According to the professor at the Pécs hospital, they have intensive care for covids in a “terrible, intolerable state, from end to end”

They are already working under tremendous pressure in intensive care units designed for covids. There are many patients, the beds fill in a matter of moments. Although the government is ordering more and more intensive beds, hospitals can only operate existing ones of adequate quality with spectacular effort.

This was revealed in the new part of the KETLAK – Intensive Sciences Online – For All (ITO-M) Webinar series, which was organized on Wednesday night to gather experiences on intensive care with covid. Collaborators, reinforcing each other, reported that it was very difficult to issue the required number of specialists and nurses. (The full video can be seen here).

In Pécs, for example, a third of the 50 nurses have left their work in the last 2-3 weeks, either because they were infected or because they had to go into quarantine as a direct contact. “We are in a very bad situation. Mainly because we did not have so many and seriously ill patients. Our autumn tasks are 8 to 10 times higher than in spring in terms of the number of patients, the severity of their condition and the speed and arrival of the wave, ”said Professor Lajos Bogár from Pécs. They must provide two-thirds of the nurses 2-3 times the amount of work. A person is under even greater pressure.

“It is a burden that is already very difficult to bear,” declared the professor, speaking of “a terrible, intolerable state, from one extreme to another.” The dramatic situation also caught the attention of the directors of the partner clinics on Tuesday, asking them to provide help, to send out a workforce that they can actually employ “to help with the extremely large number of patients and the woefully reduced number of nurses.”

“It seems that my dramatic exposure, my application, has worked for the last 24 hours, some light has shone at the end of the tunnel to really get help from clinics and universities,” he said, although it surprised most of those who came so far. . “The task is terribly big, we are not enough for it. It is necessary to assign to the task non-specialized nurses from the partner clinics, who are scared by everything they see, they experience in our department, ”said the professor.

Beetle also said that “the current mortality sometimes exceeds 50 percent, there are places where prolonged treatment is needed, we are in a permanent war.” They currently have 28 beds, 25 of which are being cared for, but they expect more beds to be opened, up to 103 in the government’s plans. “The specialized personnel will be diluted so much that they will receive 10 to 15 to 20 patients in serious condition per skilled nursing shift,” he said. Previously, experts spoke about the fact that in an ideal world, the nurse: patient ratio in an intensive care unit could be 1: 1, with a maximum ratio of 1: 2. At the cost of large compensation, 1: 3, in a dramatic situation, 1: 6, but that’s really the limit for adequate quality of care.

The teacher’s report starts here:

The re-entry of specialists and nurses was not a solution either, because the doctors sent to other places were missing from their previous places. The original plan, for example, was for Győr to care for covid patients in need of intensive care in five counties. Therefore, the doctors were transferred from the Sopron and Szombathely hospitals. However, due to this, the supply in Sopron and Szombathely was almost impossible. Győr’s 20-person bed capacity was filled in seconds, thus doubling. However, this is not enough, they have now been ordered to build another 63 beds, but while the transfer was completed, the doctors from Sopron and Szombathely returned from Győr.

Inside the hospital, they have received internal help so far, directing doctors from different departments, who have been the ones who have been able to help the most in administrative work so far. Once elective care has been suspended, discharges can also arrive there, but they are not specialists in intensive care, but ophthalmologists, orthopedic surgeons, rheumatologists. Still, they are excited and trying to help. In the spring, residents were supposed to learn the basics of intensive care and breathing in just one week, and now they have to build on them too. “I have no idea how it will go,” said the expert on the situation in Győr.

In intensive care, a few weeks to learn how to operate a ventilator is an incredibly short time, experts say. In the conversation, even routine intensive care units said that intensive therapy must be relearned in covid, and that well-proven things often don’t work.

In Győr, nurses have the same situation as doctors, they try to send nurses from other places to the intensive care units on the front line. There were those who had been intensive for 10 years and since then have avoided being nursing chiefs in the ophthalmology department. Now they were on a battle line, trying to refresh their knowledge. “I see panic in them because I won’t know, but I’ll get used to it,” said the Gy expertor expert.

The report on the situation in Győr can be viewed here:

How they are going to provide more than double the current number of intensive beds, plus, without the reassigned doctors, they don’t know in Győr either.

In Orosháza, 29 intensive beds were ordered. “Of course, we can’t do that, and we don’t have the proper staff and infrastructure. There are fans and monitors, but we know it’s just iron, ”they reported on the recently established Orosháza unit.

At Orosháza, instead of the 29 prescribed, he can provide care for six critically ill covidual patients. The report starts here:

They are in the preparation phase at Kistarcsa: they received an application / instruction to design 22 beds. Beds are designed, although not as well equipped with equipment, not even staffed. In the central region of Hungary, a large number of specialists were transferred to other hospitals. From Kistarcsa, 3 doctors were transferred to the South Pest Centurm Hospital, one to Balassagyarmat. “This brought the ground out from under our feet,” said the expert on the situation in Kistarcsa. In addition, a good number of nurses and internists were also referred. As a cold shower, they had to expand their capacity to 54 beds starting Monday.

“This is a staggering number, and there are absolutely no personnel or tools for that,” the expert highlighted the difference between the government’s expectations and realities.

Now they can start working on 8 beds. What’s more, they didn’t have fans, they had sleeping machines (although then the country is from respirator to collapse) and they only know from “narratives” how to use them for long-term breathing. “I am skeptical, but I can say that we are waiting for the task and I really want to see my colleagues reassigned, because without them it will not work,” concluded the specialist on the situation in Kistarcsa.

In addition to the ever-present shortage of professionals, especially the few intensive care nurses, and expectations of unrealistically high bed capacity, a doctor at a rural hospital drew attention to another point. He said that a forum would be necessary in which the authorities tell us what the basic principles of the treatments are. This was not included in the video at the end.

“It is difficult that way because many times decisions must be made at the bedside that has a very controversial literature, there are no clear guidelines. It is not enough to decide who gets a place, who gets a place, who does not, but we must also decide whether to try this drug now, to whom do we give the few remdesivir we have, why get more excited ”.

By the way, they expect four times more covid beds than can now ventilate a covid patient.

Experts have long said that despite the figures cited by the government, Hungary’s intensive care unit can still operate roughly 3,000 beds of adequate quality. And the Hungarian Medical Chamber has published a report on the real epidemic situation in the country.