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What crisis care standards could mean for Valley patient care

Posted at 6:37 PM, Jun 30, 2020
and last updated 2020-07-01 12:10:30-04

As ICU bed capacity sits at 88% across Arizona, hospitals are getting more leeway from the state with the use of crisis care standards if their facilities become overwhelmed.

“People who’ve experienced military triage and having to make these decisions on the battlefield are sometimes scarred for life by this. It’s not something you ever really forget,” said Dr. Matthew Wynia, an infectious disease and public health expert from the University of Colorado.

Arizona hospitals could soon be the battlefield, with our hospital systems, nurses, and doctors the ones left to live with the scars.

“People don’t choose to enter crisis standards of care, it is thrust upon them,” said Dr. Wynia.

Crisis standards of care essentially prioritizes staffing, medical equipment and other resources to those with the best chance of survival when hospitals reach maximum capacity.

Dr. Wynia says if hospital systems in Arizona activate crisis standards of care, they will do it at the same time.

“You would never want someone at one hospital to make a decision that we need to triage this resource because we’re running out, but they have that resource at a different hospital just a few miles away,” said Dr. Wynia.

Instead, hospitals and state health leaders will form a coalition that will make unbiased decisions regarding those resources.

“You need this triage team to have excellent situational awareness, not just of the resources at that hospital, but the situation across the city or even the region,” said Dr. Wynia.

Allocating essential equipment like ventilators will come down to a rather simple question.

“What’s the likelihood that you will survive this acute illness and still be alive six months or a year from now,” Dr. Wynia explained.

“Basically, everybody I’ve tested has come back positive," said Dr. Murtaza Akhter, an emergency room physician at Valleywise Health. "The numbers we’re getting are way higher than we’re even seeing in the state data."

Dr. Akhter says all hospitals are struggling at the moment with capacity.

“A lot of us are reaching the precipice, and so what can happen is even if just a few of those hospitals go over, you can see the whole Valley go into crisis mode pretty quickly,” said Dr. Akhter.

It’s a mode they’d like to avoid at all costs, but with current projections, may not be possible -- leading to decisions no one wants to make.