Wednesday, June 24, 2009

Hospitals `Overwhelmed’ By Flu Cases In Argentina

 

 

# 3390

 

 

One of the indicators we are watching closely as this pandemic spreads around the world is how badly hospitals are getting overloaded by flu cases.

 

It is still relatively early in the flu season south of the Equator, with the peak not expected until next month, but already Argentina and Chile are reporting serious demands on their medical system.  

 

Elective surgeries are being canceled in some Buenos Aires hospitals, and mobile flu clinics are being dispatched to some neighborhoods.  Of 111 people hospitalized in the country’s capital, 75 are on ventilators.  

 

What would be interesting to know (and I don’t) is how many flu patients are normally on ventilators in Buenos Aires in June?

 

In Chile, where 5,000 people have been confirmed with the virus, they have reported a total of 7 deaths.

 

 

 

Hospital surge capacity has dwindled over the years, both here in the United States and in many other parts of the world, and that has many officials worried over their ability to cope with a large influx of flu cases as this pandemic progresses.

 

This from Reuters.   

 

 

 

 

Argentina reinforces hospitals as flu deaths rise

Wed Jun 24, 2009 1:32pm EDT

By Fiona Ortiz


BUENOS AIRES, June 24 (Reuters) - Argentina is reinforcing overwhelmed hospitals as H1N1 deaths rise and flu cases swamp emergency rooms in and around the capital during the southern hemisphere winter.

 

Argentina has confirmed 18 deaths from the new strain of virus, also known as swine flu, putting the South American country third after Mexico and the United States in the number of fatal cases. The health ministry has confirmed 1,294 cases.

 

Medical authorities suspended non-urgent surgery in many urban hospitals to free up beds for flu cases.

 

The government also sent mobile clinics to poor neighborhoods and dedicated one hospital in the Malvinas Argentinas municipality outside the capital exclusively to flu cases.

 

The H1N1 virus is spreading rapidly in an area known as the conurbano, the densely populated working class suburbs and slums that ring Buenos Aires where eight people have died from the new flu and 111 are hospitalized, 75 of them on respirators.

 

(Continue . . . )

10 comments:

Kobie said...

Fla_Medic,

Number of people on ventilators in June - good question.

I would also like to know if they have gone to Triage mode. Scary thought eh?

75 folks on vents is a problem. Its even worse when 75 folks on the 75 vents with 20 more waiting or 'triaged" out for palative care.

Will post on Twitter if I hear anything about Vents, triage and H1N1.

BTW wired magazine just did another article on H1N1. Source: http://www.wired.com/wiredscience/tag/ah1n1/

Kobie

Kobie said...

Fla_Medic,

Forgot to say one other piece to the puzzel - animals.

Right now in the South America there is not the seperation of agriculture and people. People live closer to the land and their animals.

H1N1 has differnt chances to jump between live stock and people. IMO this means it has different chances not only to spread but pick up other virus parts.

Just a thought

Kobie

Zachary said...

Any word on why Argentina seems to be hit harder by this?

FLA_MEDIC said...

Zachary,

Nothing specific, but Buenos Aires is a mega-city with about 13 million people in the metro area, many of whom live in cramped quarters.

I have to suspect that poor living conditions, an abundance of people with chronic health problems, and pretty chilly temps (highs in the 50's, lows in the 40's) are contributing to the spread.

Anonymous said...

Mike,

I think your question about the 75 people on ventilators, is a perceptive one. You're assuming that the 75 might (probably) represent all etiologies resulting in the need for a ventilator.

But if you don't assume sloppy reporting, the context of that sentence strongly associates all 111 of those presenting to the hospitals are diagnosed with H1N1. If that's correct, then having 75 of this 111 on ventilators would represent a 68% severe morbidity from this previously labled moderate - to mild virus, for most folks.

I can understand why you would assume the number of ventilated patients (75) can't possibly be all related to H1N1 infection, but that's what that sentence plainly says. If you're wrong about your assumption, this virus has done some scary mutating in its travels souh.
Paul.

Anonymous said...

In cases where there is a ventilator shortage, is it possible for multiple patients to share a single machine? In other words, can 2 patients take turns with a single machine? How often does supplemental oxygen by itself (which is presumably far more available) sufficient to assist flu patients?

- o.jeff

FLA_MEDIC said...

Paul,

I'm assuming the 75 people on ventilators are flu-related, although the possibility exists of poor reporting.

My question really is, how unusual is that for that region in June? How many severe flu cases do they normally see in June?

My guess is, this is an unusually high number. But that's just a guess.

FLA_MEDIC said...

Anon,

I'm unaware of any way to split a ventilator between 2 people.

Since vents are carefully set as to pressure and volume - which is different for each patient - I'd have a hard time seeing how that would work.

Regular O2 is certainly beneficial for those able to breath on their own.

What the relative percentages are, I've no idea.

Anonymous said...

o.Jeff,

Although supplemental oxygen, used without any ventilatory support, is sometimes helpful for patients with chronic lung disease, whose blood gasses truly indicate a significant hypoxemia (i.e., the staff isn't just applying a nasal canula of oxygen to make everyone feel better that *something's* being done.) This is to address a chronically progressive condition to help oxgenate the blood, using the patient's own reduced (but still functioning) breathing efforts for gas exchange in the lungs.

Someone who develops acute respiratory insufficiency due to an infection or trauma, needs actual mechanical assistance (a ventilator) to help them inhale and exhale gases into and out of their lungs. In most situations, in the intial phase of mechanical ventilation, supplemental oxygen is also applied, as blood gases will indicate poor oxygenation.

But to answer your question more directly, a passive flow of supplemental oxygen will not help someone who, because of acute inflamation and inflamatory "junk" in the little air sacks (alveoli) of the lungs will be of no help, without the mechanical assistance of inhaling and exhaling to get it to where it needs to be, to get into the blood stream.
Paul.

FLA_MEDIC said...

Thanks, Paul for the clear explanation.