‘One health worker for each critical patient’

NEW DELHI: One health care worker must be assigned for round-the-clock monitoring of each critical patient with the coronavirus disease (Covid-19), according to “in-hospital” management guidelines issued by the Delhi health department on Tuesday.

The advisory issued by principal health secretary Vikram Dev Dutt also says the guidelines have to be followed by both government and private hospitals.

The Delhi government has been trying to recruit more doctors and nurses – including finalyear students – to staff hospitals that are grappling with staff shortage. Staff crunch was a major concern raised by medical directors of Delhi governmentrun Covid-19 hospitals while trying to increase ICU and ventilator beds.

A technician and a dialysis machine must be available for critical care patients. “Continuous renal replacement therapy or sustained low-flow dialysis with technician to be available as most of critical Covid-19 patients with ARDS (acute respiratory distress syndrome) patients develop acute kidney injury,” the guidelines say.

The guidelines also state that an internal death audit committee should be formed to look at reducing mortality. With the number of patients on the decline, the government is now working to reduce deaths.

A clinical review committee should be set up to review and standardise care and clinical outcomes on a periodical basis. Realtime monitoring of oxygen saturation of all patients has to happen and steps need to be taken immediately if it drops, the guidelines say. At the time of admission, patients’ oxygenation has to be monitored, they have to be triaged effectively with high priority being given to high-risk individuals, the document says.