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“Currently the clinical intensivist of this unit is sleeping in the Foster Home of the same healthcare center”, describes the doctor from the Uci of Punta Arenas, Patricio Vargas Errázuriz.
ORna “x-ray” of the Intensive Care Unit of the Hospital Clinico de Magallanes, “taken” by one of the team members, reveals serious shortcomings and work overload, as a result of the advance of the Covid-19 in Punta Arenas.
The document that accounts for this reality, and to which La Prensa Austral had access, is signed by the ICU intensivist doctor, Patricio Vargas Errázuriz, and is addressed to the president of the Chilean Society of Intensive Medicine (Sochimi), doctor Tomás Regueira
“I think it is urgent to share my experience on the ground at the ICU of the Hospital Clinico de Magallanes,” he says.
He starts by referring to the “pre pandemic” conditions, where there were 6 ICU beds, 12 intermediate beds and 6 special care beds.
With personnel trained to adequately care for a maximum of 8 patients under invasive mechanical ventilation.
“Among the Uci staff, there are two intensivists, one just completed 20 years of shifts (under article 44), dedicated to administrative tasks and the other intensivist dedicated to direct clinical work. Regarding critical resources, they normally have 12 invasive fans. ”
It is worth noting that the ability to refer ICU patients to other nearby centers is limited (the Hospital of the Armed Forces and the Magallanes Clinic have 4 and 7 total ICU beds respectively).
Current situation
As a witness to the current situation, the doctor details Sochimi (entity that watches over the quality and technical protocols for the care of critically ill patients), who suddenly expanded the ICU from 6 to 24 beds, 18 of these (75 %) do not have trained personnel to handle patients of this complexity (even with general doctors on duty).
“Some of the recently purchased ventilators come from Uci in the same city (further reducing the ability to outsource patients in the event of a collapse).
On the other hand, there is an evident restriction and shortage of protective equipment throughout the hospital, in addition to fairly “artisanal” isolation conditions (patient cubicles are “insulated” with plastic) ”.
80 hospital sick
“Witness to the above is the fact that in these last three weeks 80 people from the hospital staff (17% of the total hospital staff) have become ill, 12 of whom are doctors (including the same deputy director), having a 47 years hospitalized in this ICU in serious condition.
In the last week we have constantly maintained between 17 and 20 people in mechanical ventilation and in critical condition, having to refer 4 patients to other regions, seeing how new cases are added every day, ”he wrote in his letter.
Sleeping at home
“Currently the clinical intensivist of this unit is sleeping in the Foster Home of the same hospital (designed for relatives of patients from distant places), completing days of up to 16 continuous hours of work every day (including weekends), with doctors They have completed up to 48 hours of shifts in a row since Uci staff doctors have fallen ill and there are no trained replacements.
Critical inputs are scarce and the availability of many of these is uncertain (in a region at risk of isolation from winter weather events). ”
The projection
It has been reported that Punta Arenas is the sixth city in the world with the highest rate of infections per inhabitant, the curve of increase in cases has been compared with what has happened in Italy and the curve of new cases per day is still increasing. Worse still, it is estimated that the maximum number of cases will be in 7 to 10 more days.
Viewed in another way, a region that has 0.1% of the population of Chile has 6% of the total number of critically ill patients in the country, with increasing numbers of infections, with only one intensive care physician in charge, shortage of protection elements and supplies and health personnel who are overwhelmed day by day ”, is what Vargas raises with great concern, closing at the end with a phrase:“ And that winter has not yet started ”.
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