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Paradigm Shift Intervention Monitoring
Over the past month the National Health
Service has increased fourfold the number of special machines that
treat critical flu victims.
A portable Ecmo machine was flown by Prince William in a RAF helicopter to treat a young woman who developed swine flu just weeks after giving birth, but she later died in North Manchester General Hospital.
Ecmo is now on offer at seven hospitals around England, with referrals taking place at the country’s main Ecmo centre in Glenfield Hospital, Leicester. Those offering the treatment, which requires the use of increased numbers of doctors and nurses, have been told to postpone planned operations.
All 21 beds are now in use, although there is no suggestion that patients are being turned away. But as more patients continue to be considered for Ecmo, health bodies are preparing to buy even more of the £40,000 machines and install them in more centres.
“Although Ecmo is a highly specialised treatment, expert clinicians who perform cardiac surgery and provide critical support to patients in intensive care use many of the same skills and technology required for Ecmo.
“SHAs have been asked to identify appropriate cardiac surgery centres (whose staff do not normally provide the Ecmo services) so that these hospitals can also be authorised to provide a limited Ecmo service. Hospitals will only perform Ecmo if staff are appropriately qualified with the right level of experience. Hospitals will operate to strict clinical protocols and receive advice and support from clinicians at other centres.”
The above comments describe the availability of ECMO machines in England. As noted above, one was flown to Manchester in a failed effort to save the life of a young H1N1 patient. The number of critical cases has since risen and was up to 738 last week, compared to 460 a week earlier.
Although the 21 machines is higher than the 12 available last season, they are in full use and it is far from clear that machines are readily available for all of the critical H1N1 patients, which is undoubtedly higher than the 738 announced last week and is likely to grow in part due to the start of school and return to work after the holidays.
Each machine cost £40,000 and more may be ordered, but the current situation raises health care delivery concerns. These concerns extend to children, who have filled ICU beds and an increase associated with the start of school is expected.