The dramatic situation in the intensive care units is forcing the doctors to take drastic steps: In many Bavarian clinics, preparations are underway for the transfer of intensive care patients to hospitals in other federal states.
Operating theaters are also to be converted into intensive care units.
The national shamrock crisis plan has been activated for the first time. It provides for nationwide and, if necessary, nationwide transfers of intensive care patients. According to information about a dozen seriously ill Covid patients from Munich alone, they are to be brought to places with free intensive care beds. There are probably 50 intensive care patients across Bavaria. The transports by plane or Sanka could start as early as the weekend. The aim of these so-called strategic relocations is to create space for new patients in the already hopelessly overloaded Upper Bavarian intensive care units.
"The activation of the cloverleaf procedure is the logical consequence of the highly tense situation in the hospitals and in the rescue service for days," emphasized a spokesman for the BRK. For the Red Cross, the activation does not mean any fundamental change in day-to-day business, but hopefully for the clinics it will relieve the burden and thus ease the pressure on the emergency services. Upper Bavaria's intensive care physicians present the relocations with a major challenge. You have to use a kind of checklist to select suitable patients who are eligible for safe removal. Among other things, it is important that a patient's circulation and other vital signs have been stable for at least 24 hours. For example, patients who are ventilated in the prone position or who are treated with high-dose oxygen are eliminated from the start.
The expected discussions with the families are particularly sensitive.
“You will not like to hear that some of your seriously ill relatives are being moved hundreds of kilometers away.
We expect that these decisions will cause bad blood, ”predicts an intensive care doctor.
We are at the limit - even in the high-performance Munich clinics.
Clinic Director Christian Stief
Nevertheless, there is no alternative to Operation Kleeblatt, emphasize the Munich hospital coordinators Viktoria Bogner-Flatz and Dominik Hinzmann. “We no longer have any room for maneuver. It is already clear that we will have significantly more serious Covid cases in the next few days and weeks. We now need every single bed. ”Her primary goal is to avoid triage by all means. “It can't get that far. In Corona hotspots like Munich in particular, doctors and nurses are currently heavily reliant on the solidarity of their colleagues - inside and outside Bavaria, "said Bogner-Flatz and Hinzmann.
The term triage originally comes from war medicine, which is why some doctors prefer to speak of prioritization. Doctors have to decide which patients to pay more attention to. “However, triage cannot mean that one patient is treated and the other is doomed to die. This is a horror scenario that shouldn't and hopefully won't happen, ”emphasize Bogner-Flatz and Hinzmann. However, the worry lines are getting deeper and deeper also with other medical professionals. "We are at the limit - even in the high-performance Munich clinics," said the experienced clinic director and deputy head of the LMU clinic, Christian Stief. “We all still have the terrible pictures from Bergamo in mind.If we do not exhaust all possibilities and finally bring the unvaccinated to their senses, then no one can guarantee that we will experience such scenes here too. "
That is why the medical crisis managers turn all the adjusting screws in everyday clinical practice.
Plans are already underway to convert operating theaters or recovery wards into small intensive care units.
After operations that could be planned have been postponed until April, surgical staff are to be assigned to intensive care units.
Another plan: Smaller specialist clinics should be more closely involved and possibly supported by nurses with experience of Corona from the large hospitals.
“We grab every straw to get beds somewhere,” say Bogner-Flatz and Hinzmann.