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What is the difference between sustainable and unsustainable hospital surge capacity?

As COVID-19 cases continue to climb in Texas, let's take a look at what these terms really mean.

HOUSTON — A hospital’s surge capacity is its ability to expand the number of intensive care beds in a crisis.

There are different types of surge capacity: sustainable surge and emergency surge.

Sustainable surge is what we’re approaching in Houston with new COVID-19 cases.

By law, all hospitals must have a plan for sustainable surge—up to 20 percent above capacity. Sustainable surge capacity calls for re-purposing normal and emergency room beds into ICU beds. Those beds must also have a ventilator and other special patient-monitoring equipment. Staff must also be trained on how to use the equipment.

 It’s not just the rooms that would be different, said Serena Bumpus with the Texas Nurses Association, the staff would differ, too.

“We are pulling staff nurses from other areas of the hospital that maybe might not have ever worked in the critical care setting,” Bumpus said.

ICU care could also shift to emergency rooms, something Houston Health Director Dr. David Persse said could have a knock-on effect.

“It’s comparatively a more uncontrolled environment than the intensive care unit and patients ultimately get better care when they’re in the intensive care department,” said Persse. “There’s a good chance that the deaths will go up.

Emergency surge capacity is where Greater Houston could be headed if we continue to see the spike in coronavirus cases.

Emergency surge capacity means hospitals have exceeded the extra 20 percent ICU capacity they plan for. In that case, hospitals start putting two ICU patients in one room.

Hospitals must look at converting rooms not typically used for treating patients to care for those who are critically ill.

Nurses also have to care for more patients than normal.

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