We will not have the advantage of being able to transfer patients to larger centres (it is unrealistic to think that the ambulance service would agree to or cope with this).
As our physiologists and nurses cannot go anywhere but stay in their homes they have agreed to come in out of hours or at weekends, the default for anyone for a temporary wire will be full implant as the cardiologist will be called in anyway 24/7.
We usually have a radiographer for all implants, but there is a risk with staff sickness and the requirement for COVID – 19 imaging that we will not have a radiographer available for all emergency devices. Therefore a cohort of staff (more then you think given potential sickness) are going to be trained on Monday to put patients on the system and to use the equipment. The fluoroscopy doses for bradycardia and ICD implants are vanishingly low and you are likely to need only one plane of imaging so although perhaps not ideal safe in a crisis.
We are currently in the strange position of some COVID patients in the hospital but a half empty ward but this gives the chance for planning the above.
The bottom line is there is not a one fits all solution here for all hospitals.
