DY Patil Vidyapeeth [serial online] 2020 [cited 2020 Jul 5 ];13:195-196
Available from: http://www.mjdrdypv.org/text.asp?2020/13/3/195/285765


Full Text



The coronavirus disease (COVID-19) outbreak caused by novel coronavirus was declared a pandemic by the WHO on March 12, 2020.[1],[2] In India, till today, we have a total of 28,046 active cases with 10,632 recovered patients.[3] This pandemic created much frustration and changed the lives of doctors, nurses, and other health-care workers inside and outside the country.

Anesthesiologists are considered to be one of the frontline warriors in pandemic outbreaks. When our institution was gearing up to fight with the COVID-19 infection, Department of Anaesthesiology played a pivotal role in containing this viral transmission compassionately and strategically. It was a mixed feeling for us with anxiety, fear, and pride in dealing with such a high contagion. We were put to tests, to learn and acquire knowledge and situation demanding skills in a short period. We prepared ourselves for the worst days to come and made up the mind to fight with anything.

As residents of anesthesiology, it was a challenging time for us in many ways-a time, which is easy to think and fear for many things. This choice was not an easy task to deal-between protecting self and doing our job on top of everything. In the initial period, we had to deal with positive patients when the guidelines were still evolving. Everyday guidelines kept changing, and we had no idea which one to choose and how to proceed further. A COVID positive patient with acute respiratory distress syndrome was admitted in intensive care unit. We had to intubate this patient in view of decreasing oxygen saturation and increased respiratory rate. We know intubation is a high-risk procedure,[4] and terrific questions started running in our mind like “What if it turns out to be difficult intubation? What if we get exposed?” With so many what-if questions running in our mind, we proceeded further with trepidation. Donning of personal protective equipment was done, and we approached the patient. As we moved to the head end when nursing staff started giving drugs, the patient started coughing, which provoked an adrenaline surge in us, but still with a ray of hope, we proceeded further. Yes! The procedure was successful, and all the what-if questions vanished. We connected this patient to a ventilator, and our routine management started. It was almost >6 h we stayed with that patient inside, making all the intubation, central and arterial lines for ease of management, and for future sampling. After coming out of the intensive care unit (ICU) while doffing, we had a feeling such as coming out of the rotten pan, sweaty, marks on the face with a smile of contentment, and obviously a bit of fear running at the back of our mind. Few days were so depressing when we felt, “Why to do this and for whom?” But each and every time when we went inside to check the patient's status, the small hope mixed with fear in their eyes while seeing us defined our purpose of doing this. Moreover, the day finally arrived when one of our patients turned out to be negative, and our team decided to discharge him. The whole of our team heaved a sigh of relief. When we started writing the discharge summary, it was something different apart from writing the regular ones.

We may look strong and resilient in the face of the unknown, hiding the anxiousness and fear inside us. Although we are doctors, staying far away from our family is very traumatizing, as humans. Thinking about their conditions and explaining our conditions to them were challenging. It is not only that we fought against this pandemic, but our family also played a major role along with us. Emotional support is what we lacked for, but still, we managed to get it from other residents and faculty. We were not immune to stress, anxiety, and fear, which kept on haunting us. After the 15 days of ICU duty, we had to undergo quarantine of 14 days according to our institution protocol. We were relaxed and happy thinking about the next 14 days of doing nothing. However these were the nightmares of our lives when we were alone in our quarantine place. Days passed by, we were stuck with loneliness and fear kept on magnifying. However still, we had to remind ourselves to stay calm and relaxed, rather than to pull back into the pressured roving's of our mind, as this was just the beginning.

References

1World Health Organization. Coronavirus Disease (COVID-19) – Events as They Happen. World Health Organization. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen. [Last accessed on 2020 Apr 30].
2Odor PM, Neun M, Bampoe S, Clark S, Heaton D, Hoogenboom EM, et al. Anaesthesia and COVID-19: Infection control. Br J Anaesth 2020:. pii: S0007-0912(20)30200-2. doi: 10.1016/j.bja.2020.03.025. Epub ahead of print.
3MoHFW,Home. Mohfw.gov.in; 2020. Available from: https://www.mohfw.gov.in/. [Last accessed on 2020 May 03].
4Wang Y, Wang Y, Chen Y, Qin Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol 2020. doi:10.1002/jmv.25748.