Inadequate Level-1 facility possible reason of more deaths in Jammu, say experts
Govind Sharma
JAMMU, May 9: Government Medical College (GMC) Jammu, which has been designated as Level-1 COVID Hospital, has been facing acute shortage of BPAP/ventilator supported beds, which the very critical patients urgently require and in their absence they are being forced to die in designated COVID wards meant for moderate patients.
Official sources told Excelsior that Critical Care Unit (CCU), High Dependency Unit (HDU) and Isolation Ward of GMC together constitute Level-1 care facility for COVID patients. They said while ICU has 22 beds, CCU 16 and HDU has 30 beds, there are 31 beds in Isolation Ward and all these beds are ventilator/BPAP/high flow oxygen supported beds.
They further informed that there are total 317 beds in Level-2 care in GMC Jammu which comprised of Ward 2 (62 beds), Ward 3 (43 beds), Ward 7 (62 beds), Ward 11 (58 beds), Ward 15 (62 beds), Spinal Ward (20 beds) and Neurosurgery Ward (10 beds). All these beds are without ventilator/BPAP support but are supported by high flow oxygen, they said.
Sources said that a sick COVID positive patient with oxygen saturation above 90 needs Level-3 care which is available in Gandhi Nagar Hospital, MCH Gandhi Nagar and many other hospitals while a patient whose saturation drops between 80 to 90 needs to put on high flow oxygen available in Level-2 care facilities.
“But if saturation of a COVID patient goes below 80, he needs to be put on high flow oxygen with BPAP support. However, if any COVID patient falls unconscious, suffers heart attack, brain stroke or ARDS (respiratory failure), he immediately requires endotracheal tube or ventilator support with high flow oxygen,” they added.
However, on the conditions of anonymity, some clinical experts dealing with Corona patients in GMC Jammu alleged that even patients with below 60 saturation are being shifted in Level-2 care facilities as all the BPAP/ventilators supported beds in Level-1 facilities are 100 percent occupied.
They said as per protocol, a COVID patient below 80 oxygen saturation requires BPAP and ventilator supported beds but as all these beds are already occupied, authorities are forced to shift such patients in COVID wards which are supported by high flow oxygen only whereas these patients desperately require either BPAP (Non-invasive ventilator) or ventilator supported beds.
“Acute shortage of BPAP/ventilator supported beds is one of the reasons of more deaths in Jammu than in Kashmir,” experts said. They further added that out of 77 ventilators that have been installed in ICU, CCU, HDU and Isloation Wards, around 18 of them are out of order for one or other reason while 49 ventilators have been still gathering dust in store of GMC Jammu and in last one year, no effort was made to install and use them.
They said ignorance of the patients about the COVID-19 and their reluctance to visit hospital and come only at last moment when their oxygen saturation drops below 60 is also one of the main reasons of more deaths in Jammu. “But if we had enough ventilator/BPAP supported beds, such deaths could be prevented,” they asserted.
Experts said, “In brief, we can say that inadequate Level-1 COVID care facilities in Jammu province is one of the main reasons of the high mortality rate in Jammu as when we compare ourselves (Jammu) with Kashmir, their Level-1 COVID care facilities are more than three times than that of Jammu”. The administration needs to seriously think about it if they really want to save some lives, they emphasized.
Meanwhile, while talking to Excelsior telephonically, Shashi Gupta, an attendant of a COVID patient admitted in Ward No 2 of GMC Jammu for last 12 days said that her husband’s condition is worsening day by day. “His oxygen saturation is fluctuating between 50- 70% since he was admitted here and according to doctors, he needs ventilator/BPAP support but no ventilator-supported bed or BPAP machine is spare here. Doctors told us to arrange BPAP machine but even after market search, we could not find the same,” she added.
When contacted, Medical Superintendent, GMC Jammu, Dr A D S Manhas refused to comment on shortage of BPAP/ventilator supported beds while HoD Anesthesia, Dr Smriti Gulati did not pick up repeated calls made by this correspondent.
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