War Against H1N1 Likely to Be Fought in Intensive Care Units

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    http://thechronicleherald.ca/Front/9013059.html

    Quote from thechronicleherald.ca

    Intensive care specialists who fought to save desperately sick swine flu patients this spring and summer have a warning for hospitals that haven't yet dealt with an influx of these difficult-to-treat patients.

    Prepare. Now.

    Experts predict ICUs are likely to be the main battlefield in the war against a pandemic virus which so far doesn't appear to have much of a middle ground
    (hat tip crofsblogs)
    Last edit by sirI on Sep 6, '09 : Reason: edited for copyright purposes
    oramar likes this.
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    Our medical director was saying just today that our unit is going to be hammered by H1N1. He used the words "overwhelmed" and "inundated". Then he said, "But we'll manage." I asked him if he was furiously knitting nurses in his spare time and he looked at me like I was from Mars. But the fact is, we're short about 15 full-time equivalents and are staffing our unit with OT already. What will we do when we have a full house and have expanded across the hall into the vacant old 8 bed CVICU that moved into a new building six weeks ago? That's in effect 150% capacity, with only about 80% staffing. It's going to be a disaster.

    My friends in Winnipeg have only just started recovering after their crazy spring and early summer. They're not anxious to return to the mandatory OT and CO2 narcosis of the N95 mask. BUT... they'll send their sickest patients to us because we do ECMO and they don't. Yippee.
    indigo girl likes this.
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    Like I have been saying all along, add this to the fact that many healthcare institutions in the US have been cutting staff all summer and you got a problem.
    MedSurgeMess likes this.
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    http://scienceblogs.com/effectmeasur...c_looks_to.php

    Excerpt from Effect Measure post commenting on the latest WHO assessement of the pandemic:

    Quote from scienceblogs.com
    The difference between seasonal flu and swine flu is primarily one of epidemiology, that is, the pattern and distribution of the disease in the population. Younger age groups are affected (and older ones not affected), and the increased infections in the young are producing increased severe and fatal infections. By most accounts we've seen, the virus doesn't seem more virulent than seasonal flu virus. Seasonal flu always kills a certain proportion of its victims, usually in the oldest age groups.
    The Editors of Effect Measure are senior public health scientists and practitioners. Paul Revere was a member of the first local Board of Health in the United States (Boston, 1799). The Editors sign their posts "Revere" to recognize the public service of a professional forerunner better known for other things.
    Last edit by sirI on Sep 6, '09 : Reason: edited for copyright purposes
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    Quote from indigo girl
    http://scienceblogs.com/effectmeasur...c_looks_to.php

    Excerpt from Effect Measure post commenting on the latest WHO assessement of the pandemic:



    The Editors of Effect Measure are senior public health scientists and practitioners. Paul Revere was a member of the first local Board of Health in the United States (Boston, 1799). The Editors sign their posts "Revere" to recognize the public service of a professional forerunner better known for other things.
    Another excellent article. People were spreading those false rumors about "pulling the plug on grandma" in August. What is happening here is that grandma will have to make it without being plugged in or maybe not make it at all. All resources will be allocated to the young. What are you going to do, put the 76 year old on the only vent or the 30 year old mother of four. The choices are going to be extremely harsh. The only thing that might help is that the severest outbreaks may be regional. So that perhaps resources can be moved from one place to another. If all major cities are hit at same time with roughly same severity it won't be pretty. As one ICU nurse here said, "we will be dealing with 150% capacity with staffing at 80%". When it is winding done and the blame game starts perhaps the people picking the situation apart to see what went wrong can come here and read how it was all predicted by nurses.
    indigo girl likes this.
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    Not only will the staffing be at 80%. If the staff can't or won't be vaccinated, you can count on the staffing to be less than 80% because a percentage of them will be sick at any given time.

    I really, really feel for all the ICU nurses out there. It's going to be really tough. I'm starting back into the ER at the end of this month, and as bad as that will be, I think ICUs are going to get it much worse. Bless you all.
    indigo girl likes this.
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    Not only are we running at 80% of staffing on our unit, but as I mentioned on another thread, our catchment area is roughly 1.26 million square kilometers or about 783,000 square miles. In Canada our aboriginal population has been more severely affected in some provinces, including the ones my unit is responsible for when it comes to ECMO support. So far we haven't had any H1N1 patients requiring ECMO but I fear it's only a matter of time.

    While I was eavesdropping yesterday I heard our medical director also discussing the issue of our air ambulance pilots refusing to transport H1N1 patients out of concern that they can't adequately protect themselves from it in the air. There's a meeting tomorrow to discuss the issue with their union and the public health people to see if some sort of arrangement can be ironed out.
    indigo girl likes this.
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    war against h1n1 likely to be fought in intensive care units


    [color=#818181]the canadian press
    [color=#818181]mon. aug 31 - 11:45 am

    toronto — intensive care specialists who fought to save desperately sick swine flu patients this spring and summer have a warning for hospitals that haven't yet dealt with an influx of these difficult-to-treat patients. prepare. now.
    http://thechronicleherald.ca/front/9013059.html
    Last edit by sirI on Sep 6, '09 : Reason: edited for copyright purposes
  11. 0
    Threads merged.
  12. 2
    Quote from Katnip
    Not only will the staffing be at 80%. If the staff can't or won't be vaccinated, you can count on the staffing to be less than 80% because a percentage of them will be sick at any given time.

    I really, really feel for all the ICU nurses out there. It's going to be really tough. I'm starting back into the ER at the end of this month, and as bad as that will be, I think ICUs are going to get it much worse. Bless you all.
    Right now I have elderly patients who tell me that they deserve the vaccine more than any health care worker, because of all the sacrifices that they have made in the past. I just ask them who will take care of them when all of the healthcare workers are sick d/t lack of access to vaccines......Oh well, all of these new grads can step in and take the jobs, with no training on top of that!
    ReddogRN and HonestRN like this.


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