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Now, the number of covid-infected patients needing intensive care in the Stockholm region is declining, and since last week the Södersjukhuset has begun to reduce the number of intensive care units.
According to an internal message issued to hospital employees, the plan is for the hospital to reduce the number of intensive care units by five per week. The hospital currently has 34 intensive care patients with covid infections and 153 infected patients admitted to routine hospital care, according to the midweek progress report.
According to the report The need for intensive care units decreases slightly, but not the need for general care settings. The pattern of seeking emergency care is constant, with as many applicants as in the past few weeks. But several doctors testify that the need for intensive care units remains high.
– We still have many greedy patients in Sös who may need intensive care and ambulances that come with the greedy disease. We don’t understand why it should reduce the number of places, says Lotta Egelrud, an intensive care doctor in Södersjukhuset.
When the number of locations is decreasing, patients should be transferred to other hospitals that have vacant intensive care units. The most seriously ill patients are intubated and anesthetized and lie on a respirator when transported.
– This carries a higher risk for patients whom we have committed to care for. It is too early to deploy the sites. We don’t see this being ethically justifiable, says Egelrud.
That patient movement associated with significant risks are documented.
Lotta Egelrud notes that Södersjukhuset has always filled its places, and that an alternative could be to stop the flow of entry to Sös and redirect to other hospitals with more empty places. She describes the difficulty of selecting which patients to send, which also includes contact with family members.
– When it comes to avid disease, family members are prohibited from meeting with the sick person for several weeks. Explain to them that we have to send their relatives to another hospital when I myself do not understand why, it is very difficult.
Johan Styrud, President The Stockholm Medical Association and the surgeon at Danderyds Hospital are aware that the site reduction has begun and has already begun in Sös.
– It is understandable, because the places have intensified terribly and it costs a lot of staff to keep them open. After all, great care has been taken and only everything we need can be opened, says Johan Styrud.
Johan Styrud, President of the Stockholm Medical Association.
Photo: Magnus Hallgren
The reduction of places is also related to the fact that the health service must start planning to deal with the summer staff. At the same time, Styrud says it’s good to think about how deduction is best done without affecting attention.
– Starting in Sös, which is full and has so many patients, is not so smart: moving patients is dangerous. There are empty spots in Karolinska in Huddinge, and it would have been better to start closing there.
DN has sought the chief physician at the Södersjukhuset to ask questions about why the change is taking place and what risk the patient has to transfer intensive care patients.
Chief physician Eva Östblom replies in writing in an email that for many weeks Södersjukhuset has had a large number of intensive care units and that many very serious patients have been treated.
“Normally we have 16 of those places in the normal situation, but we have had 60 for several weeks. It is not sustainable to stay at this level, especially for personal reasons, and the need for intensive care has also decreased somewhat in the region” , writes.
Eva Östblom He writes that, as much as possible, one tries to avoid transportation during ongoing intensive care, but that in the extraordinary situation that now prevails it must still happen sometimes.
“Then very careful considerations are made and it is not the sickest and most fragile patients who are moving.”
The director of the Karolinska hospital, Björn Zoëga, says that the reduction of intensive care units has also started in Karolinska, and especially by reducing the places in Huddinge. He says Karolinska has the ability to help, even with ambulance routing.
– If we receive the question to help with intensive care, we will. We have that buffer.
To cope with the pandemic, the number of intensive care units has expanded significantly throughout the Stockholm region and within a few weeks has increased from 90 to more than 200.
Health Director Björn Eriksson says there is a regional plan on how sites should be reduced, as the need for intensive care is reduced. In most intensive care, 230 patients were treated for covid-19 around April 22, compared to 165 on Friday.
– If these 65 places shrink across the region, there will be a few places in each hospital, says Björn Eriksson.
It confirms that the pressure at this time is hard on Sös, compared to before during the pandemic when it was most tense in the S: t Göran and Danderyds hospital.
– It varies a bit and may have to do with the spread of the infection, which is now more concentrated in southern Stockholm, says Björn Eriksson.
Is it a good idea to go to Sös places if there is a lot of pressure on the patients?
– It’s something we have to look at. It is not good if the transport of patients in intensive care is increasing.
After DN asked questions, Eriksson returns in a text message:
– It seems true that there has been a little more transportation of Iva patients from the Hospital del Sur in the last days than usual. I will follow the reason for this.
Read more: Karolinska reduces preparation: “She wants to start the care that has to wait”
Read more: New emergency in Sös: “Well prepared for the storm”
Read more: The Director of Health: “We must aim to triple the capacity of intensive care”
