As a nursing student let me list them as:

High risk of exposure: When dealing with highly infectious diseases like COVID-19, healthcare workers involved in treatment are at elevated risk of exposure due to close contact with infected patients, aerosol-generating procedures, long work hours in protective equipment, etc. This threatens the safety of care teams and can lead to staffing shortages if providers get sick.

Resource strain: Critical infectious disease cases often require intensive monitoring and complex care over long periods. This strains scarce ICU resources like beds, ventilators, specialized equipment and supplies. It also increases demand for key staff like critical care nurses, respiratory therapists and anesthesiologists who are needed round-the-clock.

Infection control challenges: Maintaining strict infection control practices while providing emergency and time-sensitive procedures is difficult yet crucial. Teams must constantly don and doff layers of PPE properly to avoid self-contamination. Patient environments like ICUs and operating rooms pose unique airborne transmission risks and require specialized disinfection.

Lack of therapies: For novel pathogens, proven treatments may be limited or unknown, making case management and projections less certain. Clinicians have to make the best decisions possible with incomplete information and rapidly evolving knowledge, which can increase stress levels.

Patient isolation: Infectious patients, especially those on ventilators, cannot have visitors for long periods. This complicates communication with families and provision of holistic care models. It also increases the psychosocial burden and moral distress on healthcare providers.

I hope this overview provides some useful insights into the multifaceted challenges critical care and anesthesia teams face during infectious disease crises like the current COVID-19 pandemic.

Some of the key challenges gathered:

1. Infection Control: Infectious diseases can be highly contagious, and strict infection control measures are crucial to prevent the spread of the disease among patients, healthcare workers, and the broader community. Critical care and anesthesia units need to have robust infection controlprotocols in place, including appropriate isolation procedures, personal protective equipment (PPE) usage, and disinfection practices. Balancing the need for effective infection control with the provision of necessary care can be challenging.

2. Transmission Risk: Healthcare workers, including critical care and anesthesia providers, are at an increased risk of exposure to infectious diseases due to close contact with infected patients, aerosol-generating procedures, and potential exposure to bodily fluids. Adequate training, adherence to infection control protocols, and availability of appropriate PPE are essential to minimize the risk of transmission to healthcare professionals.

3. Resource Allocation: Infectious disease outbreaks can strain healthcare resources, including critical care beds, ventilators, medications, and specialized equipment. The increased demand for these resources during outbreaks may require careful allocation and prioritization of resources to ensure optimal care for critically ill patients. Ethical considerations, such as fair distribution and maximizing the overall benefit, may come into play when making resource allocation decisions.

4. Diagnostic Challenges: Prompt and accurate diagnosis of infectious diseases is crucial for appropriate patient management. However, some infectious diseases may present with nonspecific symptoms or have overlapping clinical features, making diagnosis challenging. Access to rapid and reliable diagnostic tests is essential to facilitate timely and accurate diagnosis, which can impact treatment decisions and infection control measures.

5. Staffing and Workforce Management: Infectious disease outbreaks can lead to increased patient loads and workforce demands, potentially straining the healthcare system. Adequate staffing levels, including trained critical care and anesthesia providers, are essential to meet the increased demand for services without compromising patient care. Ensuring the physical and mental well-being of healthcare providers is crucial to sustain the workforce during challenging times.

6. Evolving Knowledge and Guidelines: Infectious diseases often present new challenges and require healthcare providers to stay updated on the latest knowledge, guidelines, and best practices. Rapidly evolving evidence and changing recommendations can pose challenges in providing consistent and evidence-based care. Continuous education and training are essential to ensure healthcare providers are equipped with the most current information and can adapt their practices accordingly.

These challenges highlight the importance of preparedness, infection control measures, collaboration across healthcare teams, and ongoing education and training to effectively provide critical care and anesthesia services in the context of infectious diseases.

Hope it helps

I recommend general endotracheal anesthesia using modern synthetic narcotics to maintain respiratory rate between 8-12 breaths per minute to allow CO2 accumulation as high as 100 torr. If the patient must be maintained with mechanical ventilation, then adjust the ventilator settings to maintain hypercarbia between 50-100 torr. The endotracheal intubation will help to isolate the contagion, and enable measurement of exhaled gas concentrations. Hypercapnia will open the capillary gate, promote tissue perfusion, optimize antibiotic “penetration”, release oxygen from arterial blood into tissues (which will potentiate antibiotic potency), counteract opioid respiratory depression, and accelerate opioid metabolism and clearance. Opioid (narcotic) treatment will also control harmful nociception activated by sepsis, and optimize outcome. We have forgotten these powerful medical principles. 100 years ago, even before needle technology enabled intravenous access and before antibiotics were discovered, Dr. George Washington Crile cured sepsis and peritonitis using massive intramuscular injections of morphine that rendered patients comatose for up to a week without food or water. Simply enhancing microvascular perfusion and tissue oxygenation (which is what the morphine does) will enable the human body to eradicate stubborn bacterial infestations. They are almost always caused by gram negative “facultative anaerobes” that can tolerate small concentrations of oxygen but cannot tolerate the oxygen concentrations normally maintained in healthy tissues. The myth that carbon dioxide is “toxic waste, like urine” is arguably the most idiotic notion presently prevailing in “modern” medicine. Carbon dioxide is benign, beneficial, and essential for life. www.stressmechanism.com