ICU consultant: Is a pandemic not enough for Government to fund more ICU beds?

There is a critical shortage of ICU beds in country, made worse by the pandemic.

An extremely low number of ICU beds combined with a rising number of critically-ill unvaccinated people is creating “a complete disaster”.

A top intensive care consultant has questioned what it will take for the Government to fund more ICU beds if a global pandemic is not enough.

On Thursday, there were just 292 adult ICU beds open according to the HSE of which 286 were occupied including 107 Covid patients.

“You have to wonder what needs to happen before the authorities realise we have a very low number of beds, and that it needs to increase,” 

said Professor Ignacio Martin-Loeches, who works in the ICU at St James Hospital.

During Covid surges and as ICUs around the country fill up, staff haul ventilators and other breathing apparatus onto normal wards so they can adapt beds to care for severely ill patients, he said.

“An ICU bed is not just about having a ventilator, it requires staff especially nurses, medication, and a doctor working with the team,” Prof Martin-Loeches said.

“In the last surge, we needed to treat them (Covid patients) on the wards. We had to make the ward beds like an ICU bed but it was not the same as being in the ICU.” 

A professor in critical medicine at Trinity College, he is one of two doctors working in Irish hospitals who took part in a global study on the impact of caring for critically ill Covid-patients outside of ICUs.

“We have seen that unfortunately if patients are being cared for in an area that is not an ICU, then we see they have a higher mortality.” 

“This is something that as intensivists we are very concerned about.” 

The consultant said the number of ICU nurses is critically low, and as the pandemic continues many nurses have had to take on these roles without full specialist training.

The recommended ICU occupancy rate is 70% across Europe but even before Covid, Irish units were regularly far busier.

Unvaccinated

“When the occupancy rate is over 100%, that means the bed is being used by two people on the same day. A second person using the bed after the other person has been discharged, this is something that is not fit for purpose,” Prof Martin-Loeches said.

In recent weeks he has found treating young, healthy unvaccinated people for Covid-19 particularly challenging.

“They can hardly speak, they are very scared, they do not know whether they are going to be alive for much longer,” he said.

“When you intubate someone, it can be very rocky. This is the reality.” 

Family members have spoken to him of patients who regretted not getting the vaccine, but by the time anyone comes into his care it is far too late to think about vaccination, he said.

“In Ireland, we have a low number of unvaccinated people but their care is making the system struggle,” he said.

“The number of ICU beds is very very low, it is a complete disaster.” Hospitals are now forced to cancel elective operations to keep beds for another potential surge.

“Doctors are shopping around for an ICU bed,” he said.

Prof Martin-Loeches recently had to delay accepting a patient being transferred from a smaller hospital for specialist care as there were simply no beds which, he said, is not unusual for any large hospital here.