Patient flown for 23 hours in 'flying ICU' aircraft from US to India for emergency surgery
Southward Dakota's largest hospitals are at or above their capacity to care for critically sick COVID-19 patients, forcing some of the sickest patients to be flown out of state to receive care.
The strain of a months-long surge in coronavirus cases has reduced infirmary capacity to care for those with severe symptoms, making it increasingly uncertain whether the sickest Due south Dakotans will be able to get treatment in the state, health providers say. Meanwhile, ICU infinite is quickly evaporating in neighboring states too.
Both the Sanford USD Medical Center and Monument Health Rapid City Hospital have reported that their Intensive Care Units are out of infinite. On Dec. two, Avera McKennan reported that 6.7% of its ICU beds were available for use. Statewide, the number of available ICU beds has been steadily declining every bit coronavirus cases have continued to climb.
Major hospitals are still taking patients when they can, but some sick South Dakotans are being sent out of state, forced to use expensive urgent transportation systems to become care hundreds of miles away from their families.
COVID-19 patient Robert J. Sliper of Pb, S Dakota, was flown on an aeroplane in mid-Nov to Greeley, Colorado, considering in that location wasn't enough room in local hospitals, according to an emotional alphabetic character written by his son Mike Sliper. The letter, which Mike Sliper posted to Facebook on November. xviii, detailed Robert Sliper'southward life and the anguish his family felt watching him get loaded onto a aeroplane to fly 340 miles to a hospital they couldn't visit.
Robert Sliper, a Navy veteran and mining engineer who graduated from the South Dakota School of Mines and Technology, died in Greeley on Nov. 13 at the age of 84, the mail service said.
Sliper's trunk was brought dorsum to Due south Dakota for his funeral. "We desire to coffin him in the state that he loved so much but well-nigh the end didn't have room for him," Mike Sliper wrote.
Status changes by the minute
In Southward Dakota, hospital critical-care capacity was limited long before COVID-19 hit. Rural residents in need of intensive care already were oftentimes expected to travel up to hundreds of miles by plane, helicopter or ambulance to get lifesaving treatment at major healthcare centers in Sioux Falls or Rapid City.
As the pandemic has stretched on, South Dakota's three major hospitals — Avera McKennan and Sanford USD Medical Center in Sioux Falls and Monument Wellness Rapid City Hospital — are now struggling to find or brand space to treat the virtually ill COVID-19 patients and others with serious health problems.
Hospitals are so full, and ICU bed availability is changing so fast at large hospitals, that information reported on the state Section of Health COVID-19 webpage often doesn't reflect reality, said Dr. Srinivas One thousand. Gangineni, the ICU medical director at Monument Health Rapid Urban center Hospital. The result is that the state'due south largest, all-time-equipped hospitals tin can't always guarantee they'll have space to care for the virtually critically-ill COVID-nineteen patients on any given day.
"To be honest, I don't look at the Department of Wellness website," he said. "The data I can give y'all right at present, it could exist different in 15 minutes."
Sioux Falls-based Avera Health arrangement, which owns Avera McKennan Hospital and dozens of smaller hospitals in S Dakota, Iowa, Minnesota and Nebraska, is well into its coronavirus surge program, said Dr. David Basel, vice president of clinical quality. Avera McKennan has nearly doubled its ICU chapters by postponing some not-emergency surgeries, cross-training infirmary staff to work with COVID-xix patients and repurposing some hospital space for intensive intendance.
Almost of the hospitals affiliated with Avera Wellness, including in Due south Dakota and neighboring states, are "at, near or in a higher place" their capacity to treat COVID-nineteen patients, Basel said.
Officials with Sanford Health were not made available to speak with South Dakota News Lookout for this story.
Hospital capacity data reported by the land Department of Health suggest there is plenty of room in hospital ICU units to handle more patients. The DOH reported on December. 2 that statewide about sixteen% of adult ICU beds in the state were available for utilize. Roughly 35.ii% of all staffed infirmary beds were available for use, the section reported.
But much of South Dakota'due south open ICU space is in smaller, more than rural hospitals that don't take the staff or equipment to care for the most sick patients, including those with severe COVID-19 symptoms. Those most disquisitional patients tend to stay in hospital beds and intensive care for weeks and often require a level of intendance that tin simply exist found at major medical centers, experts say.
"A lot of our hospitals would be comfy caring for a patient with pretty normal lungs later surgery. Only these COVID patients are really, actually ill and have really complex lungs, and they have an additional skill set," Basel said. "Not all ICU beds are created equal."
Nearing limits
U.s.a. surrounding South Dakota are also seeing strains on hospital capacity. North Dakota Gov. Doug Burgum announced on November. 9 that the state'south hospitals had reached 100% of capacity. By Dec. two, Northward Dakota's hospitalization rate had fallen, and roughly 13% of the state'due south chapters to treat COVID-19 in hospitals was available.
Hospitals in South Dakota and across the country are besides undergoing challenges providing disquisitional care due staffing shortages due to disease and burnout. Across South Dakota, hospitals were enduring long-term shortages of doctors and nurses long before the pandemic. Now, hospitals are seeing dozens of staff forced to take time off due to the virus.
That has left some hospital administrators worried that they may have enough beds just not enough staff to care for critically ill patients if the number of coronavirus cases begins climbing over again.
South Dakotans who need infirmary-level intendance, including intensive care, can still go it, though they may be sent far from their homes, including to hospitals in other states. Merely infirmary capacity has tightened across the country amid the nationwide coronavirus surge, limiting options elsewhere. The state's hospitals may be forced to shut down clinics and restrict or ration care for chronic conditions such as diabetes and hypertension to gratis upwards doctors and nurses to treat COVID-19 patients. Even then, hospitals may attain the limit of their power to care for anybody who gets sick.
"I don't know what that limit is, simply if cases were to double for some other month or ii, we would exist making some hard decisions," Basel said.
Rose Mary Kor, who lives exterior the Black Hills city of Custer, was rushed to the Emergency Room at Monument Health Custer Hospital on November. 2 later struggling to breathe for nearly a week. Kor, 70, said she thought her asthma had been acting up. Then, after an emergency 10-ray, doctors told Kor that she had pneumonia due to COVID-19 and needed firsthand hospitalization at a more well-equipped facility.
The problem was that Monument Health Rapid City Hospital, where critically ill patients from Custer are usually sent, was total and couldn't accept new COVID-19 patients. Kor had to choose whether to be flown to a hospital in Gillette, Wyoming, or a hospital in Casper, Wyoming. Both options were more than 140 miles from her home.
"I was in atheism," Kor said. "The hospital in Rapid City is non small. The question in my listen was, 'Why are they not prepared for this?'"
Kor is not alone in her experience. Several other South Dakotans from East River and West River who vest to a closed COVID-19 discussion group on Facebook take shared similar stories of loved ones being diverted to hospitals far from their homes.
Monument Health Rapid City Infirmary is the flagship infirmary for the Monument organisation in western Due south Dakota and offers the highest level of intendance available in the region. The hospital's 33-bed Intensive Intendance Unit has essentially been total through much of November, Gangineni said.
The number of COVID-nineteen hospitalizations rose sharply during Nov in almost every role of the U.Southward and was even so growing at the terminate of the calendar month. On December. two, the nationwide number of COVID-nineteen hospitalizations stood at 98,691.
Ultimately, Kor chose to go to Casper, where she spent nearly 2 weeks at the Wyoming Medical Center with a high-flow oxygen mask helping her trunk part. The oxygen mask worked, and Kor narrowly avoided being placed on a ventilator.
One brilliant spot in terms of infirmary capacity is that some rural hospitals have increased their ability to intendance for COVID-19 patients. When the pandemic began, Avera Health system hospitals started sending all of its COVID-19 patients to Avera McKennan in Sioux Falls because there were more specialists and space at the larger hospital.
The Huron Regional Medical Center was 1 of the start rural Southward Dakota hospitals to see a surge of COVID-19 patients. Consequently, the independent hospital pioneered some of the emergency remodeling that other smaller hospitals after used to treat coronavirus patients safely, said Erick Larson, hospital president and CEO.
The hospital's COVID-xix unit of measurement has plenty space for xiv patients at a fourth dimension, with space for upward to four patients in intensive care. The Huron hospital's staff too created a new five-stage surge plan and secured a steady supply of personal protective equipment by working with the land wellness department and the federal Centers for Disease Control and Prevention.
Hospital staff also formed modest groups, or pods, that work closely together simply separately from other staff as a way to prevent widespread exposure to COVID-19 if someone gets sick, Larson said.
Monument Health Rapid City Hospital'southward ICU has been fortunate that none of its physicians have gotten ill, Gangineni said. The infirmary also has a plan in identify to bring in some other dr. if needed. Nurses, though, are in shorter supply.
"It takes a toll on staff, seeing how sick some of these patients get, how they stay sick for days and weeks, and sometimes months," said George Sazama, director of the nursing unit at the ICU in Monument Wellness Rapid City Hospital.
Source: https://www.mitchellrepublic.com/newsmd/some-covid-19-patients-flown-out-of-state-as-sd-hospital-icu-capacity-dwindles
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