There are a number of problems involving the delivery of oxygen to patients, but usually the problem is not an absolute lack of oxygen, according to Dr. Christina Ghaly, director of Los Angeles County Health Services.
Instead, in some hospitals in the area, the outdated infrastructure that pumps oxygen to patients’ rooms is unable to keep up with the high number of patients who need oxygen.
“They are not able to maintain pressure in the tube to maintain the oxygen supply at the high level of pressure that is required to be delivered through the high flow oxygen delivery vehicles,” said Ghaly. “Because of this high flow in the pipes, it is sometimes freezing in the pipes and obviously if it freezes, you cannot have a good flow of oxygen.”
Oxygen problems arise at a time when Los Angeles County sees an almost overwhelming increase in patients with Covid-19 bringing almost all hospitals to maximum capacity. Almost 7,000 patients are currently hospitalized, with about 20% of them in intensive care units.
The lack of oxygen cylinders also
To solve the oxygen supply problem, some hospitals are transferring patients from Covid-19 to the lower floors of the medical center, which makes it easier to pump oxygen through the pipes without freezing.
Another challenge, Ghaly said, is that several supply companies are short of the actual oxygen cylinders that patients can take home after they are discharged from the hospital. Without the containers, patients who could return home – and free up a bed and healthcare workers’ time – need to stay in the hospital.
At Martin Luther King Jr. Community Hospital in Los Angeles, for example, patients are being treated in tents outside the hospital, in a conference room and in the chapel. Stretchers are taken to the gift shop. Rationing may be the next step, said the hospital’s CEO, Dr. Elaine Batchlor, on Monday.
“If we continue to see an increase in the number of patients at Covid, we may be forced to do something that, as healthcare professionals, we all really hate to even have to think about,” she said.
At Huntington Memorial Hospital in Pasadena, California, nurses who usually care for one or two patients are now caring for three or four, infectious disease specialist Kimberly Shriner told CNN on Sunday.
“We have a limited number of fans, we have a limited number of ICU beds,” said Shriner, adding that a team including a bioethicist, a community member, a doctor, a nurse and an administrative leader will decide how to share these resources if the case.
These issues may combine for some difficult decisions ahead, said CNN medical analyst Dr. Jonathan Reiner.
“If you don’t have respirators, you don’t have nurses to care for patients, you don’t have ICU beds, we will have to have these terrible discussions with families, so people need to stay home, and when they go out, they need to wear a mask “said Reiner.
Eric Levenson of CNN contributed to this report.