Alberta revises triage protocol to exclude children

WATCH (Sept. 25): As hospitals in Alberta fill up to the brim with COVID-19 patients, fear is growing that medical staff are about to make on-the-spot, life-and-death decisions. One doctor says some triage measures are already in place. Chris Chacon has more.

Alberta Health Services will not include pediatric patients in its critical care triage protocol if it has to activate it.

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What happens when COVID-19 patients take up all surgery, ICU capacity in Alberta?

An AHS spokesperson said Tuesday the “shift” in its approach was communicated with doctors and staff last week.

“This step is not a change to the protocol but a change in how we would implement the protocol should we ever need to use it.

“The protocol now only applies to adult patients.”

AHS said the decision to exclude children from the triage protocol was made after discussions with pediatric teams, “who expressed understandable distress at potentially having to use pediatric triage.”

Any gain in ICU capacity from pediatric triage would be negligible, AHS added.

AHS has not had to implement triage protocol and said it has made every effort to find additional ICU capacity as COVID-19 admissions surged and put huge pressure on the health system. Surgeries have been postponed, additional space opened and staff redeployed to meet the historically high ICU demand.

“We currently have adequate ICU capacity and hope to never have to implement the protocol,” AHS told Global News in a statement Tuesday evening.

Triage protocol means doctors, nurses and health administrators have to prioritize patients, essentially having to decide who gets a chance to live and who may not.

In April, AHS publicly released its critical care triage document that is designed to help health-care workers make these decisions.

READ MORE: COVID-19: How will Alberta health-care workers prioritize patients amid an ICU surge?

Health-care workers would be directed to prioritize patients who have the greatest likelihood of overall survival and patients who are “most likely to have a positive outcome with the least use of critical-care resources, either by intensity or duration.”

“Incremental survival differences are based on medical assessments of the patient only and not personal or group characteristics of the patient (i.e. age, sex, race, disability, national or ethnic origin, colour, religion),” the document reads.

Read more:
Emergency doctor says some health triage has begun in Alberta: ‘People will suffer and will die’

As of Tuesday, there were 1,053 people in hospital with COVID-19, 242 of whom were in the ICU.

There were 300 total patients in ICU (COVID and non-COVID) as of Tuesday afternoon, the vast majority of whom are COVID-19 positive, AHS said. The premier added in a news conference Tuesday afternoon that about 90 per cent of COVID-19 patients in ICU were unvaccinated or incompletely vaccinated.

There were 376 ICU beds open in Alberta, including 203 additional spaces (a 117 per cent increase over the baseline of 173), AHS said.

Provincially, ICU capacity (including additional surge beds) was at 80 per cent. Without the additional surge spaces, provincial ICU capacity would be at 173 per cent, AHS said Tuesday.

The Calgary zone was operating at 75 per cent of current capacity, the Edmonton zone at 83 per cent, the Central zone at 67 per cent, the South zone at 89 per cent and the North zone at 89 per cent.

There are currently 15,295 active COVID-19 cases in Alberta.

© 2021 Global News, a division of Corus Entertainment Inc.

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