Local hospitals and State work to increase Intensive Care Unit (ICU) beds

COLORADO - The Colorado State Emergency Operations Center (SEOC) is working with communities across the state to prepare for an expected major increase in the need for intensive care unit (ICU) beds as a result of COVID-19.
The SEOC is partnering with local public health organizations, health care facilities, the Colorado Hospital Association, and federal and state agencies to prepare for a potential medical surge by:
Identifying all current hospital beds in the state by type of care.
Helping health care facilities with plans to free up ICU beds and transfer patients.
Identifying and preparing alternative care sites that could be repurposed to provide medical care.
Identifying and redeploying additional ventilators to areas of need with the goal of increasing ICU bed capacity.
Current estimates are that Colorado has 1,849 ICU beds across the state. The state’s goal is to add 1,000 beds by May, and to add another 5,000 by the summer.
In the meantime, each health care facility is working to move patients out of ICUs, when possible, into acute care beds and lower-needs beds in order to prepare for increased demand in ICU settings.
In order to open up beds in the acute care setting, ambulatory surgical centers will receive patients from acute care hospitals who are close to discharge or awaiting admission to other facilities. These ambulatory surgical centers are capable of providing medical oversight for those patients who need it, and most of the centers have space, staff, and resources available since elective surgeries are being delayed in accordance with a state public health order. The beds opened up in the acute care setting could then potentially turn into ICU beds.
Local public health organizations and local emergency managers are also working to identify alternative care sites. Potential sites are medical facilities that could be repurposed, those that are currently underutilized, or those that have been closed due to low demand or newer hospitals being built. As local agencies create local plans for alternative care sites, they are sending their recommendations and resource needs to the SEOC.
San Luis Valley Health has successfully launched its Respiratory Clinic. The clinic, located at 2115 Stuart Avenue in Alamosa, was created to triage and treat anyone who has clinical symptoms of COVID-19. These symptoms include, but are not limited to, cough, fever and fatigue.
SLVH created an isolated space with fully functioning negative pressure ventilation in place. It is staffed by primary care providers who are dedicated to slowing the spread of the virus. The providers educate the public, give advice, answer questions and in large part, “treat from afar.” The goal is to keep people safely at home.
After being open for a complete week, SLV Health staff observed that the majority of patients need symptomatic care and treatment: cough and cold medicine, rest, hydration and exercise as tolerated (to keep their immune system strong and to keep from being inside all day). Some patients have required prescription medications such as Flonase and Albuterol, and if it is safe for the patient, the prescriptions have been sent to the pharmacies without seeing the patient face-to-face.
Heart of the Rockies Medical Center in Salida previously had two negative pressure rooms at its facility but given potential increases in patient volume in the future, has converted additional rooms in the facility to negative pressure rooms, for a current total of five. Negative pressure rooms use lower air pressure to allow outside air into a contained environment, then traps and keeps potentially infectious and contagious particles within the room by preventing internal air from leaving the space.
Additional facility space is being allocated and arranged in preparation for increased patient volume. Given only urgent and emergent surgeries are being performed at this time, the Same Day Surgery unit has been reconfigured to create space for 14 additional beds. Other areas of the hospital are also being considered for reconfiguration.
In addition to medical sites, the SEOC has worked with the Army Corps of Engineers to identify other locations like hotels, dormitories and vacant buildings that could potentially be repurposed for medical use. The State Architect and the SEOC are evaluating these sites for medical use. This includes looking at condition, location, number of potential beds and cost to convert. Ideal locations are within 1 mile and up to 5 miles of current acute care hospitals.