What should the new “structural” UCRI be like?

Olga Mediano, coordinator of the Separate Year of the UCRI.

After the leading and vital role played by the Intermediate Respiratory Care Units (UCRI) During the hardest moments of the Covid-19 pandemic, the Spanish Society of Pneumology and Thoracic Surgery (Separ) have decided extend another year its annual recognition to the most outstanding subject in the specialty. An ‘extra time’ that is favored by the multitude of pending tasks to finish off, among which are the promotion that there is no hospital without an UCRI, or the demand for maintain an operative UCRI 24 hours a day in each territory according to the population range.

“There are UCRIs at different levels. in those of third level care for more complex patients, who are critical and in other centers would be in an ICU. These require the pulmonologist 24 hours. This is indisputable because if the patient is critical and it is necessary to decide whether to intubate or not, the pulmonologist must be present”, points out the coordinator of the Separate Year of the UCRI, Olga Mediano.

In this sense, the pulmonologist explains that they advocate no hospital without IRCU and that non-invasive respiratory support is present at all levels of care. However, it details that “they do not expect” this level of UCRI for all hospitals. “Yes, at least for a health area determined there must be a 24 hour pulmonologist that attends an UCRI”, explains Mediano, who adds that in some areas there should be more than one depending on the population range.

Regarding the organization of the Pneumology Service, the specialist details that it would be through medical guards rotations among hospital pulmonologists. “Already with the covid they were implanted and now we must not dismantle them because we are not in the same situation. We have the UCRIs that are extended or collected depending on the infections, but there are others that are structural and that is where they should be open 24 hours a day,” says Mediano.

UCRIs for assistance beyond the pandemic

The request to maintain the UCRIs in hospitals with 24-hour care has also been accepted by the institutions regionalfrom where they see the withdrawal or reduction of these units as a delay in treating the various respiratory diseases that they also provide care for.

Thus, from the Region of Murcia, highlights the official claim of the Murcian Society of Pathology of the Respiratory System (Somupar) to preserve these units for their potential potential “to respond to many other diseases” beyond assistance linked to the Covid-19 pandemic.

In this sense, Somupar has launched a Minimum Necessary Resources Plan in Pulmonology, where they highlight that “in those hospitals with an Intensive Care Unit, they can create mixed units with Pneumology and establish Intermediate Respiratory Care Units. Since the UCRI are cost effective, their existence supposes savings of up to 500,000 euros per yearmore so now if we take into account the Covid pandemic “.

The plans for the ‘extension’ of the Separate Year of the UCRI

The Year Separated from the UCRI It began in a National Congress with a date that is not usual. So that at the next annual meeting, already on the usual dates, the calendar year had not been completed and, in addition, there were many “important initiatives” to finish off.

On a scientific level, the medical organization is working on of the documents. The first deals with updating the consensus document on how to use non-invasive respiratory support in covid patients. “The first was a very early document, but quite visionary and it helped us a lot because in March 2020 nobody knew how to treat patients. Now we must update itWe are well advanced, but we still have a long way to go”, explains Mediano. The second pending document deals with home non-invasive mechanical ventilation. “This one goes slower because it is more extensive and we need time to finish it,” details the specialist.

Another pending task includes the solidarity actions in Honduras and Africa. That of the South American country continues to make good progress while the route of the trailer with the mobile UCRI through the African continent, given its “complexity”, is in a more initial phase.

One of the first actions that will soon see the light, and of which the UCRI coordinator of the Separ year has already slipped some image, is the 3D recreation of a UCRI. “We have recorded 360 degrees a UCRI, that we will show in a presentation to the media and relevant authorities. Through virtual reality glasses they will be able to enter a real UCRI. We were recording it recently and I think that by September we will be able to present it”.

Although it may contain statements, data or notes from health institutions or professionals, the information contained in Medical Writing is edited and prepared by journalists. We recommend the reader that any questions related to health be consulted with a health professional.

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