‘We’re pulling together but holding out for an ICU plateau’
THOSE on the Intensive Care Unit frontline all face similar difficulties. ‘Everyone is stressed and everything is tight within the unit but when you actually go in there and are working there I think everyone pulls together very well,’ Beaumont ICU consultant Dr Alan Gaffney told the Irish Mail on Sunday.
Every day, Dr Gaffney and his team leave their families behind and do battle to save the sickest of the sick in Dublin’s Beaumont Hospital.
Beyond the elevator doors, on the lower ground floor of the hospital, the ICU is the last hope of many Covid patients.
Amid the machines and ventilators many lie prone on their bellies – a marked difference to what a typical ICU would have looked like a year ago.
‘During Covid, you see a lot more of that than you would in other times,’ said Dr Gaffney.
Right now all ICUs throughout the country are close to the limits of their capacity.
‘At the moment the country is providing critical care to more patients than we have critical care bed doctors and nurses for,’ said Dr Gaffney.
They are doing this by getting help from redeployed staff and by changing the criteria for ICU admission.
Many patients who would ordinarily have been automatic candidates for ICU a year ago, are now being treated elsewhere.
‘There are patients getting highlevel oxygen support on the wards that we would, in other times, consider bringing to
ICU,’ he said. ‘There are more patients on the brink of needing ICU care being looked after on the wards.’
But Dr Gaffney is adamant that so far his team have not had to face the kind of black and white, life and death decisions often portrayed during the Covid crisis.
‘People often put forward a scenario where you’ve two patients and have to decide between them. That’s an unlikely scenario to ever arise,’ he said.
‘It’s much more likely that we would continue to offer ICU care to as many people as needed but then dilute care to everyone.’
Some worry that ICU care is already being diluted – as the system hovers perilously close to its 350-bed surge capacity.
‘There’s also a concern now that the one-on-one care that would normally be given to patients in ICU now is being diluted a little bit,’ said Dr Gaffney.
‘There’s definitely a concern that when we get to the 350 beds that maintaining the standard of care we are all used to is going to be very difficult.
‘We haven’t had to make any decision to move someone to ICU where ICU wasn’t available.’
But he is worried about the continued rise in ICU admissions which has not slowed as community transmission decreases.
‘It’s difficult to watch the numbers steadily increase day after day and we are holding our breath for when we get to the point where we do reach a plateau,’ he said.