Consultants warn on intensive care facilities

‘Real danger’ that road traffic victims may not get an intensive-care bed, say doctors

Consultants said for any patient faced with an acute life-threatening illness, “delay in accessing intensive care units demonstrably reduces the prospect of survival”. Photograph: Eric Luke

Consultants said for any patient faced with an acute life-threatening illness, “delay in accessing intensive care units demonstrably reduces the prospect of survival”. Photograph: Eric Luke

Tue, Mar 18, 2014, 01:00

The State’s foremost intensive care consultants have expressed concern over the availability of resources for treating patients who need emergency medicine.

In a letter in The Irish Times today the president and the council of the Intensive Care Society of Ireland draw attention to a 2008 report, Towards Excellence in Critical Care , which found standards of care fell short of those required.

The president, Dr Patrick Seigne, a consultant with Cork University Hospital, yesterday told this newspaper the consultants who signed the letter had been reluctant “to go to the media” on the issue.

However, he said since 2008 resources in intensive care units had suffered further cuts and the situation had deteriorated. The situation was now at the point where consultants in all the main hospitals who signed the letter had “reasons to have concern for the care of patients”.

Centralised hospitals
He said intensive care facilities in “peripheral” hospitals have been closed in a centralisation move which saw no increase in resources in centralised hospitals.

Dr Seigne said there was now “a real danger” that someone seriously injured in a road traffic incident, for example, would not be allocated a bed in an intensive care unit.

He said intensive care units across the State were using resuscitation rooms in casualty departments and recovery rooms for patients who should be cared for in fully-staffed intensive care units.

In his own base of Cork University Hospital there were just 10 “general” intensive care unit beds and a further six “cardiac” intensive care unit beds. There were a further 22 intensive care beds at the hospital which were closed.

Specialist nursing staff
A significant factor in the difficulty was the availability of specialist nursing staff. He said each intensive care bed required five to six nurses to provide cover during a 24-hour period. This meant there was a very strong need for resources at a time when nurses were leaving the country for well-paid jobs in places like Bahrain. “We are training nurses for Bahrain,” he said.

Dr Seigne said part of the solution would be to immediately set up educational programmes to encourage more nurses into the field, but “salary has to be looked at”.

In the letter the consultants said the recommendation to double bed capacity by 2020 is not on track. “Half way through this timeframe bed capacity has actually been actively reduced.”

The consultants said for any patient faced with an acute life-threatening illness, “delay in accessing intensive care units demonstrably reduces the prospect of survival”.

The letter is signed by consultants at Beaumont, St James’s, the Mater, Tallaght, St Vincent’s, James Connolly, UCH Galway, the Mid-Western, CUH Cork, and Waterford Regional hospitals.