Dearth of personnel may hit emergency care

TNN | Apr 4, 2020, 04.53 AM IST

Madurai: Lack of trained personnel to handle emergency care including ventilators may lead to government hospitals struggling to treat critical Covid-19 cases even though there are enough ventilators to handle the rising numbers at present.

At the Government Rajaji Hospital (GRH) in Madurai, one of the biggest tertiary care centres in the state, a total of 147 ventilators are in use, according to an RTI reply filed in November 2019. There are around 400 ventilators across both government and private hospitals.

“Not all ventilators, especially those in government hospitals across the state have proper batteries with power back-up. This means a patient could die if there is an unexpected power shut down. Further, maintenance of ventilators is also poor making it much difficult for doctors too,” said a senior anaesthetist who works at a government hospital.

However, doctors asserted that not all Covid-19 patients would require ventilators though there may be a rise in demand now. “Ventilators are used only for critical cases wherein the patient’s lungs are failing. Even for Covid-19, only patients with co-morbid illnesses need ventilator support. But, only doctors, staff nurses and emergency technicians who have worked in intensive care can handle ventilators,” said Dr N Uwaraja, head and consultant emergency physician at a private hospital in Madurai.

Though hundreds across Tamil Nadu have undergone emergency technician courses offered for paramedical staff, they are not recognised for roles in emergency rooms (ERs) and intensive care units (ICUs). Usually, anaesthetists take up the role of intensivists in the government hospitals. Doctors also reiterate that such courses in India are insufficient for ERs and ICUs.

“Emergency technicians if given right training and posting can properly maintain and run ventilators in government hospitals. It will reduce the burden of doctors to handle ventilators and also reduce the number of cases being referred to tertiary health care centres. We are ready to serve if the government gives us the opportunity,” said an emergency technician, who works with 108 ambulance services.

“Emergency medicine courses are currently not recognised in India. Their training also varies with the institution they study. So, anaesthetists are the ones mainly handling ventilator care. However, we are also being underutilised,” said a senior anaesthetist.