A letter to the healthcare workers and systems managing COVID-19
By: Michael Aragon, MD
Chief Medical Officer
We are all clearly facing unprecedented times as we address the immediate needs of preparing for the impact of COVID-19. While it was recognized early that the ESRD patient population would present unique challenges to manage in these circumstances, it is also now emerging that COVID-19 infected patients are also requiring renal replacement at a higher rate than originally expected. It is clear the challenges associated with managing our patients will continue to grow through this pandemic.
Strategies for managing dialysis during COVID-19
At Outset, we are seeing how a range of different providers are preparing for managing existing ESRD patients while preparing for a potential increase in AKI patients, and I wanted to take the opportunity to pass on what we are seeing in the field as a way to facilitate real-time learning as the situation unfolds. In particular, we are seeing people taking the following action:
- Repurposing existing locations, or increasing bedside dialysis to deliver isolation treatments to infected patients – whether this be an existing dialysis clinic, or leveraging other parts of the hospital
- Leveraging the pool of nurses and technicians being freed by the reduction of elective procedures to manage and/or support treatments – and rapidly deploying training to those staff prepared
- Shifting from CRRT to PIRRT in the ICU to balance the individual patient need with the increased demand for treatments, machines and supplies
- Considering alternative approaches to documentation to streamline workflow and focus on patient care
- Increasing stocking of key supplies, including PPE and dialysis machines and treatment supplies to prepare for more treatments
Both as an organization, and personally, we have received a significant number of calls from providers on how they could potentially leverage Tablo through this situation. Tablo’s integrated water purification and easy to learn interface allow it to be quickly deployed as a solution during challenging times. This fact is evidenced by Outset Medical’s contract award from HHS for disaster response and preparedness. While no system is specifically designed for a situation such as this, we’re fortunate to offer a technology solution that helps to alleviate barriers while still providing high quality patient care regardless of the setting.
We’re encouraged by initial reports from the field that indicated a COVID-19 positive patient successfully tolerated a 12 hour isolated ultrafiltration treatment with Tablo and later exhibited reduced fluid in the lungs upon imaging. We look forward to sharing other anecdotes with the community as we hear about them.
Tablo’s small footprint is a good fit for crowded treatment rooms
Even more importantly, we as an organization stand ready to support you during this time of need. As highlighted earlier this week by our CEO, Leslie Trigg, we have worked to secure our supply chain to meet the increasing demand for Tablo machines and supplies and continue to support in person training and education for providers.
Know that Team Tablo stands with you, and we will continue to share what we are learning and how we are seeing providers adjust to the changing needs of the situation. Please follow us to stay up to date, and do not hesitate to reach out directly with any questions or concerns.
Michael Aragon, MD
Chief Medical Officer