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First SA intensive care virus admissions as nurses warn on supplies

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South Australia has had its first intensive care admissions as the coronavirus crisis escalates, as the nursing union says its raised concerns “at the highest levels” about a dwindling supply of protective masks in local hospitals.

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Chief public health officer Dr Nicola Spurrier today confirmed the first ICU admissions, saying: “Unfortunately we do have two people in intensive care with COVID-19, who have needed that higher level of treatment.”

“We have people now admitted who are critically ill, so it’s so important that if you have been asked to stay in quarantine you must stay in quarantine,” she warned South Australians.

It comes as health workers warn that there are “not enough surgical masks to go around”, amid confusion about proper use of the dwindling supplies.

An email sent this week from the divisional director of nursing, seen by InDaily, tells nurses that masks are “to be worn as designed”.

Sources say some staff were directed to re-use protective masks, rather than discarding them regularly – a measure the email appears to acknowledge, but overrule.

“Having one [mask] per shift has not been approved to date,” it says.

“You should however try and limit its usage where possible , ie try and perform as many tasks as possible when you go in the room and limiting the need to go in multiple times…

“You should be wearing masks as you would have prior to COVID. If you didn’t wear it before, you shouldn’t wear it now – unless you have a potential COVID patient.”

The email says “some more formalised communication will come out” in coming days.

Nursing Association president Elizabeth Dabars told InDaily members have raised concerns about PPE [Personal Protective Equipment] with the union.

“We’ve raised it as a broad issue at the highest levels, both with the Government and the Department, about the availability of PPE and what should be worn and when,” she said.

“My understanding is they’re seeking to source more PPEs, to make sure all stocks can be maintained – and escalated.”

She also expected there would be formal communication to staff “telling people what should be worn and when”.

“My understanding is there’s confusion relating to availability, there’s confusion relating to appropriateness of use [and] we’ve raised that at the highest level,” she said.

It comes as a COVID-19 patient in SA has told InDaily of her concerns after being discharged from the Royal Adelaide Hospital, claiming staff told her to take a bus home to self-isolate.

The woman, who did not wish to be named, says she presented to the RAH testing clinic after returning from an European trip and suffering fever, a sore throat and headache.

“They told me maybe I shouldn’t have come, and should have stayed at home for 14 days to self isolate, and then come back if I still had a fever,” she said

She said she had to argue to get tested.

“They’ve set up these pavilions out the front, so you’re sitting with a family in the next seat – there’s no water, no way of sanitising… everyone’s just sitting in amongst each other,” she said.

She was later called and told the test was positive, but to remain in home isolation unless the symptoms escalated.

When she later developed chest tightness and “trouble swallowing”, she called a hotline and was told to go to hospital.

“There’ve got a place, a ward, set up for coronavirus, to help with containment,” she said, adding that it took five minutes on arrival for the doors to be opened.

“Eventually we got inside, and they put me in a room – these rooms are soundproof so they can’t hear, and at one point my heart monitor started going off – it had just come off my finger, but it was beeping like I’d flatlined… but they couldn’t hear it because it’s soundproof.

“I pressed the call button, and it was more than five minutes before they noticed anything had happened and responded.”

She said nurses limited their entry to her room, “so they wouldn’t bring me any water [until] eventually someone relented and came in and gave me some”.

“There was no pillow, and it was really cold in there and I had to ask a few times for a blanket,” she said.

She claims a nurse eventually told her “I shouldn’t be there” and “I just need to go home”.

“I said how do I get home safely, and they told me to take a bus,” she said.

“When I told her I didn’t think that was a very good idea, she told me there was no risk as long as I wore a mask.”

She eventually had someone pick her up, and is now quarantined at home.

Dr Gerry O’Callaghan, Executive Director of Medical Services, said any COVID-19-positive patients admitted for in-patient care that were “at no stage discharged when those patients are still in a contagious phase”.

“Patients that were COVID-19 positive are swabbed regularly as part of monitoring [and] patients are not discharged into the community during the contagious phase of their illness,” he said, adding they then received “regular welfare checks and monitoring for assessment of their symptoms”.

“I’m not in a position comment on individual cases [but] we’re always very interested to understand the quality of care patients experience,” he said.

“We’re anticipating a growth in demand for intensive care service [but] we’re well placed currently – we’ve done a lot of work in planning and preparation in terms of personnel, ventilators and staffing models… the number of beds available in inpatient facilities would be increased to match an increase in demand.”

In regard to PPE supply, he said there had been “no change to advice and training given to the clinical workforce in terms of the correct procedure in order to provide effective and safe patient care”.

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