{"id":18819,"date":"2020-08-12T10:03:08","date_gmt":"2020-08-12T15:03:08","guid":{"rendered":"http:\/\/thepapergown.zocdoc.com\/?p=18819"},"modified":"2023-03-06T09:50:25","modified_gmt":"2023-03-06T14:50:25","slug":"icu-capacity","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/blog\/guides\/icu-capacity\/","title":{"rendered":"What Happens When the ICU Fills Up"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Your loved one needs urgent care for a heart condition that\u2019s flared up. When the ambulance arrives, you learn that instead of heading to your local hospital\u2019s intensive care unit \u2014 which is at capacity because of an influx of COVID-19 patients \u2014 they\u2019ll be rushed to a different facility a few counties away.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It\u2019s not a typical scenario, but it\u2019s one that some patients are now experiencing as ICUs across the country fill up because of surging coronavirus cases. In late July, for example, hospitals <\/span><a href=\"https:\/\/news.yahoo.com\/miami-dade-ic-us-at-146-percent-capacity-with-coronavirus-patients-151222876.html\"><span style=\"font-weight: 400;\">in Florida\u2019s Miami-Dade County<\/span><\/a> <span style=\"font-weight: 400;\">were reportedly operating <\/span><a href=\"https:\/\/news.yahoo.com\/miami-dade-ic-us-at-146-percent-capacity-with-coronavirus-patients-151222876.html\"><span style=\"font-weight: 400;\">at 146 percent capacity<\/span><\/a><span style=\"font-weight: 400;\">. ICUs in Georgia, Texas, Louisiana and South Carolina have also recently either reached capacity or seen diminishing capacity.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">ICU beds in coronavirus hotspots have filled up with patients who\u2019ve deteriorated after contracting the virus and need round-the-clock, complex care. When this happens, fewer traditional ICU spaces are left for people who\u2019ve had heart attacks or strokes or been in car accidents, and hospitals have to find other beds for them. Care for patients without urgent needs can also be disrupted, with procedures delayed.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cWhen a hospital\u2019s ICU is at capacity, hopefully most patients will not see a difference,\u201d says Dr. <\/span><span style=\"font-weight: 400;\">Jaspal Singh, a critical care physician in Charlotte, North Carolina.<\/span><span style=\"font-weight: 400;\"> \u201cWe haven\u2019t stopped doing cancer surgery, stroke or heart disease care. But when you\u2019re at capacity, you can only do so much. Priorities change. Be prepared for things looking a little bit different.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Here\u2019s what to expect if you or your loved one needs care at a hospital that\u2019s at ICU capacity because of COVID-19.<\/span><\/p>\n<h3>What kinds of changes do hospitals make when their ICU is at capacity?<\/h3>\n<p><span style=\"font-weight: 400;\">An efficient hospital operates at around 85 percent capacity in normal times, says Dr. <\/span><span style=\"font-weight: 400;\">Ann Weinacker, associate medical director of the intensive care units at Stanford Health Care. <\/span><span style=\"font-weight: 400;\">When capacity hits 100 percent, hospitals can turn other areas into ICU units, provided they have the necessary extra equipment, like monitors and ventilators. \u201c<\/span><span style=\"font-weight: 400;\">There does become a point where we outstrip all the resources,\u201d says Weinacker<\/span><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">At the height of New York City\u2019s spring COVID-19 surge, New York Presbyterian Hospital <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7258631\/\"><span style=\"font-weight: 400;\">put ICU beds in operating rooms<\/span><\/a><span style=\"font-weight: 400;\">. Some hospitals at capacity hire extra ICU staff to help out, but others pull nurses without extensive ICU experience from other parts of the hospital to pitch in. Hospitals at capacity are also less likely to accommodate special requests. If, for example, you always take your mother to a specific hospital for care when her chronic health issue flares up, that might not be possible if a facility is at ICU capacity. \u201c<\/span><span style=\"font-weight: 400;\">Family requests may not be honored,\u201d Singh says.<\/span><\/p>\n<h3>If I need urgent care, is there a chance my local hospital won\u2019t be able to take me?<\/h3>\n<p><span style=\"font-weight: 400;\">Yes. While it\u2019s rare, if a hospital is at ICU capacity and areas that it\u2019s converted into extra ICU space are also full, you might be sent to another hospital for care. <\/span><span style=\"font-weight: 400;\">Singh recently had to send a critically ill patient across state lines to a facility with space. The problem can be more pronounced in rural areas, which typically have fewer hospitals than urban areas. <\/span><span style=\"font-weight: 400;\">A\u00a0recent <\/span><a href=\"https:\/\/www.sccm.org\/getattachment\/Blog\/March-2020\/United-States-Resource-Availability-for-COVID-19\/United-States-Resource-Availability-for-COVID-19.pdf\"><span style=\"font-weight: 400;\">report<\/span><\/a><span style=\"font-weight: 400;\">\u00a0from the Society of Critical Care Medicine found that just 1 percent of America\u2019s ICU beds are in rural areas. <\/span><span style=\"font-weight: 400;\">\u201c<\/span><span style=\"font-weight: 400;\">The patients I most worry about are those who live in rural communities,\u201d Singh says.\u00a0\u00a0<\/span><\/p>\n<h3>What else might happen at the hospital that\u2019s different?<\/h3>\n<p><span style=\"font-weight: 400;\">After observation in the ER, a patient with a serious but not critical condition might be sent home for monitoring, whereas before COVID-19, they might have stayed in the hospital overnight. That could happen, for example, if a patient with <\/span><span style=\"font-weight: 400;\">COPD, a chronic inflammatory lung disease, comes down with a viral illness that\u2019s not COVID. They might be sent home with a pulse oximeter to monitor their oxygen and an oxygen tank.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you\u2019re in a COVID hotspot, you also might not be able to enter the hospital with your loved one when you arrive. Most hospitals, however, make exceptions for patients who have cognitive disabilities or those who are in critical condition.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In general, don\u2019t be surprised if visitor policies change overnight. Stanford stopped allowing visitors as the pandemic escalated, but then relaxed its policy to permit two visitors as conditions improved. Now with COVID-19 cases rising again, only one person can visit each day per 12-hour period, says <\/span><span style=\"font-weight: 400;\">Weinacker.<\/span><\/p>\n<h3>What if I have elective surgery planned?<\/h3>\n<p><span style=\"font-weight: 400;\">You might get a call that your elective surgery has been postponed. In Texas, Gov. Greg Abbott banned elective medical procedures in more than 100 counties to free up hospital resources as COVID-19 cases escalated in the state. Noncritical surgeries or procedures like knee replacements or colonoscopies will likely be put on hold as hospitals put all resources toward COVID and other critical patients. Another reason for hospitals in a hotspot to postpone elective procedures is to keep otherwise healthy patients from being exposed to the coronavirus, says Weinacker.<\/span><\/p>\n<h3>With hospitals at capacity, what can I do to make the experience a smooth one for myself or my loved one?<\/h3>\n<p><span style=\"font-weight: 400;\">Because you or your loved one might end up in an ICU where non-ICU nurses or even non-ICU physicians are working, it\u2019s a good idea to be fully up to speed on the condition that\u2019s brought you to the hospital and on the standards of care, Singh says. That means knowing best practices in terms of procedures or medications. \u201cPatients and families may need to advocate more,\u201d he says.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you have permission to access your loved one\u2019s medical records, do that too, he adds, and get involved in looking at any labs. Doctors and nurses will likely be stretched thin and not have much time to talk. \u201cIf you can\u2019t access caregivers directly, at least you can look at the notes through the patient portal,\u201d he says.<\/span><\/p>\n<h3>Should I be afraid to go to a hospital that\u2019s at capacity because of COVID?<\/h3>\n<p><span style=\"font-weight: 400;\">No. Many conditions can get worse if you don\u2019t seek medical care quickly. \u201cPeople have stayed away from the hospital, and they\u2019ve had worse outcomes as a result,\u201d Weinacker says. Instead, don\u2019t ignore warning signs of illness. \u201cBe early and proactive,\u201d says Singh. \u201cTalk to your regular doctor and specialists. Seek them out before things get bad.\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you or a loved one does need to go to the hospital, expect to be screened at the door for any COVID-19 symptoms. Visitors who seem sick will be turned away. If you\u2019re allowed in, prepare for limited seating in public areas and expect to wear a mask at all times.<\/span><\/p>\n<hr \/>\n<h1 class=\"p2\" style=\"text-align: center;\"><span class=\"s1\">Ready to book a doctor&#8217;s appointment? Visit <a href=\"https:\/\/www.zocdoc.com\/\"><span class=\"s2\">Zocdoc.<\/span><\/a><\/span><\/h1>\n","protected":false},"excerpt":{"rendered":"<p>Here\u2019s what to expect if you or a loved one needs care at a hospital whose ICU is at capacity.<\/p>\n","protected":false},"author":41,"featured_media":18428,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[227],"tags":[149,25,95],"class_list":["post-18819","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guides","tag-covid19","tag-emergency-care","tag-hospital-stays","reviewer-dr-nassim-assefi"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>What Happens When the ICU Fills Up - Guides<\/title>\n<meta name=\"description\" content=\"Here\u2019s what to expect if you or a loved one needs care at a hospital whose ICU is at capacity.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.zocdoc.com\/blog\/guides\/icu-capacity\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"What Happens When the ICU Fills Up - 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