Explainer: What happens when the ICU reaches capacity? | Chicago News
Atlanta (AP) — The recent surge in coronavirus cases has overwhelmed many intensive care units, causing hospitals and states to run out of ICU beds in some places.
Kentucky and Texas broke the COVID-19 hospitalization record this week, joining several other states that have already reached the same milestone in the last few weeks. Arkansas said it had run out of ICU beds for COVID-19 patients for the first time since the pandemic began.
Nearly 80% of the country’s ICU beds (about 68,000) were used on Thursday, according to the US Department of Health and Human Services. And about 30 percent, or almost 25,000, of those beds were filled by someone with COVID-19.
As the state is hit by the epidemic delta mutant, the question of what that means for individual patients in places where there are no beds available is skyrocketing. Here are some answers:
What is ICU?
The ICU is designed to take care of the most critically ill people. They employ more staff, specialists and equipment to keep their patients alive. The machine monitors your breathing and heart rate. A “crash cart” is equipped with a defibrillator and an intubation tube in case people have breathing problems or the heart stops.
A typical patient has just undergone major surgery. Some people are seriously injured in a traffic accident. And, of course, some people are infected with COVID-19. Their lungs are damaged and require a ventilator. Nurses take care of them, as do respiratory therapists, respiratory therapists, and infectious disease specialists.
Nancy Foster, Vice President of Quality and Patient Safety Policy at the American Hospital Association, said:
What happens when ICU reaches or exceeds capacity?
A fully utilized ICU can be a nightmare of staffing and logistics.
A nurse who can usually take care of one patient currently needs to keep 3-4 alive. Staff other than ICU will be brought in for assistance. Patients can return to the emergency room waiting for the ICU bed to open. And hospitals are forced to creatively transform space into ad hoc ICU units.
The flood of COVID-19 patients at Phoebe Putney Memorial Hospital in Georgia has hired a large number of employees who are not normally working on the patient’s floor. They included Scott Steiner, President and CEO of Healthcare Systems.
On Sunday, Steiner helped turn COVID-19 patients in their stomachs so that their devastated lungs could probably take up more oxygen. Depending on the patient’s weight, the operation may require 6 people.
“It’s all hands-on decks,” Steiner said.
Roberta Schwartz, executive vice president of the Houston Methodist Hospital System, said that on some campuses, the number of beds reserved for procedures such as colonoscopy and carpal tunnel surgery surged and coronavirus patients Said earlier this week that it filled almost half of the ICU bed. The recovery bay after surgery has become an ICU space.
Schwartz likened the flooded ICU to a house overwhelmed by guests. The host is blasting an air mattress to contain it.
“It’s not very comfortable, but it works,” she said. “And blow-up mattresses are better than sleeping bags. Sleeping bags are better than outdoor tents.”
How does it affect patients?
Patients may have to stay in the emergency room waiting for the ICU bed, which spreads to other patients.
This week, some Texas hospital systems temporarily closed off-site emergency rooms and sent staff to hospitals that were over-expanded by COVID-19.
Patients arriving in the hospital’s emergency room may wait hours, or even days, before entering the already overwhelming ICU.
“We basically do the ICU in the emergency room,” said Schwartz, a Houston methodologist. “You can hold it there for 45 minutes and hold it for 3 days.”
“If you can come to one of our facilities, you will be very careful,” Schwartz added. “But ideally, we want to get people to the right unit as soon as possible.”
Another impact is on people living in rural areas where ICU is scarce. According to the American Hospital Association, less than 3% of ICU beds nationwide are in small rural hospitals.
Often, you will ask the ICU of a large hospital to transfer you.
Dr. Steppe Mette, CEO of the Medical Center at Arkansas Medical College, said: “All our ICUs are full, and our emergency room is full of patients in need of an ICU.”
How does it affect staff?
They are burning out more and more.
This week at the ICU of the Memorial Healthcare System in South Florida, staff were caring for 107 COVID-19 patients, “the most sick of the sick.”
Many did not respond to steroids or other treatments. They needed a ventilator and faced multiple organ damage. Many were expected to die.
“It’s very exhausting for the staff, both physically and mentally,” Saleri said.
Hospitals are already experiencing a labor shortage of nurses and other medical staff. Some staff have left and the people staying are dissatisfied and uncomfortable.
Steiner of Phoebe Putney Memorial Hospital in Georgia said: “Some are just angry because so many people have not been vaccinated.”
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