Staff at three Calgary hospitals should be aware of the use of oxygen for acute care patients “due to the limitations of bulk oxygen systems” and “the anticipated increase in demand for it. due to the COVID-19 pandemic ”.
In a letter sent to adult acute care centers in the Calgary area on Friday, Alberta Health Services said, “We need to reduce the demand on the bulk oxygen system.
The health authority said the hospitals most affected are Rocky View General Hospital, Peter Lougheed Center and Foothills Medical Center – all of which have active COVID-19 outbreaks. The guideline does not apply to intensive care, neonatal or pediatric patients.
“Clinical measures require everyone to immediately engage in oxygen conservation measures,” the advisory read.
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As of Friday, all doctors have been assessing each patient’s oxygen needs and updating orders if necessary, as outlined in the notice. Nurses and respiratory therapists have been instructed to check with their superiors to update patient orders if necessary.
“Target the lowest tolerable SpO2 [oxygen saturation]The opinion says.
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The advisory states that the target oxygen saturation for patients is approximately 90%.
It also states that a number of therapies are “highlighted as inappropriate” in the hospital’s patient management system, where doctors enter orders and medication information for nurses.
For generic post-operative patients, these restrictions include orders for continuous O2 treatment for adult patients via a nasal cannula, as well as maintaining 95% oxygen saturation with “titrate to saturation.” “.
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According to the memo, a number of “common O2 therapy prescriptions” are also restricted at this time, including a target for 95% oxygen saturation, with AHS saying “this should be reserved for patients with carboxy- hemogloblinemia or -hemogloblinemia. »Staff are also asked to« avoid if possible »ordering oxygen by device or by FiO2 [fraction of inspired oxygen].
Alberta has recorded more than 5,000 new COVID-19 infections in the past three days, with a new total daily record set on Saturday, which was then broken again on Monday.
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In an emailed statement, AHS said the Calgary area “has an adequate supply of oxygen to meet the needs of patients now and in the days to come, as we continue to treat all patients through the process. COVID-19 pandemic.
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“AHS continues to provide safe and appropriate care to all patients, including those who require oxygen therapy,” the email said.
“The released O2 monitoring and conservation memo was intended to remind clinicians to provide oxygen therapy in a responsible and evidence-based manner and to be proactive in saving the resource by recognizing that we anticipate a great number of patients requiring oxygen therapy.
AHS said it was working on “proactive upgrades” of medical gas delivery systems in hospitals, as well as other means of delivering oxygen to patients, “to meet the potentially increasing demand. patients in the weeks and months to come.
He said planning work continued “in the background” throughout the pandemic.
The staff notice said AHS had a June 2021 schedule to complete the upgrades.
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Asked about the memo on Monday, Dr Deena Hinshaw said she did not have details of the specific situation in Calgary hospitals, but said the impact of COVID-19 on the healthcare system of health is “exactly why we have measures in place, and exactly why all Albertans need to act to control the spread.”
Edmonton area medical director Dr David Zygun said AHS has planned all necessary supplies throughout the pandemic and is monitoring the oxygen situation “very frequently”.
“We are proactive in [the conservation] memo, ”Zygun said. “That said, the advice offered to clinicians in this memo is actually in a responsible and evidence-based manner that we hope all of our frontline members will follow, and educate them on the need for conservation,” did he declare.
According to Dr Raj Bhardwaj, the majority of patients admitted to hospital with COVID-19 will need oxygen, as it is primarily a respiratory disease.
“What that tells me is that the numbers that we’re going to see in the hospital, and frankly that we’re seeing in the hospital and in the intensive care units – the number of people and the oxygen requirements are going to be. overwhelming, ”Bhardwaj told me.
“And that’s the kind of stuff we talk about when we talk about flattening the curve.
“Please don’t allow healthcare facilities to be overwhelmed, as these are the types of problems we encounter when they are.”
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He said people need to see this type of warning as a clear message that they need to do their part to reduce cases, but said it was “important not to be alarmist,” adding a memo like This does not mean that health workers are being told not to give oxygen to a patient if he needs it.
Bhardwaj said he expects to see more warnings advising healthcare workers to be aware of the use of drugs and sedatives as hospitalizations related to COVID-19 continue to increase, as what happened in New York, Spain and France.
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In a press release, the opposition NDP accused the government of lying about what it called an “oxygen shortage,” saying Health Minister Tyler Shandro and Prime Minister Jason Kenney “didn’t had failed to prepare for the second wave of this pandemic ”.
In the legislature on Monday, Shandro said there was no shortage, saying hospital staff were simply asked to use oxygen when clinically necessary, which is not unique to the pandemic. .
“An oxygen shortage in Calgary is a truly disturbing picture of a busy hospital system,” said NDP health critic David Shepherd.
“Instead of tackling this serious problem directly and honestly, Shandro lied to Albertans.
“Every day we see more and more Albertans infected with COVID-19 crammed into our hospitals and intensive care units because Jason Kenney did not prepare and act. This oxygen shortage is the latest sign of stress in a healthcare system trying to contain a pandemic without significant help from the Prime Minister.
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