Department COVID-19 Update: March 27, 2020

Thank you all for continuing on in these challenging times; the unknown can be a significant source of stress. With the rules regarding patient care changing so rapidly, it is difficult to know how what is expected. This is where we are as of this morning:

Highlights from Froedtert include:

• Enterprise Incident Command goes live today: This team led By Dr. Truwit, Eric Conley, Dr. Mathews, Allen Ericson and Ann Tesmer will address broader workforce, resource and communication issues, redeploying faculty and staff across the enterprise to meet patient needs. If you do not have a clinical assignment, you may be called.
• Supply Chain has been working to ensure that we have adequate PPE. Every person in the operating room will receive an N95 to use for the day. Expect a note from perioperative leadership team today confirming this. Unless you have taken care of a COVID positive person and the mask is soiled, conserve your N95s for use on a subsequent day. Wear a regular surgical mask on top of the N95 to protect it. We are working on a process to treat masks with UV light and will provide more detail as the process is finalized.
• We will also have yellow gowns available in the OR for the person intubating the patient and, if that is a CRNA/CAA/Resident, for the attending – should they feel they will need to assist in the intubation.
• Review our FAQs on A*Net for more information regarding this as well as information regarding intubation/extubation of patients.

Highlights from Children’s include:

• Children’s has been ahead of its peers in slowing down procedural/anesthesia care. This has, though, led to a growing need to address the ongoing health care needs of pediatric patients. To address this a multilevel triage system has been created to review cases for scheduling to the OR.
• A strategy has been developed to risk-stratify the patient population. While this is a work in progress, that will allow for more rational application of PPE and need for isolation.

Highlights from the VA include:

• The VA rapidly decreased the number of non-time-sensitive cases that are done and is all in with preparedness.
• Every airway is treated as if the patient is COVID+
• Full PPE, including PAPRs, is used for intubations
• To date, no COVID+ patient has required emergent intubation

While it may not always feel like it, there is really a lot of great work going on throughout our medical system.

Our ability to weather the coming weeks will depend on our working together and taking care of ourselves and each other.

I am humbled by the dedication of each of you to our mission.

With gratitude,

Cindy

Cynthia A. Lien, M.D.
John P. Kampine Professor and Chair
Department of Anesthesiology
Medical College of Wisconsin