Effective Quality Care of patients with Severe COVID-19 on a Respiratory Ward

Title: Effective Quality Care of patients with Severe COVID-19 on a Respiratory Ward
Author(s): E Burke, T Byrne, G Farmer, A Yunes, M Shah, H McLoughlin
Institution: Portiuncula Hospital
Poster: Click to view poster
Category: COVID 19
Abstract: Severe COVID -19 defined by the National Office of Clinical Audit as Care in an intensive Care Unit (ICU) or use of mechanical ventilation or discharge to hospice or death (NOCA 2020). Many patients with severe COVID not suitable for the ICU may not be included in statistical analysis therefore.
Retrospective study of patients admitted to the respiratory ward with Severe COVID 19 March 2020 to April 2021. Severe COVID classified as Covid Respiratory Category C (High flow Nasal Oxygen HFNO or CPAP therapy- ITS).
90 COVID-19 patients admitted to PUH audited. 25% DNAR status. 35 Severe COVID patients managed on Respiratory Ward using CPAP. 10 failed CPAP and intubated(29%). 25 ward CPAP survived to discharge. 5 ward CPAP deaths (20%). 12 ward patients HFNO up to FiO2 0.7.
CPAP hoods used to facilitate compliance. Well tolerated and preferred by many.
Many patients with Severe COVID-19 can be successfully managed on Respiratory Wards. The NOCA definition of Severe COVID should be amended to take this into account. Consideration should be given to additional funding for Respiratory Wards to reduce pressure on ICUs.