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Mulago developing guidelines for transferring COVID-19 patients to ICU

FILE PHOTO: Mulago hospital

Kampala, Uganda | THE INDEPENDENT | Guidelines are being developed at the coronavirus isolation and treatment centre in Mulago to help health workers a make quick decisions on what kind of patient benefits from ICU services first, in case they are faced with multiple cases with serious symptoms.

Dr Elizabeth Namukwaya, a palliative care physician at the hospital currently based at the Isolation centre said they have finished initial drafts and hope to have a complete document by the end of this week.

She said these guidelines are necessary considering the fact that there are not enough facilities to offer intensive care services with only 55 ventilators for the whole country.

She said that while they haven’t received anybody among the 44 who have tested positive for COVID-19, so far, getting acute symptoms that require a high dependency on life support might present themselves in future and find medical teams ill-prepared for big numbers.

She said that they are also including a guideline on what sort of psychosocial support health workers can give to people affected by the disease for both those in the mild and moderate category.

Her colleague, Dr Mhoira Leng said that to develop these guidelines, they are comparing notes with what has already been developed elsewhere especially in India and Europe.

She however notes that for these guidelines to be implemented in the hospital, they will first have to get approvals from the Ministry of Health which to her is currently pre-occupied with ensuring that all people in isolation and those that have developed symptoms are tested and those that test positive are admitted for supportive care.

Responding to this Dr Miriam Ajambo, an official at the Ministry of Health said that even without the guidelines in place, they have resorted to virtual training for health workers at hospitals in the districts.

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One comment

  1. I can imagine the confusion at the hospital when the 50 beds are full.
    Given how things work in Uganda, phone calls will be made to hospital from important people and ventilators would have to be pulled from the faces of some patients and placed on others.
    At the moment the prices of ventilators have hit the roof and Uganda may not be able to afford a decent number.
    What are the options?
    1. I recently saw Andrew Cuomo who has purchased over 4000 Bag Valve Masks which are a crude ventilators which have to be squeezed 24/7 by a nurse. It is relatively cheap and no serious developed country would put this into practice (cost of labour).
    2. Private partnerships with universities or local engineers (katwe) in uganda. Those engineering students are capable of making ventilators out of any parts they can find using blue prints they can find online. These students should be exempt from stay at home
    3. Put an order in with China, Korea, Italy. The countries which are coming or will be coming out of it.

    It would be very disturbing in Mulago when those beds get full and hospital standard operating procedures are overruled by phone calls from outside. It is best this is avoided at all costs!

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