From the COVID front line


Written by Dr Sanjiv Nichani, Consultant Paediatrician


I spent the day on Thursday last week at the Glenfield Hospital in Leicester on the Unit where I normally work i.e. the Children’s Intensive Care Unit which has been handed over to my Adult Intensive Care colleagues in order to help them care for the sheer number of adults being overwhelmed by the Coronavirus.

It was a strange experience to see 12 critically ill adults in beds where we normally look after children following cardiac surgery at the East Midlands Congenital Heart Centre. However these are exceptional times.

The COVID disease and process is something I have never witnessed before, the lengths to which all the staff must go to protect themselves from this tiny but deadly microbe which faces an existential threat if it doesn’t come into contact with humans.

Quite an irony given what it is doing to the human race.

As I entered the Intensive Care Unit (ICU) through what is normally the parent’s entrance I noticed that the whole parent’s area had been turned into the command and control centre.

It was a hive of activity

In addition a section of The Command and Control area also functioned as the staff room where staff would come back from the ICU to take a break and would get brief respite from the life and death battle that they were immersed in .

All staff who were working on the ICU entered through this newly configured area whose pivotal function was to don the staff in the protective layers of PPE in the right order to ensure that the virus stays exactly where it should be and that is away from the healthcare worker.

This crucial role is performed by either a healthcare assistant or a nurse who take extreme care to ensure that the virus had no chance of entering the body of their colleagues who they were literally dressing for battle.

The PPE looks exactly like what has been seen on television so many times.

Humour that essential human emotion, necessary to keep spirits up was alive and present, as every time a time a nurse or doctor was kitted out, not only did they have their names and roles scribbled on their protective gowns but very quickly acquired nick names as well.

It really doesn’t take long and everyone in the vicinity breaks out into a smile lightening the mood before each team member now donned enters the fray.

Once donned properly the doctor or nurse enters a holding area called the warm zone through a set of double doors .This warm zone is in turn separated from the ICU by another set of double doors.

The warm zone protects the Command and Control centre from the ITU and only if the door to the Command and Control centre is closed can the door to the ITU be opened.

Once I entered the clinical arena, I felt like I was on a Hollywood film set except that this is no tale of fiction but a deadly serious battle for life and death.

Communication between the ITU and the team outside is maintained with the help of a walkie talkie and there is a runner at the end of each walkie talkie fetching essential pieces of equipment throughout the shift.

Even the passing of this equipment between the control centre and the ICU via the warm zone needs to be coordinated and performed very strategically and safely in order that the deadly COVID stays in the ITU.

The ICU itself consists of a central nursing station positioned in the middle of the Unit which gives the medical and nursing team a view of all the patients on the Unit.

As I entered the ICU, I observed that the atmosphere was serious but calm.

Everyone donned in their PPE were going about their jobs with a qui