Indian Journal of Ophthalmology

LETTER TO THE EDITOR
Year
: 2020  |  Volume : 68  |  Issue : 7  |  Page : 1482-

Fighting the COVID-19 pandemic: An ophthalmologist's experience in an intensive care unit at the All India Institute of Medical Sciences


Swechya Neupane 
 Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Dr. Swechya Neupane
Dr Rajendra Prasad Centre for Ophthalmic Sciences, All Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
India




How to cite this article:
Neupane S. Fighting the COVID-19 pandemic: An ophthalmologist's experience in an intensive care unit at the All India Institute of Medical Sciences.Indian J Ophthalmol 2020;68:1482-1482


How to cite this URL:
Neupane S. Fighting the COVID-19 pandemic: An ophthalmologist's experience in an intensive care unit at the All India Institute of Medical Sciences. Indian J Ophthalmol [serial online] 2020 [cited 2020 Oct 24 ];68:1482-1482
Available from: https://www.ijo.in/text.asp?2020/68/7/1482/287473


Full Text



Dear Editor:

COVID-19 is a contagious acute respiratory infectious disease that has emerged as a pandemic affecting over 83,000 people in India and over four and a half million people worldwide today.[1]

All India Institute of Medical Sciences (AIIMS), New Delhi, one of the best medical institutions in India, had anticipated significant rise in number of cases in future and set up a separate Intensive Care Unit (ICU) for COVID-19 positive patients with arrangement of best facilities for patient care. AIIMS had declared 25 percent of the resident doctors from each department to be trained and deployed for COVID-19-affected patients after a training session.

We had three days training where we were taught about the donning and doffing process that had to be followed before entering and after exiting the COVID-19 ICU. Basic ventilator settings in the ICU were taught to us along with the life-saving procedures like laryngoscopy and endotracheal intubation. Being in a field that does not deal with ICU patients, it was a different experience. However, following my conscience and medical ethics, I completed the training.

On the day of ICU duty, I showed up an hour before for donning which is a very crucial step. The wearing of Personal Protective Equipment (PPE) had to be performed outside the COVID-19 ward in a donning designated area. We were instructed by a nurse to wear inner gloves making sure that cuff of gloves went as far as possible. This was followed by sitting on a clean chair followed by wearing boots, gowns, masks, face shields and outer gloves. While wearing every item, hands had to be sanitized in between. We were geared up with our PPE ready to face COVID-19.

As I entered the ICU along with an anaesthetist colleague, there was fogging on face shield, which led to poor visibility. We monitored three COVID-19 positive patients throughout six hours duty.

After six hours of ICU duty, I handed over to the next batch and went for doffing or taking of the PPE. Doffing was even more important than donning as I had to go home from there. Doffing had to be done with utmost care and slowly so as not to generate any aerosol. Trying my best to be as gentle and cautious as ever, I sat in a dirty chair with legs uncrossed. I removed boots followed by outer gloves. Inner gloves were disinfected followed by removal of gowns, face shield, mask, and inner gloves which were discarded in a red bin. This was followed by a shower. Hand hygiene was performed after each and every step. The entire doffing procedure was performed in front of an observer.

While driving home, I was pondering upon things that could be done from my side as a budding ophthalmologist to prevent health workers from getting contracted with the disease and minimizing transmission from one patient to another with the use of proper hand hygiene after seeing every patient. Similarly, detailed history and details of patient should be noted so that contact tracing can be done, if anyone is suspected of having this disease.[2] I believe, as stated in the Hippocratic Oath, “I will prevent disease whenever I can, for prevention is preferable to cure” should be our motto in fighting COVID-19 in the upcoming days.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Unknown. Worldometer. [Online]. Available from: https://www.worldometers.info/coronavirus/. [Last accessed on 2020 May 15].
2Shetty R, D'Souza S, Lalgudi VG. What ophthalmologists should know about conjunctivitis in the COVID-19 pandemic?. Indian J Ophthalmol 2020;68:683.