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Last week, the intensive care occupancy rate in the Stockholm region was 99 percent. This weekend, capacity skyrocketed: occupancy on Saturday morning at eight o’clock was 101 percent, with 164 of 162 spots taken, according to data DN has read. When anesthesiologist Maria Sellvall started her ER on Saturday night, the intensive care unit in Huddinge was still overcrowded and challenged trying to free up places to be prepared for new patients.
– It is a great stress when you are already full when you start your workout. We tried to arrange for the patient who planned to leave the intensive care unit but did not work out, got worse and had to be intubated again, says Maria Sellvall, who has been increasingly on call in the care unit for the past six months intensive in Huddinge, both in covid and in the hospital. regular intensive care, which now has a significantly higher pressure than last spring.
Photo: Daniel Costantini
Instead, a jolt followed. of patients within the hospital to free up space and avoid transport to other hospitals, which involves both risks and great human resources. Currently, the pressure is significantly higher in ordinary intensive care than in the spring. The one that must work in parallel with the covid care.
Björn Persson, manager of operations for perioperative medicine and intensive care, PMI in Karolinska, says that the high occupancy reported during the weekend, and that occasionally exceeded 100 percent, is exceptional.
– Never experienced such a high occupancy rate regionally, writes in an email, stating that intensive care runs the risk of crossing the threshold because everyone who needs intensive care is raised inadvertently, with safety risks of the patient as a result.
Small margins It has also become notable for pediatric care employees, who are now in command of the adult covid care staff, as DN reported on Friday. 120 employees, doctors, nurses and nursing assistants will work with Covid Care over Christmas and New Years, and all planned pediatric operations that can wait without medical risk, around 75 operations, have been postponed until January 10, a reduction of the 30 per cent.
– Unfortunately, it’s the kids who have to back off because adults think it’s important to shop on Black Friday. I am convinced that most children want their parents home for Christmas and not hooked up with many hoses in an intensive care unit without the opportunity to meet their children, says Lars Falk, acting director of children at PMI in Karolinska .
It describes how pediatric care does everything possible to contribute to the care of covid, but that the effect of the second autumn wave has not been anticipated:
– If I had to wish something for Christmas, it would be that private actors contribute to the attention of the covid and that the public does not end up in the intensive care unit. And the best way is then not to go to dinners, Christmas shopping and, unfortunately, refrain from meeting with relatives.
On Monday in the morning Staff at the Astrid Lindgren Children’s Hospital at Karolinska in Huddinge were told that one of the two pediatric wards, where eight seriously ill children are now being cared for, will be closed due to staff shortages because some of the staff have received care orders for covid.
Children currently being cared for in that room will be transferred within the hospital to other care rooms, according to Svante Norgren, theme manager at Astrid Lindgren Children’s Hospital.
– To deal with this, we have reduced the expected enrollments. We also collaborate with the Sachsska Children’s Hospital, so children who need hospital care in the region will get it, says Svante Norgren.
“It just came to our knowledge then. We take care of seriously ill children from Stockholm and all over Sweden,” says ST doctor Emelie Sundkvist, who has been ordered to work on covid care starting next week. This spring, he worked there for two months.
Photo: Daniel Costantini
Frustration is great among colleagues, according to pediatrician Emelie Sundkvist.
– You have the feeling that it is not enough. I don’t understand how you can advocate for protecting staff from seriously ill children when it’s still voluntary for private care or outpatient care to contribute, he says.
Various doctors and nurses Given that DN has been in contact, it is critical that staff working with seriously ill children receive covid care, while it is still voluntary for private actors to contribute. And that takes place at the same time that pediatric care enters the period of RS infection, which means high pressure. The opportunity for reinforcement of staff within the region’s own operations has also diminished, as open pediatric care in the spring switched to private care options.
Katarina Wide, chief physician of the Pediatric Emergency Care medical unit and pediatric neurologist in Huddinge, wants to see better coordination within the region.
“Our colleagues who work with covid patients are working very hard and need help. But I don’t see the logic in taking from the most seriously ill children when there is competition between private actors, “says Katarina Wide, chief physician at the Karolinska Pediatric Emergency Care medical unit and pediatric neurologist in Huddinge.
Photo: Daniel Costantini
– Our colleagues who work with covid patients are working very hard and need help. But I do not see the logic in taking from the most seriously ill children when there is competition between private actors. Why can’t they support rather than withdraw the already overburdened pediatric care staff? It’s the same tax money.
Rozita Zarif, Safety Representative for the Swedish Health Association at Astrid Lindgren, says that moving pediatric care staff carries great risks:
– This is actually a threat to pediatric care, both for patients and staff. The staff are tired after the first wave and cannot return to work in the covid rooms and then return and deal with the debt of care. I believe that the region must take responsibility here, says Rosita Zarif.
The opportunity for the Stockholm Region Gaining national reinforcement has been constrained by the fact that the region has been in a staff situation and therefore has not indicated how heavily burdened the region is, according to Johanna Sandwall, head of crisis preparedness at the National Board. of Health and Well-being. On Monday, the region went from personnel mode to reinforcement mode, a higher degree of preparation.
– It is because we assess, given the situation, that it is a correct emergency situation that gives us the conditions we need to be one step ahead and guarantee the need for sustainable emergency care even during the pandemic, writes Björn Eriksson in an email electronic.
Eriksson said Friday that he had a meeting with private caregivers and expected their contribution, voluntarily, not by force.
– Many private care providers now provide some emergency medical care that would otherwise be carried out in emergency hospitals, thus indirectly strengthening hospital care. Right now we have a good dialogue with private care providers to identify resources that can directly or indirectly strengthen emergency hospitals.
Regarding the intensive care occupation, Björn Eriksson says that according to his own control, there were seven vacant intensive care positions on Saturday morning.
– But it is too small a margin and that is one of the reasons why we are now entering boost mode to do everything we can to have more capacity in the future.
