In Houston, Overwhelmed ICUs Leave COVID Patients Waiting In ER
Houston hospitals are having to treat hundreds of COVID-19 patients in emergency rooms for hours or even days as they hurry to add intensive care beds for the seriously ill.
- The 12 busiest hospitals are telling emergency responders that they cannot safely accept new patients.
- On Thursday, 3,812 people were hospitalized with COVID-19 in the area, including a record-setting 1,000 in ICU.
- Texas officials have not issued another stay-at-home order, so hospitals also need to provide care for victims of car accidents, violent crimes, and heat-related emergencies.
“Normally that patient would just go to an ICU bed, but because there are no beds available, they continue to board in the emergency room,” said Esmaeil Porsa, President and CEO of Harris Health System. “It is not an optimal level of care. This is not something we would choose to do. The only reason this is happening is because we are being forced to do it.”
Pre-pandemic studies show that the longer patients stay in the ER, the worse their outcomes.
- The ICU has medical personnel with specialized training for specific interventions, whereas the emergency department quickly assesses patients and stabilizes them before getting them to where they need to be.
- ER doctors are forced to function like the hospitalist or ICU doctor, though that is not the role they are supposed to take on, according to Dr. Cedric Dark, an emergency physician at Baylor College of Medicine. “The bad thing about having any patient boarded in the emergency department, regardless of the situation, is that it slows down the beginning of care for somebody who needs hospitalization, and the beginning of care for any medical condition is the most crucial period of time.”
“All the hospitals are full,” said Dr. Jamie McCarthy, an executive vice president at Memorial Hermann Health System and an emergency room physician. “All the hospitals in the city are boarding patients. We are expanding capacity, but we can’t turn those on immediately. It requires staffing. It requires nurses and doctors to come in. And so, as we’ve continued to expand our inpatient capacity, we’re just keeping up with the volume that’s coming in.”
The SouthEast Texas Regional Advisory Council reported that multiple hospitals are running out of available nonsurgical ICU beds. Memorial Hermann sends intensive care doctors and other specialists to the emergency departments to spread the health care providers.
- McCarthy said, “We are adding more capacity, but we are absolutely stretched now, and if it keeps going this way, we’re going to run out of room.”
- Officials say the number of patients being treated in emergency rooms demonstrates the challenges to adding new ICU beds amidst the growing crisis: “The bottleneck to do that is really staffing.”
- ER departments are too busy to receive new patients quickly, but are forced by law to screen and stabilize any patient who arrives.
- An NBC News and ProPublica report showed a growing number of people dying suddenly at home, before emergency responders arrived. McCarthy encouraged people to come to the hospital for emergencies: “Delaying care for time-sensitive emergencies is time we don’t get back. If they wait to call for help when they are having a heart attack, it will be worse than if they come in early.”