Shiloh
Editor, Senior Moderator
Source: http://www.thespec.com/News/Local/article/659694
Hospitals get ready for H1N1 onslaught
Extra ventilators, expanded intensive care units part of strategy to cope with pandemic
October 24, 2009
Joanna Frketich
The Hamilton Spectator
(Oct 24, 2009)
Hamilton hospitals are prepared to pull ventilators out of storage and from operating rooms to combat pandemic flu.
They have enough equipment, space and staff to expand intensive care units by 15 per cent.
If that's not enough, the province has a stockpile of ventilators Hamilton could try to access.
"We've been using that to try to plan ahead for what we anticipate will be a second and much bigger wave," said Dr. Peter Kraus, chief of critical care at Hamilton Health Sciences. "We're in a lot better position to respond. The problem will be the size of the response required. That's the million-dollar question. How big is it going to be?"
Kraus said Hamilton got off lightly during the first wave of H1N1 from April to July. During that time, there were six people requiring intensive care at Hamilton General, Henderson General, McMaster University Medical Centre and St. Joseph's Hospital.
All six were women -- none of them pregnant -- and had other significant diseases. Four of them died. H1N1 contributed to or caused three of those four deaths. The other death was caused by the disease the woman had before getting H1N1.
"They were really sick and they were a real challenge to oxygenate to keep them from lung failure," Kraus said. "They were on ventilators."
The urgent need to have extra ventilators available to hospitals was made clear by a Hamilton study published online this month by the Journal of the American Medical Association. Scheduled to be in print next month, it was deemed to be of such public importance by the medical journal that it released the observational study early.
The researchers from McMaster and St. Joseph's Healthcare found H1N1 caused critical illness rapidly after hospital admission, especially in women. They accounted for nearly 70 per cent of the 168 patients in 38 intensive care units across the country between April and June. Of those, 7 per cent were pregnant, which is normally rare in critical care.
Many of the patients required mechanical ventilators due to oxygenation failure for weeks in intensive care units.
"This study has underscored the importance of being prepared for the upcoming pandemic," said Dr. Deborah Cook, a co-author of the study. "We are well prepared in Hamilton."
Smaller neighbouring communities are concerned they don't have the same ability to provide extra intensive care. Hospitals across the local health integration network are working out a plan to share beds, equipment and staff if an intensive care unit becomes overwhelmed.
There is a provincial and LHIN inventory of ventilators and hospitals are looking at what they could quickly cut back on, such as elective surgery, if H1N1 started filling the intensive care units.
So far, the beginning of the second wave has been light, with four H1N1 patients currently in intensive care in Hamilton.
"No one knows how much impact the vaccination program starting next week will have," said Kraus, who added he plans to get the shot.
"It may help us avert a crisis."
jfrketich@thespec.com
Hospitals get ready for H1N1 onslaught
Extra ventilators, expanded intensive care units part of strategy to cope with pandemic
October 24, 2009
Joanna Frketich
The Hamilton Spectator
(Oct 24, 2009)
Hamilton hospitals are prepared to pull ventilators out of storage and from operating rooms to combat pandemic flu.
They have enough equipment, space and staff to expand intensive care units by 15 per cent.
If that's not enough, the province has a stockpile of ventilators Hamilton could try to access.
"We've been using that to try to plan ahead for what we anticipate will be a second and much bigger wave," said Dr. Peter Kraus, chief of critical care at Hamilton Health Sciences. "We're in a lot better position to respond. The problem will be the size of the response required. That's the million-dollar question. How big is it going to be?"
Kraus said Hamilton got off lightly during the first wave of H1N1 from April to July. During that time, there were six people requiring intensive care at Hamilton General, Henderson General, McMaster University Medical Centre and St. Joseph's Hospital.
All six were women -- none of them pregnant -- and had other significant diseases. Four of them died. H1N1 contributed to or caused three of those four deaths. The other death was caused by the disease the woman had before getting H1N1.
"They were really sick and they were a real challenge to oxygenate to keep them from lung failure," Kraus said. "They were on ventilators."
The urgent need to have extra ventilators available to hospitals was made clear by a Hamilton study published online this month by the Journal of the American Medical Association. Scheduled to be in print next month, it was deemed to be of such public importance by the medical journal that it released the observational study early.
The researchers from McMaster and St. Joseph's Healthcare found H1N1 caused critical illness rapidly after hospital admission, especially in women. They accounted for nearly 70 per cent of the 168 patients in 38 intensive care units across the country between April and June. Of those, 7 per cent were pregnant, which is normally rare in critical care.
Many of the patients required mechanical ventilators due to oxygenation failure for weeks in intensive care units.
"This study has underscored the importance of being prepared for the upcoming pandemic," said Dr. Deborah Cook, a co-author of the study. "We are well prepared in Hamilton."
Smaller neighbouring communities are concerned they don't have the same ability to provide extra intensive care. Hospitals across the local health integration network are working out a plan to share beds, equipment and staff if an intensive care unit becomes overwhelmed.
There is a provincial and LHIN inventory of ventilators and hospitals are looking at what they could quickly cut back on, such as elective surgery, if H1N1 started filling the intensive care units.
So far, the beginning of the second wave has been light, with four H1N1 patients currently in intensive care in Hamilton.
"No one knows how much impact the vaccination program starting next week will have," said Kraus, who added he plans to get the shot.
"It may help us avert a crisis."
jfrketich@thespec.com