Thread by @awong37

This is an explanatory 🧵 on ICU capacity in Saskatchewan, the different levels of ICU care & support provided across #SK, and why freeing up ICU beds in Regina & Saskatoon is SO important right now for us.

Put plainly: "not all ICU beds are equal"

(1/n)

#COVID19SK

Not all ICU "beds" are created equal. There's different capability levels to provide support for complex patients depending on the expertise of available doctors, nurses, respiratory therapists, and specialist support. (2/n)

#COVID19SK

Let's divide "care levels" into 3 buckets:

✅ 1. BASIC = ventilatory support, cardiac monitoring, IV blood pressure management, sedation, high-flow O2 support

✅ 2. SPECIALIZED = BASIC + continuous renal therapy, complex ventilatory support (eg. proning)

(3/n)

#COVID19SK

✅ 3. TERTIARY = SPECIALIZED + ECMO support, cardiac surgery, neurosurgery, complex trauma, critical care oncology, high risk obstetrics, burn care

(4/n)

#COVID19SK

BASIC care is what can be provided by smaller centers like Moose Jaw, Swift Current, Prince Albert, Yorkton. It is what can be provided by the "surge" beds in Regina and Saskatoon.

SPECIALIZED care can be provided by St. Paul's in Saskatoon, Pasqua in Regina.

(5/n)

#COVID19SK

TERTIARY care can ONLY be provided at Royal University Hospital (RUH) in Saskatoon and Regina General Hospital (RGH) in Regina. This is where the interdisciplinary team expertise and facilities exist to look after the most complex & very sickest #SK citizens.

(6/n)

#COVID19SK

By freeing up ICU space at RUH & RGH, that gives us the 'wiggle room' needed to look after the most complex people HERE in #SK, without the need for transport out-of-province OR triage. Complex trauma or motor vehicle accident? We can handle it.

(7/n)

#COVID19SK

Freeing up a bed in Moose Jaw or Prince Albert helps manage a 'simple' COVID+ patient or someone with single-organ sepsis, but it DOESN'T help a person waiting in Regina or Saskatoon for critical open-heart surgery, or complex cancer surgery.

(8/n)

#COVID19SK

There are multiple patients in both Regina and Saskatoon who are waiting critical surgeries right now, such as open-heart procedures, neurosurgery, or complex cancer surgeries. They can't get LIFE-SAVING surgery because there aren't beds at RUH or RGH.

(9/n)

#COVID19SK

This is why transporting COVID+ persons out of RUH & RGH to Ontario is so critical. It frees our #SK "in-house" resources to manage the most critically ill & complex people. COVID+ persons will often take weeks to get off the ventilator & out of ICU.

(10/n)

#COVID19SK

We NEED transfers to Ontario in large numbers to give our ICU systems here the buffer to do things safely, to minimize the degree of compromised ICU care we provide to #SK citizens, and to avoid horrible triage decisions.

Please @SKGov - help us. Thanks.

(end)

#COVID19SK