Patient suffers cardiac arrest in packed ER

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This article was published 13/08/2021 (1674 days ago), so information in it may no longer be current.

Hours after managers hastily called a staff meeting to discuss concerns about long patient wait times in an overloaded emergency department, a St. Boniface Hospital patient suffered a cardiac arrest in a hallway.

The man had been waiting about four hours on a stretcher, after being rushed to the ER by ambulance when he became unresponsive late Tuesday and needed to be resuscitated, according to two ER staff who separately confirmed the incident to the Free Press.

An ER nurse who was working on that shift said the incident was a sign of a systemic problem at the hospital, one that forces patients to wait for hours alone, with no family members around due to COVID-19 protocols. There were about 30 patients in the waiting room at the time, and 14 ER beds had been closed because of a lack of staff. Only two nurses were expected to triage all of those waiting.

When something like this happens, the nurse said, “you really, really take it to heart. But it’s not our fault. We are doing the best we can.”

When it’s that busy and so short staffed, “we can’t do our job properly.”

The Winnipeg Regional Health Authority couldn’t provide details on the incident but stated its regional patient safety team is determining whether it should be deemed a critical incident (which would trigger an investigation under provincial legislation).

ER physician Dr. Paul Doucet previously warned about the risk of patients suffering cardiac arrests while waiting too long for emergency medical attention. He raised the concern Tuesday in an interview with the Free Press — and the very thing he was worried about happened after his shift ended the same day.

“It’s unacceptable and avoidable,” Doucet said. He said the patient needed a high-acuity bed, but was forced to wait because there wasn’t one available.

High turnover and a lack of nursing staff in the ER has worsened wait times, causing some patients to wait more than 10 hours in recent weeks. Nurses are leaving the department because they can no longer tolerate the untenable work environment, Doucet said.

“It’s a complete and utter failure of senior leadership at the highest level,” he said, meaning within the hospital and politically.

A patient going into cardiac arrest in an ER is not unheard of, Doucet said, but it can be expected to happen more often when patients are forced to endure longer waits for the care they need, and could have serious repercussions.

“With the lack of capacity, people suffer longer than they should.”

Doucet said he didn’t attend Tuesday’s virtual staff meeting, saying it didn’t make any sense to call an emergency meeting to discuss something that has been a problem for years.

Increasing wait times, fuelled by staffing challenges and a lack of in-patient hospital space, “is top-of-mind for the region and currently represents the most pressing operational issue for WRHA,” a health authority spokesman wrote in a statement.

On Wednesday, the WRHA triggered an incident command protocol for the regional emergency and urgent care programs to try to speed up the flow of patients through the ER.

“Regional officials have met with emergency physicians and other clinical staff, and will shortly meet with representatives from both the emergency and medicine (hospital in-patient) programs to identify immediate actions that can be taken to expedite the flow of patients out of hospital to alleviate capacity issues for those patients awaiting admission from emergency and urgent care units,” a spokesperson stated Thursday evening.

katie.may@freepress.mb.ca

Twitter: @thatkatiemay