Hospitals ready doctor guidelines for ventilator shortage
Aug. 9, 2020 PLYMOUTH VOICE.
Plymouth Michigan News
With an uncertain future ahead, Detroit area hospitals and doctors are readying guidelines for patients with ventilators in the event of shortage. With the surge of critically ill patients they’re telling their staff which patients should and should not get the devices, based on their short-term survival rate – in other words who will live or die.
Last month an intercepted policy letter authored by Henry Ford Hospital stated their plan to ration ventilators with the sobering fact that should the hospital run short some patents will be denied the critically needed life-saving devices.
“Some patents will be extremely sick and very unlikely to survive their illness even with critical treatment. Treating these patients would take away resources for patients who might survive. Patients who are not eligible for ICU or ventilator care will receive treatment for pain control and comfort measures…”
The letter addressed to patients, families and community was never mailed after it was discovered and publicized. It was a preview of how doctors now have to deal with the unprecedented strain caused by the COVID-19 virus. Doctors admit it’s a terrifying situation as they try to answer tough questions from family members who plead for more treatment for their loved-ones.
The Henry Ford Health System triage plan established who would receive full care based on age; health status and the severity of the illness and the rest would be simply given “comfort care.”
Published instructions to hospital doctors and staff dictate that a ventilator should not go to a patient with no chance of survival and those who would not meet the criteria for ICU admission, because of a progressive illness or conditions expected to result in near-term mortality.
Like Detroit area hospitals, Mount Sinai Health System in New York – where the number of cases was the highest in the nation at 77,967 and the number of deaths 3,602 as of Wednesday, has prepared emergency room doctors with suggested scripts for how to respond to distraught family members.
One script example cites the case of a 90-year old COVID-19 victim.
“I wish things were different. This is an extraordinary time. Your grandmother’s situation does not meet the criteria for the ICU today.”
Experts say lengthy stays in ICU complicate recovery and the ventilator itself can do damage to the lung tissue based on how much pressure is required to help oxygen get processed by the lungs. They say patients who survive extended time on a ventilator are often left with emotional or cognitive problems like memory deficits, similar to dementia or cognitive functioning and have a long road to recovery.
A British study released this month reports that 67 percent of the early COVID-19 patients given ventilations or other advance respiratory support died. Most coronavirus patients who end up on ventilators go on to die.