Surgery postponed as Delta Surge pushes hospital capacity to the limit | Northwest

No matter what you do in the next few weeks, don’t have a heart attack or stroke. Do not hurt as badly as you need to be hospitalized. Given that unvaccinated COVID-19 patients are filling hospital beds throughout Washington, the care they need may not be available.

Already quite full hospitals are skyrocketing, primarily for unvaccinated, COVID-positive patients.

As a result, patients with other emergency medical needs, from stroke to infections in rural hospitals, sit and wait while waiting for the bed to open somewhere.

Local hospitals are not the only ones struggling. At Spokane, both Providence and Multicare announced non-urgent surgery and procedure delays in the coming weeks due to capacity limitations.

This puts patients in the Spokane area back for weeks or more with hernia repair, joint replacement, back surgery, and some colon surgery due to the current burden on local and state hospitals. Must be pressed against the burner.

If the patient is not significantly affected by the delay of about 2 weeks, it may be postponed. Hospitals work with surgeons and their patients on a case-by-case basis to make these decisions, but they can be pushed back as well for procedures that may require a longer stay in the hospital. There is sex.

“Selective” surgery can be more serious than the name implies.

“Selective” can be heart valve replacement or removal of a cancerous tumor, Cassie Sauer, CEO of the Washington Hospital Association, told reporters earlier this month. “What is currently being postponed is really serious care.”

Due to the current surge in COVID cases, people in need of emergency care may have to wait for emergency care.

Rural facilities, which often transfer patients to larger hospitals for emergency surgery or procedures, wait hours, or even days, to transfer patients.

Hospitals were nearly full, even before the latest COVID surge, recording some of the busiest summers in emergency rooms and rural facilities in eastern Washington. Spokane hospitals have been criticized, especially for their ICU capabilities, but rural hospitals are feeling another kind of intense tension.

As Dr. Geoff Johns, Medical Director of the Emergency Department at Newport Hospital, said, “this is a completely different ball game” in the Delta Variant.

“Are you accepting more COVID patients than before? Absolutely,” Jones said. “Do we hold patients longer? Absolutely.”

The ability of local hospitals to transfer patients to larger hospitals is an important part of the state’s health system.

Remote district hospitals are usually not equipped to handle the most difficult cases. They stabilize and triage those patients and then send them elsewhere for a higher level of care.

That higher level of care is now hard to find. Many of those rural patients wait hours or days to get a bed elsewhere, in hospital beds, sometimes in emergency rooms.

Previously, Jones could call Spokane Hospital and then Kootenai Health to find space for patients in need of an ICU bed.

Well, that’s almost impossible.

Last weekend, Jones called for more than three hours looking for an ICU bed for a patient wearing a ventilator.

He called all the big hospitals in Spokane, Kutenai Health, and asked the Washington Medical Coordination Center for help, but all were unlucky. He reached out further. He even called two Boise hospitals and Misura. He thought Boise’s bed had opened, but it was filled with the time he was on the phone.

Finally, the bed opened in Seattle and I was able to transfer the patient.

At Newport Hospital and many local facilities, once a patient is intubated and stable, they are ready to move to a larger facility for a higher level of care. Due to the rapid increase in COVID-19 cases and hospitalizations, rural facilities will face difficulties in the near future.

Due to the planned large trade fair in the Northeastern Tri-County area, medical officer Dr. Sam Alzis anticipates a surge in COVID and fallout in the area, and the hospital will prepare accordingly. I advise you.

Artzis, who also works as an emergency physician at Ferry County Hospital, said: ..

“Things are not good, and we have no place to move people, and we are preparing for intensive care in hospitals that are not staffed or built to provide ICU medical care, We are preparing because there is likely no local hospital to send these patients. “

Jones is considering setting up several telemedicine options to support providers who are tasked with providing unfamiliar intensive care or critical care. On-screen providers can help you walk through the steps your doctor or nurse is taking.

“It may help us expand our capabilities and continue to provide good care,” Jones said.

The current surge has led to excessive deaths in people who have not been hospitalized for the virus. The exact number is not yet clear.

Artzis explained that he had an infection in his lungs that got worse as he waited for his bed at another hospital. Don’t worry about the ICU, he said, even in some local facilities and even larger hospitals, there are patients waiting to be admitted to the emergency room.

“Looking back, objectively, there is no doubt that mortality will increase with delayed care,” says Artzis. “It makes sense. If you don’t get the care you need during the Golden Hour, your mortality rate will increase.”

This week, Dr. Steve Mitchell, who runs the Washington Medical Coordination Center, knows that one patient has died while waiting for bed, and this situation continues as capacity is tight. He said he expected.

As of August 26, there are 1,425 COVID-19 patients in hospitals throughout the state. This is the highest ever Washington facility, all at the same time.

Washington state hospitals in the state are trying not to overwhelm even one as long as there is space elsewhere, and even local facilities have recently fulfilled this promise.

Over the past eight weeks, Pullman Regional Hospital has had 22 COVID-19 patients, seven of whom have been transferred from Othello, Tricities, Walla Walla, and even Kellogg, Idaho.

However, critical access hospitals cannot handle all transfer requests, said Genie Eyler, Chief Clinical Officer at Pullman Regional.

“Last weekend alone, we were asked to transfer patients 21 or 22 times, six of which were accepted,” Eylar said, especially because Labor Day is imminent. Said that they need to monitor their abilities. Washington State University football match is back.

The Pullman Regional Hospital has lent some oxygen tanks and ventilators to other hospitals in the region, but the hospitals see the same trends that other facilities are experiencing.

“The ER levels in June, July and August were the busiest ever, and the eyesight of these patients improved significantly,” said Eylar.

Coupled with a major event in Pullman, the tension warns hospital managers about what the next few weeks will look like.

“Pullman’s size could double again, which will affect our ability to accept transfers late next week and next week,” Eylar said.

The same staffing challenges found in large hospitals are also hitting local health teams.

“We’ve been doing this for months, our staff are exhausted, and it’s hard to stay morale,” Shane McGuire, CEO of Dayton’s Columbia County Health System, told reporters earlier this month. ..

One nurse or nursing assistant who complains of illness during a shift can mean that 25-30% of the shift’s workforce is gone.

Seven nurses have recently retired from Pullman Regional Hospital, Eyler said.

Service is declining in rural areas due to lack of staff. Jones said a recent day at Newport Hospital had to wait for a man to be hospitalized because the hospital was in the capacity of its staff.

According to healthcare providers and hospital managers, the solution is in the numbers.

The majority of COVID-19 patients in hospital beds were not vaccinated with COVID-19 vaccine.

From February to mid-August, 94% of hospitalized COVID-19 patients were unvaccinated, according to state data.

People hospitalized with the virus are sick and younger than the previous wave of the virus. Artzis explained that both 22 and 45 years old are using ventilators after being infected with the virus. The number of COVID-19 cases in children is increasing, leading to several hospitalizations.

“Currently, all the data for these inpatients is so clear that it is the unvaccinated people who need to be hospitalized, so we need to ask people to vaccinate,” Eylar said. ..

The surge no longer affects only those who have not been vaccinated, “affecting the capabilities of the entire health system,” she added.