ICU team at the Midland Regional Hospital Portlaoise
'All changed, changed utterly.
A terrible beauty is born' W.B. Yeats
Coronavirus(Covid 19) is a major healthcare crisis nationally, internationally and locally.
Most people, young and old, who contract the illness will recover completely but vulnerable people and people with some pre-existing health conditions are at risk of a more serious illness.
Midland Regional Hospital at Portlaoise(MRHP) has been planning and preparing for a significant increase in Covid-19 related patients for the last number of weeks. All staff members have embraced this upcoming challenge in a united team approach.
The structure of the hospital has been reconfigured, beginning at the entrance to the Emergency Department (ED/A&E) where patients are directed to a Covid section, for people with symptoms of Covid 19, particularly breathing problems and a non-Covid-19 section for the usual chest pain, stroke, injuries, surgical problems etc - the hospital is open to deal with normal emergencies! Similarly, wards and areas of the hospital have been designated as Covid-19 or non-Covid-19.
Many patients with Covid 19 become ill, stay at home and get better. A small proportion need hospital admission for treatment of more serious symptoms including breathing difficulties and may need oxygen mask treatment on a ward but will recover.
A small fraction of these patients in the hospital are transferred to the Intensive Care Unit(ICU) where various devices are used to give Oxygen under high pressure culminating in a patient being sedated and put on a ventilator. Ventilators are not a treatment but a 'bridge' to do the work of the sick lungs, until they hopefully recover.
The ICU at MRH Portlaoise has been moved in the last few weeks to a more isolated and larger area of the hospital, to allow the option of increasing our normal ICU capacity to 200%, in preparation for a surge of critically ill patients.
Work is underway to further build on this but we hope not to need this additional capacity. As per usual, a team of Medical and Intensive Care/Anaesthetic Consultants will decide on and plan a care pathway for each critically ill patient, to be managed by specialist intensive care nurses on a 1:1 basis.
Sometimes a patient in our ICU will require more complex treatments and supports that are only available in a Tertiary Centre ICU in Dublin and will be transferred by a special Mobile Intensive Care Ambulance and team to that hospital. In this crisis, if hospitals in Dublin reach full surge capacity, some more stable patients, still on ventilators in Dublin may have to be transferred in the opposite direction to MRH Portlaoise for the continuation of their treatment. The HSE has facilitated planning for all such scenarios.
'Prevention is better than care'. The doctors, nurses, hospital staff, ambulance service, hospital and ICUs can save many patients but you, the public, can save thousands of lives by following the simple rules of staying at home, washing hands, social distancing and good cough etiquette.
There is no specific treatment or vaccine yet for this virus and the only way to survive Covid-19, particularly for vulnerable groups is to try and avoid contracting it. The solution is in all our hands.
This is a scary time for our country but we have made our preparations and plans. We are ready to do battle with the invisible enemy and have 'nothing to fear but fear itself'.