Jaipur’s largest state-run Covid-10 facility RUHS CMS Hospital recorded 442 deaths of patients on ventilator support in just 20 days as per a Dainik Bhaskar report. The main reason cited for these deaths is not cleaning the endotracheal tube by the hospital staff which resulted in infections.
The endotracheal tube (a flexible plastic tube that is placed through the mouth into the windpipe to help a patient breathe) attached to critically ill patients on a ventilator needs to be cleaned 5-6 times a day. However, the tube was being cleaned only thrice in two days by the hospital staff which resulted in Black Fungus and other bacterial infections to already critical patients.
As per the report, the cleaning of the tube takes not more than 2-3 minutes yet the process was not being conducted by the hospital putting at risk the lives of several patients.
Patients reveal the mismanagement by the hospital staff
Rohitash Jat whose relative has been admitted to the hospital informed that his relative has been on respiratory support since two days. However, he said that the doctors come for a visit only in the morning and not once has the pipe been cleaned by the hospital staff in two days.
A Sumant Singh whose brother-in-law has been on a ventilator since 48 hours also informed the same.
Satyaprakash whose father has been admitted in the ICU and on ventilator said that the hospital staff have asked the family members to call them when needed since they are preoccupied with work.
Experts emphasize on regular monitoring
Dr Nagendra Sharma, RUHS’s board member informed that it is imperative to check patients on ventilators every half an hour. Fear of anaerobic bacterial infection, black fungus, multi-drug resistant bacterial infection lingers if the tube is not cleaned regularly, Dr Sharma informed.
What do the studies suggest?
As per a study, dirt in the tube can result in chest infections which can prove fatal. The mucus has to be cleaned from the tracheostomy tube through suctioning every 3-4 hours.
Jaipur hospitals facing unprecedented load
As per a May 05 report of The Hindu, the RUHS Hospital was full with patients which forced the hospital administration to install beds in corridors from the ground to the eighth floors of the ward buildings. The 442 oxygen beds and 153 ICU beds with ventilators of the hospital were fully occupied.
The Medical & Health Department had asked the hospital to shift the less critical patients to the Sawai Man Singh (SMS) Government Hospital, where the beds were being reserved, however, the latter refused to admit new patients citing the absence of sufficient medical oxygen.
Working ventilators dumped as ‘faulty’
We had earlier reported on how in Congress-ruled Rajasthan, 1,500 ventilators received under the PM CARES Fund are lying unused and unopened. These ventilators were received over ten months back.
Another Dainik Bhaskar report revealed that of these 1,500 ventilators, 230 are faulty but even amid the raging Chinese coronavirus pandemic, these ventilators have not been repaired and put to use.
The report suggested that in Jodhpur, of the 100 ventilators received under PM CARES Fund, not a single one was put to use.
After similar incidents were reported from Punjab and Jharkhand, the Central Government in a letter had highlighted how some states have been mismanaging the ventilators allocated to them.
The Union Government said that while the manufactures will supply the ventilators and demonstrate their proper usage, hospitals also need to take some measures that include “training of the user staff of hospitals, provide them with manuals and audio-visual/online training for guarding against any information gaps in the use of ventilators” and “ensure robust and prompt follow-up of complaints received from hospitals/States in the WhatsApp groups, email, telephonic calls and through toll-free numbers already communicated to the States/UTs.”