Ebersberger chief physician: "There was the covert triage"

Created: 03/04/2022, 15:00

"It's a kind of faint feeling": Clinic chief physician Dr.

Peter Kreissl on the uncertainty of dealing with the pandemic.

Archi © Stefan Roßmann

Peter Kreissl, Medical Director of the district clinic, gives an insight into the grueling work of the medical team in Ebersberg during the corona pandemic.

He speaks of an immense mental burden.

Dr.

Kreissl, what has bothered you and your colleagues the most over the past two years?

Phew, picking one point out of the whole package of challenges isn't that easy.

I think the worst thing was the fear of a triage – that is, having to decide which corona patient to treat and which one to let die if the clinic was completely overwhelmed.

For me and certainly for the whole team, that was a nightmare that pushed us to our moral and ethical limits.

Was there a triage in Ebersberg?

Thank God no.

At the peak of the last wave just before Christmas 2021 we had a scary shortage of intensive care beds and it was also difficult to find a free bed for Covid patients in other clinics because they felt the same way.

But finally the hospital coordinator for Ebersberg and Erding managed to organize two transfers to Hamburg.

So we didn't have on-site triage, but there was covert triage...

What do you mean, covert triage?

Tumor patients who could not be treated in the way that would have been good for them, or patients who, for fear of being infected with corona, did not dare to go to the clinic even with acute illnesses.

Fortunately, since the vaccine has been available, people's fear of infection has lessened.

Operations had to be postponed.

How did this affect patients and yourself?

At this point I would like to emphasize that emergencies and tumors were always operated on during the entire time.

Only elective interventions were relocated by order of the Bavarian state government.

That means planned or elective surgeries, such as knee, hip or gallbladder surgeries or inguinal hernias.

However, we have made this dependent on the pain situation.

A team of doctors from the respective departments called each affected patient beforehand and asked them how they were doing, whether they were in a lot of pain or had serious limitations.

The decision to reschedule the surgery was then made at chief physician level.

Most of the patients were very understanding, which was a great help to us.

If the surgery could not be postponed, we had to find a solution and create additional space and personnel capacities.

One of the biggest challenges during the pandemic, right?

However!

We had and still have to constantly adapt to changes in the situation, move patients from normal wards to set up corona isolation wards, scale back our routine work in every crisis to generate staff from all departments, and restructure everything again in phases of relaxation.

Right at the beginning of the pandemic, the motto was: completely rethink.

Specialists from other areas, such as plastic surgery or urology, had to help care for Covid patients and suddenly take on tasks that they had never done before.

For example?

In the second and third waves, in which up to 40 percent of Covid patients were in the clinic, this included, for example, conducting rounds on these patients in the normal wards.

Before that, the colleagues had to be briefed by the internists on medication and other therapy measures.

The cardiologists who look after the Covid patients in the intensive care unit received support from anesthesiologists in critical phases.

The question that was particularly stressful was: How much capacity do we have to keep free in order to be able to treat in-house emergencies in intensive care, such as patients who spontaneously develop heart or lung problems, but also for other, external emergencies.

It's a kind of powerlessness, not knowing what's going to happen next and living with the worry

unable to meet his medical needs.

Before there was vaccination, there was also the fear of infecting yourself.

What is the current situation?

Omikron is changing everything again.

We have fewer Covid patients in the intensive care unit as well as in the normal wards.

We currently have an isolation ward for suspected cases and a Covid ward, but we can set up a second one within a day or two depending on how the pandemic develops.

So far, the forecasts of the virologists have always been correct, which means that we will have to reckon with more infected people in the next few weeks, but above all with a lack of hospital staff and the resulting supply restrictions.

That means: always “drive on sight” and act with great sensitivity.

That is exhausting.

Sybille Föll conducted the interview