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Dublin: 2°C Monday 17 January 2022

'Inconceivable' that health system would be able to deal with mass casualty event

A senior doctor has warned that the system cannot deal with the day-to-day workload.

Image: Shutterstock/hxdbzxy

THE PRESIDENT OF the Irish Hospital Consultants Association has warned that the health system would not be capable of dealing with a mass casualty incident.

Dr Thomas Ryan, who is also a consultant in the intensive care unit at St James’s in Dublin, said doctors and nurses were already stretched – and that there was an intensive demand on ICU facilities.

“We don’t have the capacity to deal with our day-to-day workload let alone have any notion that we would be able to deal with a mass casualty event,” Ryan told Morning Ireland.

It’s just inconceivable that we would be able to deal with it.

Ryan told the Sunday Business Post yesterday that doctors were effectively “rationing” life support for patients and being forced to make very “tough decisions” about which patients to prioritise.

Speaking this morning, he explained:

We don’t have enough beds to cater for the day-to-day workload that we’re presented with for the number of patients that come to our ICUs who need life support with mechanical ventilation and other such life support.

Patients who are critically ill were being cared for outside intensive care units in emergency departments or other areas of hospitals “for many hours”, Ryan said.

The second problem is when there aren’t enough ICU beds to cater for the critically ill patients – that other patients who need major surgery have their surgery delayed or deferred.

International studies had shown patients do best when cared for in large and complex ICUs, Ryan said.

If you cannot provide that level of care, the mortality rate for treatable illnesses increases excessively.

A report published in 2009 said Ireland needed to double ICU bed capacity by 2020, he said, but in the interim years ”the actual number of ICU beds has stayed the same or actually decreased”.

We don’t see any progress in sorting it out.

‘Need a plan’

Speaking on the same programme, Medical Clinical Director at Cork University Hospital Mike O’Connor warned that doctors needed to be “cautious about scaring the population” and stressed that the health service was filled with staff working long hours in demanding conditions.

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Ireland had the second lowest number of hospital beds in the OECD, however, he said.

“We have less critical care beds in the system as well.

These things have been identified for quite some time. We need to do something about it – we need to stop talking about it every January.

O’Connor said stakeholders needed to act “collectively, collaboratively” to make a plan on how to build the health service over the next three to five years.

The HSE has been asked for a response to Dr Thomas Ryan’s comments.

The number of people waiting on hospital trolleys at emergency departments reached an all time high twice last week.

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Daragh Brophy

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