[ad_1]
The outbreak of contagion with the new coronavirus could not be stopped, and the bed
◆ Fully occupied since the beginning of the year
-How is the tightness of the corona bed in Ashigarakami Hospital?
Originally, there was an infectious disease ward (6 beds), which started with accepting passengers on the Diamond Princess cruise ship in February last year, and during the first wave, we stopped all outpatient clinics and general emergency services to ensure a crown. bed. As the number of patients decreased, in June general medical care was resumed and infectious disease beds were returned to 6 beds, which was sufficient until November, but in December the number of hospitalization requests increased and it became impossible to cover it. the number of beds crowns in two parts, beginning and end of the month. We are increasing the number of corona beds to the limit of compatibility with general emergencies,Almost full since the beginning of the yearThe state of continues.
◆ Nurses need twice as much as usual
If you increase the number of crown beds, you will naturally need a nurse. To accommodate crown patients, at least twice the normal nurse placement criteria (1 nurse for 7 patients) are required. Since only doctors and nurses can enter the infectious disease room, nurses must do all cleaning and servicing, in addition to regular nursing.
In our hospital we use protective equipment to enter the room, and when we go out we try not to touch the handrails as much as possible, so we ask them to open the door from outside. For this reason, you have to work as a couple with someone.
Many elderly patients need long-term care and assistanceThere are also difficulties such as dementia. It is also necessary to secure zoning and flow lines in the hospital, install exhaust ducts in the hospital room, etc.Increasing beds is not easy。
Many people get sick during the cold season and many patients go to the general emergency department.Myocardial infarction, stroke, in the elderly
◆ I have to refuse to accept crown patients …
-Are there many cases in which we have to refuse to accept patients with a crown?
Until mid-December, the balance between hospitalizations and discharge was relatively balanced, and I managed to cope without refusing. However, since the end of the year and the New Year holidays, the number of times we rejected the request from the prefectural coordinating headquarters increased significantly because we could not respond more because we were full or we accepted it in quick succession.
Dr. Keisuke Iwabuchi from Kanagawa Prefectural Ashigarakami Hospital in response to online interviews
The number of rejections is much higher now than around January 10. On the 19th (interviewed), a person from the place who was slightly ill and suddenly ill was requested by an emergency and was able to accept it, but it happened that a flat was empty. If it was full, I had to refuse, and then I had to search the entire prefecture for a bed, and maybe I wouldn’t have found it.
◆ Risk of aggravation when treatment is started after deterioration
-What is the status of the transported patient?
By the end of the year, moderate beds in Kawasaki City began to tighten, and by the beginning of the year, more than half of the hospitalized patients were in Kawasaki City. Currently, we accept from all parts of the prefecture, including Kawasaki, Yokohama and the central part of the prefecture.
Compared to October and November, when we were able to say, “because it is positive and the risk is high, let us be hospitalized just in case”, many patients are already in poor condition and are transported. Today, even if a positive result is found, the patient is not immediately hospitalized, and the patient has to wait at home or receive medical treatment at home, so the introduction of treatment tends to be delayed.
If treatment is started after it worsens, it takes time to recover.And the risk of becoming severe increases. Also, there are many seniors, including sprouts in senior facilities. Older people tend to become more severe and take longer to heal, so the length of hospital stay is longer and it takes longer to accept the next patient without having a bed.
◆ Seriously ill people who are not counted
When the elderly become more ill, the Ekmo ventilator and cardiopulmonary bypass machine place a great burden on the body, which is why the individual or family is often not recommended or unwanted. If you do, you will not be transferred to another hospital and you will continue treatment as long as you can at our hospital, which specializes in moderate illnesses. Although it does not require as much staff as the treatment of ventilator patients, it is a life threatening situation and a heavy burden. There are cases of serious illnesses that are not counted as serious illnesses.
He had been thinking about seeing a crown patient since the early days, but said it was “not too painful” even though he seemed to be clearly exhausted from the decreased oxygen saturation of the blood. In the case of older people, the impression is that they are vague.
If I don’t move, it’s not that painful, so I’m resting lying down, and when I feel it, it hurts to move, so I can’t move.It is especially dangerous for an older single person to stay home alone.en.A pulse oximeter is used that measures oxygen saturation, but not only the machine itself, but also through a phone call.There is a shortage of control systemsI think.
◆ Medical collapse has begun
-Tell us your feeling of crisis about the current situation.
The patient was accepted at 3:00 am on January 10. In this case, the destination of hospitalization of the positive person who was diagnosed at night in a certain hospital was not decided, and the transport coordination headquarters was full of adjustments for the seriously ill person, and even contacting almost 30 cases by himself, all were rejected.
Originally, it was difficult to accept at night due to lack of manpower, but the shift teacher kept calling from night, and considering the situation where the patient had been waiting for hours during that time, I decided to do something. about. . In a hospital like ours, where we mainly see local people in the western part of the prefecture.In general, it is unthinkable that up to 30 patients are brought from afar.。
There are situations around us that we cannot control and I felt that it was an abnormal situation. Local, perhaps just around us, but perhaps the first step in the collapse of healthcare is happening. Since then, waiting for hospitalization has become the norm, and eventually some people are disappearing while waiting at home.What I feared became reality one after anotherIt has become.
I think everyone is having a hard time right now. This is unusual in a world where you continue to pay attention to infectious diseases. However, if this does not converge and this condition persists, the number of people who will not be transported and will die at home or who will not receive necessary medical care will continue to increase. I would like you to know that now it is not a normal medical condition.
◆ Know your risk of getting infected even if you don’t have symptoms.
Increasingly, the whole family is infected without any knowledge. In some installations, all users have been infected. In hospitals where all people perform CRP tests on admission, there are a number of outbreaks that occur in the hospital and lead to outbreaks. It is not uncommon for older people to become infected after dining with a family member who has visited them from afar.
When infected with the new coronavirus, the virus is released about two days before the onset of fever and cough, increasing the risk of infecting other people. Young people are less likely to get sick, so they are active and unknowingly transmit the infection, and weak people get sick and use intensive care beds all the time.
This virusIt is made to be easy to spread, so it is easy to punch the space... Really cunning and obnoxious. It is a pathogen that destroys the way health care and society should be. But if you don’t take action, it will spread further and the situation will get worse. I would like each and every one of you to know and reflect on this.
○ Don’t eat with anyone other than those who live together
○ Wear a mask when you go to a place where people gather
○ Wash and disinfect your hands when you return home, before meals, and after touching public objects.
○ Don’t visit older people or dine for a while
○ If you have any symptoms, don’t go out as much as possible
