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Bennington Hospital Adds Beds, Infrastructure to Prepare for Surge

By Stephen DravisiBerkshires Staff
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BENNINGTON, Vt. — Southwestern Vermont Medical Center had Vermont's first patient to test positive for COVID-19.
But hospital officials knew it would be far from the last.
Since then, the facility has been gearing up for the surge that public health officials nationwide are predicting.
"We actually had plans in place, like most hospitals, prior to the pandemic as to how we would tackle a surge need, whether from a disaster or an infectious outbreak," said Dr. Trey Dobson, an emergency department physician and SVMC's chief medical officer.
"We secured additional actual beds — some we shifted from other locations and some we rented. Then we got staffing levels up to accommodate a number of patients two to three times our normal census.
That census normally is between 35 and 40 patients, Dobson said. Right now, SVMC has plans in place to treat about 100 patients inside the hospital.
After that, it would look to transfer patients to other facilities. And if the surge hit hospitals throughout the region simultaneously and transfers are not an option?
"If it came to it that we were full and had nowhere to transfer, we would have to start putting patients in the hallway as you would in a disaster," Dobson said. "Right now, … lower acuity patients would be treated outside the hospital."
Southwestern Vermont already has set up a Respiratory Evaluation Center adjacent to its emergency room for patients who have respiratory symptoms but stable vital signs.
"They are evaluated, treated and most likely discharged home," Dobson said.
Not all will receive a blood test to detect the novel coronavirus.
Although the early shortage of testing resources has improved over time, Dobson said the facility still has to be selective about who does and does not receive tests.
Generally speaking, tests are reserved for patients who are symptomatic and meet certain criteria: over age 65; have risk factors like diabetes, heart disease or lung disease; on immuno-suppression therapy; and health-care workers.
For now, testing of asymptomatic people is not advisable, Dobson said.
"We recognize that the sensitivity of testing in asymptomatic patients is not as high," he said. "There are many more false negatives, and that gives false reassurance. Second, there are still not likely to be the resources to test all the asymptomatic patients who want it. And third, when you test, you have to wear specific [personal protective equipment]. We want to save that for treatment, first of all, and second for testing of symptomatic patients."
"So for a young, healthy, minimally symptomatic patient right now, we don't have the resources to test and feel comfortable that those patients can be safely returned home for home isolation."
In the near future, Dobson said there likely will be more sensitive tests and the ability to test more of the population, "not for a medical reason but for epidemiological and societal reasons to determine who has been exposed and who has not."
Besides ordering beds, SVMC is making improvements to its infrastructure to handle a likely wave of patients who need treatment for COVID-19.
"We had to do some actual facility improvements to make sure those locations are capable of handling patients overnight, making sure enough oxygen is available, making sure there's enough storage," Dobson said. "We expanded our negative pressure rooms up to 44 rooms, which is a lot more than we normally have. We normally have around 10."
Negative pressure rooms use ventilation systems to allow clean air to flow into an isolation room but not out, thereby reducing cross contamination between patients.
Another change to SVMC's operations because of the pandemic: Like most hospitals, it has eliminated all non-urgent and elective procedures in order to free up space for COVID-19 patients.
But, at the same time, the hospital is reaching out to patients to make sure that their critical, non-coronavirus needs are being met and that people are not avoiding treatment out of fear of coming into contact with the virus.
"I am concerned about that, and I would not be transparent if I said I wasn't," Dobson said. "We try continually to find ways to communicate with individuals. We're doing a lot of telemedicine and telephone medicine.
"When I said we're not doing urgent procedures … we try to convert many patients to telemedicine and then reassess. What may not be urgent today may become urgent in two weeks when we don't talk to them now.
"We know that patients who forego treatment because they're scared or have misconceptions about our desire to see patients get very sick and end up in the Emergency Department. It's a balancing act, a lot of it is."

Tags: COVID-19,   SVMC,   

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Ten Tips for Safely 'Decking those Halls' this Season

No matter what you’re celebrating this holiday season, lights, fireside gatherings and decorations are a common part of creating a festive mood.

According to the National Fire Protection Association, 30 percent of all home fires and 38 percent of home fire deaths occur during the months of December, January, and February. While these fires result from a variety of sources, the Federal Emergency Management Agency notes that winter holiday fires are more severe than the average fire during the year across all loss measures and that holiday decoration and Christmas tree fires, in particular, are substantially more damaging than other fires.  These fires result in twice the injuries and five times the fatalities per fire as the average winter holiday home fire.  

Another common source of holiday injuries is falls. The Consumer Product Safety Commission reports that approximately 160 decorating-related injuries occur each day in the U.S. during the holiday season. Almost half of those accidents involve falls which often lead to broken bones, concussions and pulled muscles.

To ensure you enjoy your holidays safely and to their fullest, follow these safety tips when decorating.

1. Check all holiday light cords to make sure they aren’t frayed or broken. Don’t string too many strands of lights together—no more than three per extension cord.

2. If you are buying an artificial tree, look for the fire-resistant label. When putting it up, keep it away from fireplaces, radiators, and other sources of heat.

3. If getting a live tree, make sure it’s fresh. You can do this by gently pulling on a shoot with your thumb and fingers; if the tree is fresh, you should not have any needles come off in your hand. Before placing it in the tree stand, cut 2 inches off the trunk to expose fresh wood for better water absorption (if you don’t have a saw, ask the person at the tree farm to do this for you). Be sure to water daily to keep it from drying out. If your home is especially warm or dry, you may need to add water more than once a day.

4. Don’t use electric lights on metallic trees.

5. Don’t forget to turn off all holiday lights when going to bed or leaving the house.

6. When decorating outside, make sure decorations are for outdoor use and fasten lights securely to your home or trees. If using hooks or nails outside, make sure they are insulated to avoid an electrocution or fire hazard.

7. If using a ladder, be extra careful. Always inspect the ladder for any damage prior to using it. Make sure to have good, stable placement and wear shoes that allow for good traction and follow the 1-to-4 rule for extension ladders: for every four feet the ladder rises, move the base out one foot from the structure.

8. Always keep three points of contact on the ladder: two hands and one foot, or two feet and one hand.

9. If hanging items indoors, use a step ladder and make sure it’s on a level, stable surface. Never use furniture as a ladder.

10. Place candles where they cannot be knocked down or blown over and out of reach of children. Keep matches and lighters out of reach of children. When possible, opt for flameless, rather than lighted, candles.

One last precaution to take before the holidays: test all smoke alarms and carbon monoxide detectors. Lest you think that’s excessive, remember that a high percentage of home fire and home fire deaths occur during the upcoming months and, according to the Centers for Disease Control and Prevention, half of all reported cases of carbon monoxide poisoning occur during the winter. A simple test that takes just seconds can literally be lifesaving.

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