Patients with cough. Health workers from there to here. The waiting room was overcrowded. Users who wait hours for their turn.These days, this scene is happening again Hospital Province of Seville (and half of Spain).This is a result of an increase in respiratory disease infections, some of which are caused by Covid-19 and RSV (respiratory syncytial virus), but most importantly, for Prosperity Influenza A, which raises a problem that affects all of Andalusia. A source in the Andalusian health service noted: “While a specific start date for the increase in care services cannot be determined, a significant increase in the number of visits to hospital emergency rooms began to occur from the Christmas holidays on December 26.” Health (SAS) ).
According to the latest data from the Carlos III Health Institute, influenza primary care rates across the community last week were 621.9 cases per 100,000 inhabitantsThat’s an increase of nearly 74% compared to the previous week’s 459.6. In terms of hospitalization rate, as of the 14th, the hospitalization rate has dropped from 26.4 to 23.7 per 100,000 residents, which is far lower than the national average of more than 28.
The anesthetist and epidemiologist demonstrated how these figures put pressure on hospitals, where the pace of activity is overwhelming. Ignacio Jimenez.In these busy days, there is time to explain what is going on Santa Maria Rossio Hospital, a reference public center for the whole of Andalusia. He is your Medical Director and Coordinator of the High Frequency Program.Be part of the team sentinel The center collects data and organizes resources on the evolution of respiratory virus epidemics.
“The reality is that, with support from the Department of Health and SAS, we are responding flexibly to changes in emergency department pressures which will be critical to Epidemic management And in a sense of control over the situation We have this situation in the health center,” the anesthetist concluded.
Please note that current care needs for this virus remain High
. “Our professionals, particularly emergency department professionals, have been operating at high levels in recent weeks due to the increased number of hospital visits,” he said. A peak in cases is expected between today and next week, with demand for care expected to follow. Increase.account “Hard to guarantee” Whether this prediction will come true, it is too early to quantify the global impact of the Seville flu. Meanwhile, experts look to what happens in southern Australia during the winter. Influenza also appears earlier on the ocean island, although numbers drop significantly after the peak. This is the hope of the health workers at Our Lady of Rossio Hospital. “We will have to keep a close eye on the situation over the next few weeks, but we hope that there will not be another significant increase in pressure compared to this week and that we will start to see a gradual decrease in pressure,” the doctor added.The Virgen del Rossio hospital complex has five centers and four urgent care sites – General Hospital, Trauma Hospital, Children’s Hospital and Women’s Hospital.among all these high frequency plan Within the framework of the guidelines set by SAS to adapt to the healthcare needs during this period of the year. “The dedication of resources is determined daily based on need,” said Dr. Ignacio Jimenez.
The main objectives of the program are Reduce the impact of infection and avoid overload In the healthcare system during influenza, COVID-19 and bronchiolitis season. To this end, it has developed measures and protocols in hospitals, primary care centres, residential and emergency services to deal with high attendance rates. In addition, it seeks to improve coordination between different levels of care to enable more effective care, expand intensive care unit treatment capacity, ensure the correct functioning of ventilators, and speed up waiting times in consultation and observation areas.
multidisciplinary committee
In order to improve the response to such situations, Virgen del Rocío Hospital has a multidisciplinary committee, Coordinated by Aid addresses and sub-addresses and consists of professionals from All areas and horizontal services This is essential to streamline diagnostic processes or support services in hospital organizations, such as admissions or preventive medicine, analyzing events in detail first thing in the morning and coordinating all resources to streamline processes, allowing for a more flexible and integrated management of the winter months each year. months, deal with this common situation as soon as possible.
“Our number one activity every day is analyzing Captain’s report It reports to the entire management team and service leaders on the different functional areas of the hospital. “Special detail is given to the situation of the emergency services and the patients who are still under observation, as well as the availability of beds in the medical and surgical areas throughout the hospital,” explained Ignacio Jiménez. Participate in emergency statistics Phases of high-frequency planning are established daily in each of the four emergency points in different centers on campus so that we can make the necessary decisions every day,” he added. That said, Stages 0, 1, 2 and 3
Depending on whether there is an increase in base activity of less than 15%, an increase between 15% and 25%, between 25% and 35%, and an increase greater than 35%.The plan, repeated in all hospital centers but with slight differences according to the stage of illness in each hospital, includes the organization of different circuits in the emergency department “for patients with suspected or confirmed respiratory infections, including the provision of waiting rooms for patients and their families” , to avoid nosocomial infections,” clarifies the coordinator of Virgen del Rocío. During the hospitalization, for their part, they can Single room or group Always treat patients with the same type of respiratory infection after identifying the bacteria causing the infection with the help or advice of our Preventive Medicine Service.
Refers Resource optimizationBoth manpower and materials are allocated based on the patient’s diagnosis and needs. “We reallocate hospital beds to the services most in demand, Reinforcement template a doctor or nurse (if necessary) and necessary technology Such as oxygen therapy equipment, respirators, perfusion pumps, etc., depending on the needs of each area,” the health worker clarified.
Specifically, decisions were also made during these meetings about the reinforcement of professionals who work the most frequent shifts in the emergency department; use of emergency department resources from other centers on campus, such as rehabilitation and trauma hospitals with lower pressure; or use of resources from other emergency departments with lower pressure of services provide inpatient beds for patients with respiratory infections. “As stress increases, these are some of the steps we are taking,” Dr. Jimenez said.
Lessons from the COVID-19 epidemic
Stop a deferrable scheduled activity This is an extreme situation, but there is currently no need to put it into practice at Santa Maria del Rossio Hospital. The measure is included in the scope of action in the third phase of the high-frequency plan, which is activated when emergencies and hospitalizations increase by more than 35% for three consecutive days. “walk into The third phase This does not mean taking all measures, but we can escalate as needed until reaching extreme measures that have not been necessary so far in the center,” the doctor stresses. Before getting there, “there are other ways”, the anesthesiologist noted , for this reason, now people in hospitals are making numbers and rearranging the pieces of Tetris, where the health of the people is the only goal.
The epidemiologist came out of the hospital peaceful. “Influenza viruses are circulating again as usual this time of year,” he said. That is, they are behaving similarly to before the pandemic. “I don’t feel that way special gravity This year compares favorably to previous years, except of course the pandemic years. It’s true that 2020 and 2021 have been particularly difficult, but it has taught us a lot about how to handle these situations. ” added the doctor. This is a common feeling noted by experts. The influenza virus has returned to its previous levels. Furthermore, due to post-pandemic vaccination fatigue, good enough vaccination rates have not yet been achieved.
Ignacio Jiménez points out in this term “Intensive vaccination campaign” Fight against influenza, Covid-19 and RSV. “The Ministry of Health is taking all necessary means to promote publicity, prevention and health care among the population. In addition, recommendations have been made on the use of masks, especially in hazardous environments and for vulnerable groups,” the report concludes. Virgen del Rocío doctor.
Sevilla maintains first phase of high-frequency plans
Currently, in general, the province of Seville is in the first phase of the high-frequency plan and is preparing for the possible launch of the second phase after last week’s increase in hospitalizations for hospital emergencies and respiratory infections. 8,000 and above (8.101), in the first case, and 734 income.
In the first phase, health centers have all available resources to cope with different peaks in demand in terms of emergencies and consultations and, in the case of hospitals, the need for diagnostic tests and in-patient care.
Divided by center, Santa Maria Rossio Hospital Repeat for another week The third phase, In other words, their emergency room and hospitalization numbers increased by more than 35% for three consecutive days. Macarena and Valme are in the first phase, with increases ranging from 15% to 25%. The second phase is HAR (increase between 25% and 35%) in Utrera, Sierra Norte and Lebrija and 0 Écija and Morón.