Extra ICU beds are being opened by the Belfast health trust to cope with a surge in Covid-19 admissions, according to Northern Ireland's chief nursing officer Charlotte McArdle.
The beds for Belfast trust patients are being made available at Belfast City Hospital due to capacity issues at the Royal Victoria and Mater hospitals.
Ms McArdle said there was currently no plan to reopen Northern Ireland's Nightingale facility at the City Hospital, but she warned that would become a "very real possibility" if the surge continues.
She said there were 15 new ICU patients admitted in Northern Ireland over the week.
"The Belfast trust are planning to open additional Covid ICU beds in the BCH on the ground floor which would be for Belfast patients," she told BBC Radio Ulster's Nolan Show.
"We haven't yet made a decision to reopen regional Nightingale, but if this pressure continues that's a very real possibility and, of course, that comes with complications and other decisions that need to be made around the balance in keeping surgery going."
She said all five health trusts in Northern Ireland were under increasing pressures.
"All our trusts are having extreme difficulties coping, the health and social care system across all our trusts are struggling to cope with the current levels of demand for care," she said.
"It's impacting on the emergency departments, on GP services, on the ambulance service, and in all areas really. The five trusts today are in extreme escalation and at the moment across the five trusts there are 190 people waiting more than 12 hours for hospital admission."