How are at risk of other emergency patients by Covid-19?

Thousands of new infections, hundreds of deaths: The Coronavirus is spreading in many countries rapidly and it is clinics like staff in many places to the edge of the load. As critical is the Situation in Italy is especially true Because the case numbers in a few days, have risen sharply, threatening the local health system collapse. The medical staff reported sometimes dramatic conditions. Some patients may not be adequately supplied, because intensive care beds are scarce. Often the staff has to decide which patients have a life-saving treatment – and which are not.

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It is already clear that A medical crisis going on currently in Italy, has not only consequences for Covid-19-patients. The Overcrowding of hospitals is true of other Diseased, in need of intensive medical assistance. “Excess mortality” is what researchers call the phenomenon, when the number of deaths goes beyond how it would actually be expected under normal circumstances. “In particular, patients with acute stroke, myocardial infarction, Sepsis, Polytrauma, and others are at risk,” says Max Geraedts, Director of the Institute for health services research and Clinical epidemiology in Marburg.

But how realistic is such a scenario in Germany?

Reinhard Busse, head of the Department of health care Management at the TU Berlin, with a view of the current Situation the all-clear. “On normal days, over 100,000 beds in German hospitals empty,” explains Busse. “As elective, which means scheduled recordings to be cancelled, there are currently less patients than usual.” Also on the ICU, so the capacity could be increased. As to be displaceable orthopaedic interventions on the hip or knee are. “This can usually be easily moved, even over long periods of time or would not even take place at all. Other operations, such as in cancer patients, however, should be done rather promptly.”

Another possible lever is to beds, according to the coaches, the length of stay in intensive care. “That is, who else, to say we would be half a week, there remained – the equivalent of the average -that would then be moved a day earlier on a normal station,” explains the expert. Of course, Germany would be far to 28,000 intensive other patients ‘ beds also continue to be available and not only for Covid-19-cases be provided.

The request of the patient respect

All should despite these measures, ICU and ventilator beds temporarily occupied, would sign out the appropriate clinic at the monitoring station. “Patients will be distributed to surrounding hospitals, where these have capacity,” says Busse. An Overview of available intensive care beds there are in a publicly accessible Register of the “German Interdisciplinary Association for Intensive and emergency medicine” (Divi). There were (23. March), an estimated 312 Covid-19-documented patients in intensive care units. Many clinics currently that is still available intensive care beds – identified with a green dot.

Intensive medical treatment may be for many patients a life-saving one. It should be checked in the individual case, but always, whether or not it actually meets the desire of the patient, says Annette Rogge, Chairman of the Clinical ethics Committee. “Do not want the treatment, it may be – as well as outside of a crisis situation – not carried out.”

When resources are scarce as in Italy “should be transparent and all those responsible will be in accordance with the same criteria,” said Rogge. Recognised criteria, such as the medical needs of patients, so the severity of the illness and the expected medical Benefits. The principle of joint decision-making of an individual is preferable “decision-making”, emphasizing the medical ethics. “If the clinical Situation allows this, it should be a vote by the treatment team.”

Personnel is the largest factor of uncertainty

Free intensive care beds are important to patients adequately treated. The biggest factor of uncertainty, according to buses, but the failure of the medical staff. Doctors and nurses had a double burden: physically as well as mentally. Add to that: Should infect staff due to a lack of protective clothing with the pathogen, is also likely to be illness-related outages.

“In high-Covid-19-load loss of Personnel will have negative consequences. This can actually be a Problem – the staffing situation is not solved well today,” says the supply of researchers Max Geraedts.

“So far we see but also in the other countries – a tremendous amount of use and the Reporting of volunteer,” says Busse. Alone: “How long is this to endure, it is currently difficult to assess.”

Sources: citations according to the Science Media centre

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