FROM PAGE 3

Their only hope for survival is if they are given immediate support of high pressure oxygen using ventilators that are capable of providing 100 percent oxygen per minute or the HFNC that supports 75 percent oxygen per minute, they said.

But most of these patients were being treated with the hospital’s central oxygen lines, oxygen cylinders and concentrators that are capable of providing not above 15 percent oxygen per minute.

As a result, most of the deaths are occurring at the Covid unit, according to senior doctors and officials of the hospital.

The hospital data shows that 18 patients died at the Covid unit in 24 hours till Monday morning, raising the death toll to 82 in the first five days of July.

In June, 354 patients died while the number was 124 in May. The hospital was treating 495 patients with bed capacity for 405 in 13 wards of its Covid unit yesterday, with 70 patients admitting daily on average.

Doctors estimated that 40 percent of critical patients (at least 198) need ICU or HFNC support.

But RMCH has only 20 ICU beds that have been remaining full from June 1 while at least 90 patients await an ICU bed.

The hospital was also provided with 69 HFNC which at present are not sufficient to meet the rising demand.

While sharing her experience, a doctor of the hospital told this correspondent that her 32-bed ward had only one HFNC a week ago. She had to ration the use of the lone machine among patients.

On June 29, she had four patients aged between 32 and 42 requiring the HFNC support at her ward. “I had to limit its use to three hours each. Can you imagine how cruel the decision was?” she said.

“When I was taking away the machine from one patient to give it to another, the patient’s son cried out and requested me not to remove the machine from his father. I had to hold my tears at that time, but I had no choice,” the doctor said. Her ward was provided with two more HFNC the next day.

At the ward on Sunday, patients’ attendants told this correspondent seven patients were sharing three HFNC.

This newspaper also visited seven wards out of total 13 in the Covid unit on Monday and found two wards -- 15 and 14 -- without any HFNC in place.

This correspondent also learnt ward-16 has no HFNC where at least seven patients have died in 24 hours till Monday morning.

At ward-15, where Shampa’s mother died, eight patients died in the last 48 hours.

Contacted, RMCH director Brig Gen Shamim Yazdani declined to acknowledge the HFNC or ventilator crisis.

He said the 69 HFNC are sufficient for the hospital, and 10 more have been sanctioned. They were yet to receive those, he added.

“Out of the 69 HFNC, 57 are in use… What we lack is trained manpower to run those,” he said, adding that operating an HFNC requires special training.

He said the 48-bed HDU wards of the Covid unit have the highest 20 HFNC and patients insist doctors to admit them there.

Other wards were provided with more than two HFNC, but not all the wards have trained staff, he said.

“Even at Rawshan Ara’s ward (no-15), two HFNC were available,” the director said.

“In case of necessity, trained staffers from other wards go to the wards to help run those machines. But the trained staffers hardly get any call as staff members at most wards are not even aware of the machines,” the director said.

“We’re training the staff, but that needs at least ten days,” he said, adding that they got a supply of 1,600 non-rebreather masks to ensure that oxygen pressure is above 20 litres per minute.

A non-rebreather mask is a medical device that helps deliver oxygen in emergency situations. It consists of a face mask connected to a reservoir bag that’s filled with a high concentration of oxygen.

Apart from its stock of 183 oxygen concentrators and 1,122 oxygen cylinders, the hospital authorities have also got a supply of 12 BiPAP machines to support patients with BiLevel positive airway pressures.

Like other ventilators, BiPAP machines use pressure to push air into one’s lungs, improving the level of oxygen in the blood. These machines are called “BiLevel” because they have two air pressure settings. When a patient breathes in, it delivers more air pressure and when a patient breathes out, it reduces the pressure.

The RMCH director said, “We have enough oxygen stock. Against a requirement of 6,000 litres of oxygen for Covid wards, we’ve a 10,000-litre oxygen tank and a standby 14,000-litre oxygen tank carrying truck.”

“What we need is trained staffers to operate the available machines,” he said.

The director, however, acknowledged that the number of critical patients with very low oxygen saturation was around 60 percent a week ago. But it has decreased now, he said.

“It is happening as most patients are from rural areas and they don’t understand the initial lowering of oxygen saturation. Once they comprehend that, they delay more to manage money for coming to the hospital, or face difficulties in finding a vehicle during the lockdown,” he said.