Day 8 – A Typical Day | Jessica Bussert  |  Founder & CEO Friday, April 17th

I mentioned yesterday that I’d offer more details about a typical day in a COVID-19 emergency room.  Let me begin with the fact that there is never a typical day in the ER.  A lot of folks have this notion that a full moon brings out the craziness or that weekends are often insane in the department.  While these statements -can- be true, the fact is that a lazy Tuesday afternoon can just as quickly turn upside down following a single car crash or a barroom brawl.  Conventional emergencies still happen regardless of the added COVID-19 patients.  The only difference is that we need to respond to all of them while wearing a full complement of personal protective gear.

PPE is hot, bulky, and difficult to manage.  Imagine trying to perform even the most basic of tasks while wearing all that stuff and you begin to get an idea of the magnitude of the problem.  Now, add to it the extra challenge when your task requires a sterile field.  Believe me, it can be a real headache.

Take for example the very common task of inserting a urinary catheter.  Also called a Foley, this is a tube that is inserted into the urethra to help a patient void.  The tube, the patient, and the nurse performing the procedure all need to remain sterile throughout the whole procedure.  If your gown flows out and touches your sterile field you need to stop everything and start over from scratch.  That means throwing out all of your existing supplies, getting new ones, re-prepping the patient, and trying again.  Now, if your mask slips down in the middle of the procedure and blocks your vision, you might need to do it all a third time.  Usually, we get it right the first time, even with the added challenges.  Still, mistakes and accidents can and will happen even to the best of us.

During normal ER operations, you will sometimes get patients that are agitated, angry, uncooperative, or even downright hostile.  In normal times, people suffering from an altered mental state don’t often remember to keep their masks on or cover their coughs.  Mentally ill patients sometimes like to throw things at the staff.  Sometimes the things they throw come from their own bodies.  While disgusting at the best of times, each of these situations can potentially become deadly for staff and other patients during a pandemic.  It’s a scary situation to be in for anybody and anxieties run high for everyone in the facility.

Finally, there are many procedures that create airborne particles just through their normal operation.  The news is filled with stories of ventilator shortages but I haven’t yet seen one story about the drastically increased risks incurred by doctors, nurses, and respiratory techs while intubating a COVID patient and placing them on a vent.  Think about it… The care providers engaged in that task are literally hovering over an infected person’s open airway while using suction devices, flowing oxygen supplies, and ET tubes.  It’s the healthcare provider’s version of vacationing in Chernobyl!  That added risk doesn’t stop my coworkers.  They just do their job and pray that their PPE remains intact.

So, that’s just a few examples of what a day in the ED might look like.  I hope you didn’t read this post right before dinner…