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Table 1 Selected elements of the Infectious Disease Epidemic Plan of King Abdulaziz Medical City-Riyadh as it relates to the intensive care (initial release in May 2014 and first revision in March 2015)

From: The critical care response to a hospital outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection: an observational study

 

Task/description

Plan activation

The plan will be activated by the Chair of the outbreak response committee based on the phase definition

 Phase I 0–5 cases of suspected or confirmed in the hospital

 Phase II 6–30 cases of suspected or confirmed in the hospital

 Phase III >30 cases of suspected or confirmed in the hospital

MERS patient placement

Phase I

 Confirmed MERS-CoV cases requiring intubation will be assigned a negative-pressure room and cohorted in one ICU

 Confirmed cases that have been diagnosed with MERS-CoV in any ICU other than the Trauma ICU (Unit A), shall be transferred to the Trauma ICU (Unit A) as soon as possible.

Phase II

 All MERS-CoV patients will be cohorted in one unit. If the number of patients exceeds its capacity, then other units are identified to receive the additional cases

Closure of all nonessential hospital functions

Phase I

 All services run without interruptions except for certain precautions for MERS patients

Phase II

 All elective surgery shall be canceled to free more ICU beds

Phase III

 All elective cardiac surgery shall be canceled

 Outpatient clinic visits shall be limited to urgent visits only

Healthcare worker (HCW) management

All HCWs shall be aware of

1. Relevant infection prevention and control policies and procedures

2. Their annual influenza immunization status. If not vaccinated, please contact the employee health clinic to arrange for an appointment

3. Their N95 fit check/test status. If have not been fit-tested, please contact the employee health clinic to arrange for an appointment

HCWs exposed to a confirmed MERS-CoV case shall be assessed according to a predetermined protocol

HCWs requiring isolation at home and happen to share a room with another HCW will be provided a room in the designated accommodation for isolation till cleared by the Infection Prevention and Control Department

An Infection Prevention and Control officer is available 24 h per day, 7 days per week

  1. ICU intensive care unit, HCW health care worker, MERS-CoV Middle East respiratory syndrome coronavirus