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SHORT COMMUNICATION
Year : 2020  |  Volume : 6  |  Issue : 1  |  Page : 20-21

Maintaining oxygen supply in hospitals treating coronavirus disease 2019 cases


1 Member of the Medical Education Unit and Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission15-Apr-2020
Date of Decision24-Apr-2020
Date of Acceptance04-May-2020
Date of Web Publication26-Aug-2020

Correspondence Address:
Saurabh RamBihariLal Shrivastava
Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Tiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu - 603108
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/digm.digm_8_20

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  Abstract 


The role of oxygen therapy in the management of coronavirus disease 2019 (COVID-19) cases is extremely crucial and all steps should be taken to ensure its availability in adequate amount in all the health care establishments treating the patients. The clinical data obtained from China revealed that out of the overall reported cases, 15% severe cases and 5% critically ill patients will require oxygen therapy. Moreover, it is essential to estimate the requirement of oxygen in the hospital and it can be done by using the essential supply forecast tool. In conclusion, in order to improve the treatment outcomes of COVID-19 patients, it is crucial to ensure the supply of high quality medical-grade oxygen to the severe and critically-ill group of patients. In addition, the hospitals should prepare for improving the oxygen surge capacity to meet the needs of sudden rise in the number of cases.

Keywords: COVID-19 pandemic, Oxygen, World Health Organization


How to cite this article:
Shrivastava SR, Shrivastava PS. Maintaining oxygen supply in hospitals treating coronavirus disease 2019 cases. Digit Med 2020;6:20-1

How to cite this URL:
Shrivastava SR, Shrivastava PS. Maintaining oxygen supply in hospitals treating coronavirus disease 2019 cases. Digit Med [serial online] 2020 [cited 2020 Oct 20];6:20-1. Available from: http://www.digitmedicine.com/text.asp?2020/6/1/20/293508




  Introduction Top


The role of oxygen therapy in the management of coronavirus disease 2019 (COVID-19) cases is extremely crucial, and all steps should be taken to ensure its availability in adequate amount in all the health-care establishments treating the patients.[1] It is important to consider that the global tally has increased to 1,844,863 cases and 117,021 deaths, while the overall case fatality rate has been estimated at 6.3%.[2] Moreover, the number of reported deaths each day is still increasing, and it is quite essential to strengthen the management protocol and ensure the supply of all essential logistics to save the lives of infected patients.[1]

Clinical spectrum of disease

The clinical data obtained from China revealed that out of the overall reported cases, almost 80% suffer from mild to moderate forms of illness and can recover with the symptomatic therapy, which is delivered either in domiciliary (mild cases) or as an inpatient (moderate cases).[3] From the logistics perspective, it is worth noting that both mild and moderate categories of patients do not generally require oxygen therapy. However, the remaining 20% of the reported cases (viz. 15% suffering from severe forms of the disease plus 5% critically ill patients) require oxygen therapy, and it becomes our responsibility that such arrangements are made. Further, the critically ill group of patients requires management in the intensive care units, and apart from oxygen therapy, they also need mechanical ventilation.[1],[3]

Ensuring effective oxygen delivery

In order to enable the effective delivery of the oxygen therapy to the eligible category of patients, it is an indispensable requirement to ensure the availability of pulse oximeters, functional oxygen systems, and other logistics (such as nasal cannula, venturi mask, reservoir bag, and high flow nasal cannula).[1],[3],[4] Even though the delivery of oxygen through high flow nasal cannula minimizes the need for intubation (which is good in busy settings or where there are a limited number of mechanical ventilatory support), the device does carry the risk of aerosol generation and thus should be carefully done.[3],[4] However, the decision to select for a source of oxygen is determined by the variables such as amount of oxygen needed in the facilities, infrastructure attributes, involved expenditures, continuous supply of electricity, and access to maintenance.[5]

Moreover, it is essential to estimate the requirement of oxygen in the hospital, and it can be done using the essential supply forecast tool.[6] The oxygen estimates should be done for the severe and critical category of patients admitted in the health-care establishments. Further, there has to be an intrinsic plan to enhance the capacity of the hospital to deliver oxygen therapy; this entire plan should be merged with the functioning of the hospital system, and this becomes quite crucial in resource-constrained settings.[3],[6] After the oxygen estimation is done using the forecasting tool, gap analysis needs to be done, and depending on the requirement, the hospital authorities should identify a feasible and appropriate strategy for the oxygen surge suitable to the local settings.[1],[3],[4]


  Conclusion Top


In conclusion, in order to improve the treatment outcomes of COVID-19 patients, it is crucial to ensure the supply of high-quality medical-grade oxygen to the severe and critically ill group of patients. In addition, the hospitals should prepare for improving the oxygen surge capacity to meet the needs of sudden rise in the number of cases.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Mash B. Primary care management of the coronavirus (COVID-19). S Afr Fam Pract (2004) 2020;62:e1-4.  Back to cited text no. 1
    
2.
World Health Organization. Coronavirus Disease 2019 (COVID-19) Situation Report – 85. World Health Organization; 2020. Available from: https://www.who.int/docs/defau lt-source/coronaviruse/situation-reports/20200414-sitrep-85-covid-19.pdf?sfvrsn=7b8629bb_4. [Last accessed on 2020 Apr 15].  Back to cited text no. 2
    
3.
World Health Organization. Oxygen Sources and Distribution for COVID-19 Treatment Centres – Interim Guidance. Geneva: WHO press; 2020. p. 1-4.  Back to cited text no. 3
    
4.
He G, Han Y, Fang Q, Zhou J, Shen J, Li T, et al. Clinical experience of high-flow nasal cannula oxygen therapy in severe corona virus disease 2019 (COVID-19) patients. Zhejiang Da Xue Xue Bao Yi Xue Ban 2020;49:0.  Back to cited text no. 4
    
5.
World Health Organization. 2019 Novel Coronavirus (2019-nCoV): Strategic Preparedness and Response Plan. Geneva: WHO press; 2020. p. 1-20.  Back to cited text no. 5
    
6.
World Health Organization. Coronavirus Disease (COVID-19) Technical Guidance: Essential Resource Planning – Forecasting Supplies, Diagnostics and Equipment Requirements. World Health Organization; 2020. Available from: https://www.who.int/emergen cies/diseases/nov el-coronavirus-2019/techn ical-guidance/covid-19-cri tical-items. [Last accessed on 2020 Apr 15].  Back to cited text no. 6
    




 

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