Anesthesia Residency During COVID-19 Pandemic
Our COVID-19 Pandemic Response
We are incredibly proud of the response of our department and trainees to the COVID-19 pandemic.
BIDMC was in the hot zone of the COVID-19 surge in Boston. For approximately three months the operating rooms were closed to elective cases. Our anesthesia, critical care, and pain medicine department was on the front line of COVID-19 care: Our staff intubated every COVID-19 patient, staffed 9 ICUs (an increase over the 4 ICUs we typically staff) that included 3 PACU ICU teams utilizing anesthesia machines as ventilators, developed COVID-19 intubation protocols and coordinated the training and simulation sessions for OR and ICU staff in the safe management of COVID-19 surgical patients and parturients.
The protection of our trainees and staff was paramount; only the most experienced staff (therefore not trainees) managed the care of COVID-19 patients' airways and surgical cases. In the ICUs, residents were critical to our ability to provide safe and effective care. Many of our anesthesia residents volunteered to do additional ICU rotations to care for these patients; in the PACU ICUs, our residents further solidified their expertise by using several different types of ventilators, including anesthesia machines, in the management of severe respiratory failure. The residents caring for COVID-19 patients always had adequate PPE and we scheduled additional off-time and used CRNAs to provide extra on-call support to help support our trainees during this challenging time. Our fellows helped organize and staff the COVID-19 field hospital, Boston Hope.
Currently, all patients are screened and elective cases are COVID-19 tested prior to the OR. Now that we have confidence in the effectiveness of our PPE practices, our trainees are now involved in all cases regardless of COVID-19 status. We have ensured that all staff members have adequate PPE and any time-out related to COVID-19 (for testing, for example) is forgiven. Case numbers and missed rotations were tracked and schedules adjusted to make up for the OR downtime, so we anticipate all residents will meet their case minimums. During the height of the crisis we pared down our didactic schedule and converted to online formats and have now returned to a full albeit virtual — didactic schedule, using the pandemic experience as an opportunity to explore additional modes of learning outside of the traditional lecture style talks. Finally, our critical care leadership is closely involved with hospital leadership in planning for any potential resurgence to minimize the effects on our day-to-day practice.
In response to the coronavirus pandemic, our department also provided a robust wellness response to support our staff and trainees. Virtual social events — including happy hour, yoga, and meditation — are provided by members or friends of the department, and we developed the HEALS (Hearing Each other And Lending Support) pager: a 24-7 confidential hotline for any member of the department to get support.
The Commonwealth of Massachusetts also has had a strong response to the COVID-19 pandemic: there is mandatory masking and limits on large gatherings of people; as a result of these efforts we are in Phase 3 of reopening and our positivity rate is near 1%.