Alberta Hospitals Approach Previous Capacity Threshold to Activate Classification System for Critical Care Patients

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Alberta appears to be on track to soon activate its intensive care triage protocol for the first time in the COVID-19 pandemic.

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Intensive care capacity in the province reached 89 percent Thursday afternoon. At 90 percent, the document previously published by the provincial health authority notes that the framework could guide which patients will receive care.

If Alberta Health Services promulgated the protocol, first released in April, only patients with a greater than 20 percent chance of surviving the next 12 months would be admitted to ICUs.

However, in Thursday’s COVID-19 update, AHS CEO and President Dr. Verna Yiu said that there is now no definitive number that triggers the classification protocol and that the capacity of the bed is ” fluid “.

Yiu said staff are working to create space and some patients have been transferred to other health zones, but over the past five days, an average of 23 COVID-19 patients have been admitted to ICUs per day.

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“It is tragic that we can only keep up with these kinds of numbers because, in part, some of our ICU patients have passed away. And this reality has a profound and lasting impact on our ICU teams, ”he said, adding that over the past two days, 18 recovering patients have been removed from intensive care.

Kerry Williamson, a spokesman for AHS, said Thursday that the classification framework will only be implemented if all other efforts to create additional capacity have been exhausted.

He added that AHS continues to add capacity and only adds emergency spaces if it can be safely staffed, but staffing is the biggest challenge right now.

Dr. James Talbot, former Alberta health medical director and current co-chair of the Edmonton Area Medical Personnel Association (EZMSA) pandemic committee, said Thursday that he expects implementation of the triage protocol to be “imminent.” Either this week or next. – and said the province is approaching a “system failure.”

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Talbot said that, based on what other jurisdictions have seen, that could mean drug shortages, overcrowded emergency departments and healthcare workers who will be forced to decide which patients have meager beds.

“If you are at the limit of your capacity and there is an ICU bed available because the person passed away, then decisions have to be made for two or three or four or five candidates who need to be in the ICU with a ventilator. Which of them is going to get it? And those who don’t probably won’t survive, ”he said, adding that those decisions are difficult for the family, difficult for the staff and there is no appeals process.

There are 350 open ICU beds in Alberta, including 177 additional spaces, more than double the normal baseline of 173.

There are currently 310 ICU patients, of which 226 are COVID-19 positive, the highest number of ICU patients since the pandemic began.

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Without the additional emergency beds, the capacity of the provincial ICU would be 179%.

However, some parts of the province are under more pressure than others, including in the North Zone and the Central Zone, which are operating at 100% or above the capacity of the UCI.

In the Edmonton area, there are 150 ICU beds operating at 91% of current capacity.

In the Calgary area, there are 123 ICU beds operating at 80% of current capacity. The ICU of the South Zone is currently operating at 89% of its capacity.

The fourth wave of COVID-19 has already affected healthcare, with the province announcing last week that it was postponing most surgeries and procedures. Urgent operations are only taking place if they need to be performed within a three-day period in an effort to deploy staff to support intensive care and critical care beds.

Meanwhile, Federal Minister of Public Safety Bill Blair tweeted on thursday the Canadian government would provide resources in response to Alberta’s request for assistance, which could include the deployment of the Canadian Armed Forces, assisting patients in air travel, and dispatching the Canadian Red Cross.

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