Manitoba's acting health minister is addressing conversations of an oxygen shortage at Boundary Trails Health Centre (BTHC) caused by an influx in severe COVID-19 cases being admitted to the hospital.
Kelvin Goertzen says there's no question, the facility between Winkler and Morden has been under stress lately.
"They did have a high usage, my understanding is, on oxygen. They always maintain a reserve supply of oxygen and I understand that they had gone into that reserve supply, which is unusual for them," said Goertzen.
"Obviously, beyond the normal sort of operations in terms of how far down they were getting on oxygen supply, but there was not a situation where they were running out of oxygen, from what I understand from health officials, they were just going deeper into that reserve supply than they normally would," he further explained.
Goertzen noted the Province is there to ensure the main supply and reserve supply get replenished.
Dr. Dan Hunt works in BTHC's emergency department.
He agreed that the facility is going through a much larger supply of oxygen than normal and has been needing to order more than usual as a result.
"For example, the average person who has pneumonia or problems with COPD, in a normal year they might be on two to four litres of oxygen while in hospital, they get antibiotics and they get better. Many of these people (referring to the severe COVID-19 patients being treated at BTHC) are needing to be on very high levels of oxygen - fifty to sixty litres - and that's kind of the last resort before having to intubate someone," explained Dr. Hunt.
Dr. Ganesan Abbu, Special Care Unit Lead at BTHC, added, the bottom line is the hospital is not running out of oxygen but he says the demand is putting a strain on the system.
The hospital is outfitted with an oxygen concentrator that makes about 200 l/minute of oxygen at about 97 per cent concentration, and a bank of six cylinders that each hold about 7,800 litres of oxygen. According to Dr. Abbu, total normal oxygen use at BTHC is about 50 to 75 litres a minute, but on a day like today (Friday, May 28) he says that jumped to 150 l/minute, including use in operating rooms, patients on the ward and in the special care unit. However, Dr. Abbu says last weekend there were three patients at BTHC that were on high-flow nasal oxygen pushing out 60 l/minute per patient.
"Over the weekend we were running at over two hundred fifty litres per minute, which is way beyond our capacity," he explained. "To put that into context, when you see paramedics carrying around an oxygen cylinder tank, we were using two-and-half of those tanks every minute."
Dr. Abbu says this excess oxygen use is COVID-19-driven.
While he believes the backup bank of the six, 7,800-litre oxygen cylinders is enough to carry the facility, Dr. Abbu says the hospital has procured more cylinders just in case.
"I doubt that we would need much more because we do not have the capacity in our hospital like we don't have any more of the machines that dole out oxygen at sixty litres a minute. The strange thing is, if we intubate and ventilate a patient, then we actually would need less oxygen because we don't need to blow it at that high of rate...probably about fifteen/twenty litres (a minute)," said Dr. Abbu. However, he agreed with Dr. Hunt that this move would be a last resort.
In the last two weeks, Dr. Abbu says 10 patients at BTHC have been intubated, there have been three patient ground transfers and six transfers via STARS, and 10 patients hooked up to the high-flow oxygen machines, all due to COVID-19.
Meantime, Goertzen said the hope is that the COVID-19 case numbers in the region start to stabilize and then decrease. "There's clearly been a surge of cases in that area, and some very critical cases."
For now, he says one of the main concerns for health officials is peoples' reluctance to get tested for COVID-19 upon the first sign of symptoms.
"A lot of the people who are presenting, not just in that area but certainly in that area as well, are coming in (to hospital) at a very critical stage and had not been tested before, and had obviously been sick for quite a while, and that becomes more difficult to treat and manage those kinds of patients," he explained.
As well, Canada's military has kicked off a four-week mission in Manitoba as the province continues to navigate through the third wave of the pandemic.
Goertzen says so far, there hasn't been a call for those additional supports at BTHC.
"I know the federal government has been working with the military when it comes to the reserves in Manitoba, but we do have military resources now in Manitoba but they're generalized," he explained.
"The nurses are going to be primarily, at this point, at the Health Sciences Centre. As more come, they might be in more places. And then the flight apparatus that is already on the ground in Manitoba is going to be used to transport patients, and they can transport two at a time if necessary."