CLINICAL PROFILE AND OUTCOME OF COVID-19 PATIENTS WITH REQUIREMENT OF OXYGEN THERAPY FOR GREATER THAN ONE WEEK

The novel coronavirus disease (COVID-19) pandemic, caused by the highly contagious severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), is still at its height causing thousands of deaths each week.Although several large randomized drug trials are underway, current survival from severe COVID-19 de- pends entirely on providing the best possible supportive care.1 Data from China suggests that although the majority of people with COVID-19 have mild illness (40%) or moderate illness (40%) about 15 % of them have se- vere illness requiring oxygen therapy, and 5% will be critically ill requiring inten- sive care unit treatment.2,3 Oxygen therapy is recommended for all moderate, severe and critical COVID-19 patients, with low doses ranging from 1-2 L/min in children and starting at 5 L/min in adults with nasal cannula, moderate flow rates for use with venturi mask (6-10 L/min) or higher flow rates (10-15 L/min) using a mask with reservoir bag. In addition, oxygen can be delivered at higher flow rates and in higher concentrations, using high-flow nasal cannula (HFNC) devices, non-invasive ventilation (NIV) and invasive ventilation devices.4 In this study we would like to identify the risk factors leading to prolonged oxygen requirement in COVID-19 patients.This information will help us in managing our resources effectively in a resource-limited setting by preparing the mindset of the patients early on in the admission for home oxygenation. The aim of the study is to assess the clinical profile and outcome of COVID-19 patients requiring oxygen therapy for more than one week duration.

Ethics in the Intensive Care Unit: a Need for Research

Intensive care units are challenging and technologically advanced environments. Dealing with situations that have an ethical dimension is an intrinsic part of working in such a milieu. When a moral dilemma emerges, it can cause anxiety and unease for all staff involved with it. Theoretical and abstract papers reveal that having to confront situations of ethical difficulty is a contributory factor to levels of poor morale and burnout among critical care staff. Despite this, there is a surprising dearth of published nursing research in the UK that investigates how staff deal with ethical issues in intensive care units. The purpose of this paper is to explore and discuss the development of a research framework designed to explore how staff deal with moral dilemmas in a British inten sive care unit.