COVID-19 continues to overwhelm the healthcare system, and clinicians across the country are feeling the mental, emotional and physical toll of maintaining the healthcare safety net. It’s during times like these that we must care for one another, because we truly are in this together. I recently had such an opportunity to support a colleague — a story that unfolded in an unexpected way.
Responding to an Urgent COVID-19 Case
I had recently completed rounding on my in-hospital pain management patients when I noticed an anesthesia colleague who was nearing the end of their shift and appeared to be exhausted. Expecting the call team to arrive in 30 minutes, I told my tired colleague to go home while I covered the rest of the shift.
As any physician can attest, no good deed goes unpunished. Ten minutes later, I received a call from an emergency medicine doctor who needed urgent help with intubation on a COVID-19-positive patient.
The patient in question and his wife had presented to the emergency department (ED) one week earlier, both complaining of coughing and fever. The wife was admitted at the time, but the husband was considered stable enough to self-monitor at home. Now, the husband had returned to the ED – this time with significant difficulty breathing.
Anesthesiologists in the Emergency Department
An anesthetist colleague and I briefly gathered supplies and medications from a neighboring endoscopy suite before we entered the ED – our hospital’s equivalent of ground zero.
When we arrived at the patient’s room, it was obvious he was in significant distress. Unable to sit still, he was yanking on his monitoring wires and mumbling incoherently. As we were visually evaluating him and simultaneously donning our PPE, we assigned tasks to the team members to intubate the patient quickly and efficiently.
I was able to push a small amount of sedative to allow the patient to calm down and tolerate the non-rebreather, which would allow him to improve his oxygen saturation. After a few moments, we performed rapid sequence intubation without much difficulty and with minimal aerosolization. We exited the room and assigned another member to watch us doff, or remove, our PPE safely (you can make the argument that removing PPE appropriately is equally as important as putting it on).
Relying on One Another
For me, this was a perfect example of the collaboration happening on the frontlines. Our emergency medicine colleagues are swamped. They rely on us anesthesiologists to absorb some of the critical tasks in caring for these acute patients. And we're glad to provide a helping hand in any way, shape or form and care for one another.
Unrelated to the intubation, I did receive notice a few days ago that a person I was working closely with tested positive for COVID-19 and that I had been put at high risk for exposure. But as I enter my quarantine period, away from my wife and my two young kids, what gives me solace is that I can confidently say that I know my pain patients – particularly my cancer pain patients – will still receive high-quality care, because truly we're all in this together.