Premium
Surge capacity of intensive care units in case of acute increase in demand caused by COVID ‐19 in Australia
Author(s) -
Litton Edward,
Bucci Tamara,
Chavan Shaila,
Ho Yvonne Y,
Holley Anthony,
Howard Gretta,
Huckson Sue,
Kwong Philomena,
Millar Johnny,
Nguyen Nhi,
Secombe Paul,
Ziegenfuss Marc,
Pilcher David
Publication year - 2020
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/mja2.50596
Subject(s) - covid-19 , surge capacity , intensive care , business , pandemic , medical emergency , virology , medicine , intensive care medicine , outbreak , disease , infectious disease (medical specialty)
Objectives To assess the capacity of intensive care units ( ICU s) in Australia to respond to the expected increase in demand associated with COVID ‐19. Design Analysis of Australian and New Zealand Intensive Care Society ( ANZICS ) registry data, supplemented by an ICU surge capability survey and veterinary facilities survey (both March 2020). Settings All Australian ICU s and veterinary facilities. Main outcome measures Baseline numbers of ICU beds, ventilators, dialysis machines, extracorporeal membrane oxygenation machines, intravenous infusion pumps, and staff (senior medical staff, registered nurses); incremental capability to increase capacity (surge) by increasing ICU bed numbers; ventilator‐to‐bed ratios; number of ventilators in veterinary facilities. Results The 191 ICU s in Australia provide 2378 intensive care beds during baseline activity (9.3 ICU beds per 100 000 population). Of the 175 ICU s that responded to the surge survey (with 2228 intensive care beds), a maximal surge would add an additional 4258 intensive care beds (191% increase) and 2631 invasive ventilators (120% increase). This surge would require additional staffing of as many as 4092 senior doctors (245% increase over baseline) and 42 720 registered ICU nurses (269% increase over baseline). An additional 188 ventilators are available in veterinary facilities, including 179 human model ventilators. Conclusions The directors of Australian ICU s report that intensive care bed capacity could be near tripled in response to the expected increase in demand caused by COVID ‐19. But maximal surge in bed numbers could be hampered by a shortfall in invasive ventilators and would also require a large increase in clinician and nursing staff numbers.