Only one ventilation bed, but two serious Covid 19 cases: Triage must now be used. The nightmare of doctors, nurses, patients and relatives. We explain what triage is and what it means for hospitals in the Corona crisis.
Table of Contents
What does triage mean?
In medicine, triage describes the prioritization of medical care services . Triage must be used whenever time or resources are scarce and the number of patients exceeds the care capacity . Until now, triage had to be used mainly in wars or disasters. Physicians must then make decisions about which patients to treat first or at all .
For example, if there is a shortage of beds in a clinic, doctors have to decide who they can and cannot admit. Here physicians must actually make life and death decisions based on their own judgment and knowledge .
Triage in Germany: according to which criteria are decisions made?
In triage, the aim is to help the patient whose chances of survival are the best. This principle contrasts with the ethical approach in today’s medicine: there, the person who is most seriously injured or whose condition is most critical is helped first. In dramatic crisis situations, however, the triage procedure must often be used and the chances of success of treatment must be weighed according to the following criteria:
- Severity of the current illness (in this case Covid-19)
- Comorbidities , i.e. concomitant diseases that worsen the prognosis (e.g. lung diseases, immune deficiencies, cancer diseases)
- General state of health (physical condition; criteria such as age and social factors such as level of education, ethnicity or income may explicitly not be taken into account in Germany)
However , the German Foundation for Patient Protection warns against tying the decision to the treatment of Covid 19 patients to their chances of survival. Eugen Brysch, the chairman of the foundation, criticized Funke Mediengruppe newspapers for saying that the triage “turns the ethical principle on its head” . In this country, the “principle is that the sickest patient is the first to be helped”.
Have there been cases of triage in the Corona crisis so far?
So far, doctors in Germany have been spared the problem of triage as a result of corona cases. In other countries, however, the situation was unfortunately different. The intensive care units of many hospitals in Spain, Italy or the USA were overcrowded – doctors had to use triage .
There has been a lot of discussion about triage in Germany since April and there have also been calls for a triage law that should uniformly regulate the decisions of doctors. So far there is no legal basis for triage. There are only recommendations for action from medical societies and the German Medical Association for triage in Corona times .
Cases of triage in Saxony: clinic denied
As a result of the steady increase in corona cases and patients who need intensive care, the medical director of the Klinikum Oberlausitzer Bergland gGmbH, Dr. Mathias Mengel, reporting on triage cases. That a hospital in Saxony had to be triaged several times. “In the past few days we have been in the situation several times that we had to decide who gets oxygen and who doesn’t ,” said Mengel.
The statement of Dr. Mengel has now been officially denied by the spokeswoman for the clinic in Zittau. . At no time was anyone here not or no longer ventilated.” She added: “All patients who come to our hospitals receive the best possible therapy.” The Robert Koch Institute (RKI) also commented in a press release: “The German health system is under heavy strain. However, we are currently NOT at the point where we have to prioritize patients! ”
Beds in Brandenburg are running out: Berlin takes over 50 Covid patients from Brandenburg
Fortunately , no triage has had to be used in Brandenburg so far . Nevertheless, the intensive care beds are running out and Brandenburg had to ask the surrounding federal states for help . The situation is particularly critical in the south of Brandenburg, which is why clinics located there have initiated relocations to hospitals in the north of the state or the surrounding states. Berlin has already pledged to accommodate 50 Covid patients in an emergency clinic.
