Posted: Saturday, November 28, 2020 3:09 PM
In the intensive care unit of Puerta de Hierro Hospital, in Majadahonda (Madrid), patients do not breathe on their own. “Everyone needs ventilators and infusion pumps, but there is also a series of devices that you can share,” explained Javier García Fernández, head of the anesthesia service at Puerta de Hierro hospital and president of the Spanish Society of Anesthesiology.
What can we share? An artificial kidney or the possibility of having ultrasound at the patient’s foot. Everything, monitored and centralized. “When the pandemic arrived, many respirators were in demand. As if making a respirator means having an extra bed in the intensive care unit, and unfortunately it’s not like that, ”Javier continued. The key to these units is human resources.
“People think about teaching everyone to intubate, but it’s something very complex. The problem with intubation is that you either solve the patient’s path or he dies, ”said the president of the Spanish Society of Anesthesiology. It is the intensivists themselves and some anesthetists who have these skills.
In this regard, Javier stressed that there have been “regions like Madrid, Catalonia or Galicia where intensive care units have increased rapidly because anesthesiology has these powers”. The work of nurses, as in the case of Luis Palomino, is also very specific: “You have to be in everything. Know how to look at the monitor, the ventilator. And if something rings, be on the alert to identify with any time the alarm that its ringing “.
For Manuel Hernández, also a nurse, the problem during the pandemic was that most of his colleagues had never worked as critics. “The adaptation was very complex because you had to work with your patients and help our colleagues to take them correctly”; some patients who receive almost personalized attention.
There is one staff doctor and one resident for every three patients, while in the ward they can reach 20. In the case of nursing the ratio is “one nurse for two patients, while in the ward there is has a nurse for 14, 15 or 18, “said Luis Palomino. To relieve the intensive care units, some hospitals are expanding the intermediate beds. Since they are not intubated, they need less equipment, less professional specialization, and they may be more numerous than in ICUs.