Record numbers of sick people on trolleys and chairs in hospital emergency departments will lead to an increase in deaths, senior emergency medics warned today.
Although the numbers waiting for a bed in a ward fell by 77 from yesterday's record 569 headcount, doctors claimed the overcrowding crisis was a grave situation for all patients.
The Irish Association for Emergency Medicine (IAEM) warned that trolley waits were potentially a matter of life and death. And the group dismissed the Health Service Executive's (HSE) claim that increasing numbers of swine flu cases were to blame for the spike in waiting times.
"It is now well-established that boarding hospital inpatients in emergency departments results in increased numbers of deaths among this group of ill patients, compared to similar patients who are admitted to a hospital ward in a timely fashion," a spokesman said.
"And contrary therefore to the line taken by the HSE, patients with seasonal influenza have not contributed significantly to the current excess of inpatients being boarded in emergency departments," a spokesman said.
A survey of emergency department overcrowding found 492 patients unable to get a space on a ward, down 77 from yesterday's record high of 569.
The Irish Nurses and Midwives Organisation (Inmo) said Cork University Hospital, the Mid-West in Limerick and Beaumont and Tallaght in Dublin were facing the worst conditions with more than 33 people waiting for a bed in each emergency room.
Other hospitals badly hit by overcrowding were the Midland Regional in Mullingar with 29; Cavan General with 27; Our Lady of Lourdes Drogheda with 24 and in Dublin, The Mater with 29; St Vincent’s with 25; and Connolly Hospital, Blanchardstown with 24.
Hospitals have begun to reopen closed beds in a bid to relieve overcrowding in emergency departments which reached record levels yesterday.
The Department of Health confirmed last night that individual hospitals are managing the situation through a range of measures including “opening closed beds, cancellation and deferral of elective procedures and the use of day wards for emergency department activity”.
Labour's health spokeswoman Jan O'Sullivan accused Minister for Health Mary Harney of failing to respond.
"The very least that people should expect when there is a mess like this, is for some kind of reaction from the person who is supposed to be in charge. Instead we get a deafening silence," she said. "Just where is Mary Harney, and why at a time when people expect some leadership and some action, has she gone to ground?"
There were 570 patients on trolleys waiting for beds early yesterday, up from a record-breaking 511 a day earlier. As the trolley crisis worsened, consultants at two Dublin hospitals warned that patients on trolleys in overcrowded emergency departments across the State are in danger of picking up infections such as swine flu.
Overcrowding was worst at Cork University Hospital with 48 patients on trolleys. Dr Chris Luke, an emergency medicine consultant at the hospital, said the situation at CUH was the worst he had seen in his 11 years at the facility. He rejected suggestions by the Health Service Executive that the overcrowding was due primarily to increases in seasonal admissions due to strains of the flu virus, and ice-related injuries, with CUH seeing one case of swine flu every two or three days.
The main factor was bed closures, he said. CUH, which has postponed elective surgery, said the situation should ease next week when it opens a 23-bed acute medicine unit.
Dr John McInerney, honorary secretary of the Irish Association of Emergency Medicine and an emergency consultant at the Mater hospital, said his hospital had reopened a ward to cope. He was concerned that patients being kept for hours or days on trolleys would pick up swine flu as more patients present with flu-like illness. “There is going to be a possible contagion effect,” he said.
He also fears the trolley crisis will get worse before it gets better, citing bed closures and a significant number of delayed discharge patients as the main reasons. He said the lack of beds, a shortage of junior doctors, swine flu and another cold spell could be enough to tip the health system “over the edge”.
Dr Pat Plunkett, a consultant in emergency medicine at St James’s Hospital, said he believed swine flu would spread in overcrowded emergency departments. “I’ve no doubt it will and is happening in emergency departments in this country at the moment,” he said.
The Department of Health said that in addition to reopening beds and cancelling routine surgery, hospitals will try to free up beds by carrying out further ward rounds and discharging in-patients where appropriate.
The HSE said the numbers on trolleys had been reduced to 259 by yesterday afternoon. It said a number of factors contributed to the surge in emergency department activity including an increase in the number of patients presenting with swine flu, flu-like illnesses and other seasonal illnesses. Hospitals were taking all necessary steps to deal with the surge, it added.
Additional reporting: PA