BHUBANESWAR: With rising fatalities due to the lack of timely treatment and monitoring of Covid-19 patients emerging a serious concern, the State Government on Tuesday directed the district administrations to ensure proper care and attention to every person afflicted by the virus.
Taking strong note of the practice to shift patients to Bhubaneswar and Cuttack at the slightest hint of deterioration in their condition, the Government directed all Collectors and Municipal Commissioners to manage Covid patients requiring critical care in the ICU and to set up high dependency units (HDUs) in their respective districts instead of referring them in a routine manner.
Directing health officials and doctors at the district-level to closely monitor the health condition of all patients, including those in home isolation, the Health and Family Welfare department said steps must be taken for early detection of lung infection and timely treatment so that severity of the deceased is reduced.
Additional Chief Secretary PK Mohapatra said the training of doctors and paramedics at grassroots and district-level hospitals would be strengthened to ensure proper patient management and provisioning of critical care.
"The districts have been divided into clusters. All facilities will have to follow the notified referral policy to enable seamless coordination between the sending and receiving hospitals.
If no ICU bed is vacant in a particular district, the first step would be to shift any serious patient to nearby COVID hospital in the cluster. Patients insisting on being referred to Bhubaneswar or Cuttack should be counseled and dissuaded as there is life is at risk in transport," he said.
In case of referral, Mohapatra said, patients in transit should be accompanied by an emergency medical technician so that they do not develop hypoxia.
Unless stable, the patients should not be shifted from one hospital to another, he pointed out.
Stressing on close monitoring and timely treatment, the ACS has instructed districts to provide non-invasive care like high-flow nasal cannulae therapy at all COVID hospitals.
The Collectors and Municipal Commissioner have been asked to set up step down ICUs to decrease the load on those units and ensure that the HDU/semi ICU beds are at least half the number of the ICU beds.
The patients are to be shifted to the step-down ICU once their condition is stable in the ICU.
The Department also directed the districts to set up more dialysis, maternity, oncology, and trauma beds for COVID patients, especially in peripheral facilities, and suggested the adoption of virtual ICU so that appropriate care can be given by experts from tertiary hospitals.
As part of the decision, Acharya Harihar Post-Graduate Institute of Cancer (AHPGIC) will have 25 beds to take care of the chemotherapy requirement of COVID patients with cancer and SCB MCH will have neonatal ICU to take care of COVID positive infants.
“Diagnostic facilities such as CT scan and ultrasound of lungs will also be strengthened in peripheral hospitals and doctors will be trained in these diagnostic procedures.
Trained manpower will be mobilized from low-burden districts to high-burden ones besides timely supply of equipment and drugs," Mohapatra added.
In a report published on September 13, The New Indian Express had highlighted the plights of patients who are made to suffer in absence of proper monitoring besides ICU management in periphery hospitals leading to over-dependence on city hospitals.