(Yellowknife, September 22, 2021) NTHSSA is advising that the current surge in hospitalized Covid-19 patients has identified an infrastructure limitation related to the oxygen system in Stanton Territorial Hospital. This issues centres around the distribution system for oxygen within the hospital and limits on the total volume of oxygen that can be delivered in each zone of the building at one time. This has become apparent as the numbers of Covid-19 and other patients requiring ventilatory support in the hospital has grown in recent days.
It is important to note that we are still able to care for patients who need acute care services, whether related to COVID-19, or otherwise. This notice is being provided as a precaution to let residents know there may be further impacts should case counts increase and in turn put demands on our acute care services and as a reminder to residents to follow public health guidance, and to get vaccinated, to prevent hospitalizations in the first place.
To ensure ongoing care of patients currently hospitalized, Stanton took the following immediate actions when the issue was identified in the early hours of Sept 21, 2021:|
- Cancelled surgeries for the morning of Sept 21 as a precautionary measure to allow assessment of the issue;
- Moved patient(s) from the ICU to another suitable zone in the hospital with appropriately qualified staff and other supports;
- Assembled a technical and clinical team to assess the issue and determine immediate mitigation strategies (such as the use of bedside oxygen tanks where possible, etc);
- Engaged with Alberta Health Services to seek advice on immediate mitigation strategies;
- Engaged the GNWT Department of Infrastructure.
As of September 22, surgeries have resumed however further cancellations may be necessary, if this is required any impacted patients will be contacted directly.
NTHSSA is continuing to assess this situation in collaboration with the P3 facility management provider Dexterra, the GNWT Department of Infrastructure, and other external technical experts. There have been no negative impacts to patient care aside from yesterday’s surgical cancellations, and we continue to be able to provide high quality care to our current covid-19 and other patients. NTHSSA is focused on determining the impact on the overall ability to implement further surge capacity at Stanton as set out in the Authorities Pandemic Response Plan for Health Services. This is particularly important as we observe the strain that the Alberta health system continues to face.More information and updates will be provided as we continue to work to assess the situation.
Now more than ever, NTHSSA asks residents to continue to work together to protect our limited health system capacity by following the guidance provided by the Chief Public Health Officer – wear a mask, limit gathering, get tested if you are symptomatic, and most of all, please get vaccinated if you have not already done so.
As background, the mainstay of treatment for severe covid-19 patients has shifted in recent months away from early intubation and mechanical ventilation to the use of less invasive high-flow oxygen devices which require upwards of 4 times the oxygen flow of a ventilator. While some patients may still require a mechanical ventilator many are now first put on a high-flow oxygen device.
NTHSSA-Stanton had previously undertaken a review of overall oxygen delivery capacity based on projected surge plans; however, this review focused on mechanical ventilator capacity as the high-flow oxygen devices were not yet part of the standard treatment for COVID-19. Gradually our understanding of the illness and the approach to care has shifted and with this change comes these unexpected demands on our infrastructure. Other jurisdictions have faced similar issues related to capacity as these devices were implemented and NTHSSA is reaching out to determine what solutions or lessons may be available.