WTB
Resident
'Difficult decisions' ahead for specialists
By KIM THOMAS - The Press Last updated 05:00 24/07/
The Ministry of Health yesterday warned that the swine flu pandemic was just beginning, and that intensive care units would be under pressure from increasing numbers of critically ill influenza patients.
In Australia, health authorities had stockpiled 130 new ventilators as the number of flu patients in hospitals trebled.
Canterbury intensive care specialist Dr Geoff Shaw said there were 20 people in intensive care in Christchurch yesterday, including 15 on ventilators. Ten had or were suspected of having swine flu.
Shaw said the hospital's ICU usually had a 12-patient capacity but extra staff had been brought in. A cardiac ward had also been cleared to provide extra intensive care beds.
However, Shaw warned that life-saving ventilators and specialist ICU staff were in limited supply and doctors could be forced to ration care if increasing numbers of swine flu patients in critical condition were admitted to hospital.
"We are faced with a situation we've never had before. We've got more people requiring ventilators (because of the swine flu) and it's only expected to get worse," he said.
"We don't have the resources to manage the caseload if patients continue to come in in increased numbers, and, at some stage, we may have to make some difficult decisions about who gets care."
Research shows the swine flu virus penetrates deeper into the lungs than seasonal flu, causing greater damage to the respiratory system.
This meant higher numbers of patients, including the young and people without underlying health conditions, were requiring ventilation.
Shaw said doctors would use every option available before rationing ventilator access.
Elective cardiac surgery and other operations requiring a post-operative stay in ICU were being postponed to free up beds, he said. Experienced nurses had also been seconded from other parts of the hospital, Shaw said.
Some patients had been transferred to other ICUs, including Dunedin, which had some spare beds.
Specialists from ICUs nationwide were talking daily to ensure all beds were being used, Shaw said.
The number of flu patients in Australian hospitals had trebled in a very short time a situation that could occur in New Zealand, Shaw said.
If this happened, rationing of ICU care was likely. These decisions would be made by teams of doctors rather than individuals.
Ministry of Health deputy director of public health Dr Fran McGrath said some ICUs were at capacity, but coping.
"The extended length of ventilation time required by patients with pandemic influenza (H1N1) 09, which can be up to 14 days, along with the peak winter requirements, indicates that there will be continuing pressure on ICU capacity for the foreseeable future."
The ministry was monitoring the situation and working with district health boards to manage hospital capacity, she said.
http://www.stuff.co.nz/the-press/news/christchurch/2669264/Difficult-decisions-ahead-for-specialists
By KIM THOMAS - The Press Last updated 05:00 24/07/
The Ministry of Health yesterday warned that the swine flu pandemic was just beginning, and that intensive care units would be under pressure from increasing numbers of critically ill influenza patients.
In Australia, health authorities had stockpiled 130 new ventilators as the number of flu patients in hospitals trebled.
Canterbury intensive care specialist Dr Geoff Shaw said there were 20 people in intensive care in Christchurch yesterday, including 15 on ventilators. Ten had or were suspected of having swine flu.
Shaw said the hospital's ICU usually had a 12-patient capacity but extra staff had been brought in. A cardiac ward had also been cleared to provide extra intensive care beds.
However, Shaw warned that life-saving ventilators and specialist ICU staff were in limited supply and doctors could be forced to ration care if increasing numbers of swine flu patients in critical condition were admitted to hospital.
"We are faced with a situation we've never had before. We've got more people requiring ventilators (because of the swine flu) and it's only expected to get worse," he said.
"We don't have the resources to manage the caseload if patients continue to come in in increased numbers, and, at some stage, we may have to make some difficult decisions about who gets care."
Research shows the swine flu virus penetrates deeper into the lungs than seasonal flu, causing greater damage to the respiratory system.
This meant higher numbers of patients, including the young and people without underlying health conditions, were requiring ventilation.
Shaw said doctors would use every option available before rationing ventilator access.
Elective cardiac surgery and other operations requiring a post-operative stay in ICU were being postponed to free up beds, he said. Experienced nurses had also been seconded from other parts of the hospital, Shaw said.
Some patients had been transferred to other ICUs, including Dunedin, which had some spare beds.
Specialists from ICUs nationwide were talking daily to ensure all beds were being used, Shaw said.
The number of flu patients in Australian hospitals had trebled in a very short time a situation that could occur in New Zealand, Shaw said.
If this happened, rationing of ICU care was likely. These decisions would be made by teams of doctors rather than individuals.
Ministry of Health deputy director of public health Dr Fran McGrath said some ICUs were at capacity, but coping.
"The extended length of ventilation time required by patients with pandemic influenza (H1N1) 09, which can be up to 14 days, along with the peak winter requirements, indicates that there will be continuing pressure on ICU capacity for the foreseeable future."
The ministry was monitoring the situation and working with district health boards to manage hospital capacity, she said.
http://www.stuff.co.nz/the-press/news/christchurch/2669264/Difficult-decisions-ahead-for-specialists
