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A Kansas Doctor Tells The Story Of Sending Her Critically Ill COVID Patient 570 Miles Away

A hospital emergency sign
David Condos
Kansas News Service

With the coronavirus surging again, smaller hospitals in Kansas can't count on the life-saving help of bigger, nearby facilities.

Last Thursday, the 25-bed hospital in Abilene, Kansas, sent a patient 570 miles away by air ambulance to Wisconsin.

Like many rural hospitals, Memorial Health System does a bit of everything. But it doesn’t have an intensive care unit.

In a pre-pandemic world, anyone needing critical care got transferred to Salina Regional Health Center, 30 miles away. Occasionally, a patient might get sent to Topeka or Wichita.

The Kansas News Service talked with Abilene physician Megan Brown about how she finally found an ICU bed for her gravely ill patient last week. Her interview has been edited for length and clarity.

(You can read more about current hospital capacity in Kansas here.)

Dr. Megan Brown's story

We had a patient who did happen to be a COVID patient. …  But, I mean, it would have been the same really probably for any patient needing an ICU.

His condition was getting worse to the point where we weren’t able to continue taking care of him here. He really needed to be on a ventilator — which typically we don’t keep ventilated patients here, because those patients should be in an ICU.

Talking with him and his family … we gave them the option of keeping him here and keeping him comfortable, knowing that he may or may not survive. Versus, transferring him out to a bigger hospital.

Megan Brown is a family doctor in Abilene, Kansas.
Megan Brown is a family doctor in Abilene, Kansas.

And they elected to transfer.

So, the KDHE (Kansas Department of Health and Environment) has set up what they’re calling mission control — where you can call and they’ll help make those phone calls (to other hospitals) to find a bed for the patient.

So I called them and they said, “Well, I have four patients needing an ICU bed in front of you. We’ve already called (hospitals across) Kansas, Missouri, Nebraska and Oklahoma. And there are no beds available.”

They said, “The last patient we were able to place was in Des Moines, Iowa. We think maybe there’s some beds available in Minneapolis. Do you want us to add you to the list?”

And I said, “Well, yes.” But knowing that there were four patients ahead of us, we ended up making phone calls as well.

So I had to cancel an entire afternoon of clinic (hours) and spent three-and-a-half hours on the phone calling hospitals further and further away, trying to find a bed for this patient.

I had a medical student that was helping me, and she’d called South Dakota. And they said, “We’re getting calls from as far away as Louisiana.”

So at that point, we said, “You know, everyone else who’s looking for a hospital is calling the biggest cities in the states.” And so we kind of thought we needed to shift our focus and try to call some smaller hospitals.

And we were already kind of calling around in Wisconsin. And I had gone to college as an undergrad in Appleton, Wisconsin, and I knew they had some ICU beds. Whether they were available or not, I didn’t know.

So I called them. And they finally were like, “We don’t have any beds — but have you called this hospital in Oshkosh?” And (they) gave me the number.

And then we finally found a bed there.

But that took three-and-a-half hours of phone calls. And then we had another hour waiting for transport to get here.

(An air ambulance) plane flew into Dickinson County Airport. EMS brought (the air ambulance crew) to the hospital, picked up the patient. Once they were ready to go, took them back to the airport.

And they flew into Oshkosh, and then an ambulance on that end had to pick him up to take him to the hospital.

It was frustrating with the amount of time it was taking. (And) it made me more concerned for patients. You know, I think patients are going to die needlessly, because there’s nowhere to go.

It’s been a real mess and very difficult — not just for COVID patients.

Now we have to do the same thing for any patient that needs a higher level of care than what we can provide. Like I said, we don’t have any specialists here.

I was having a conversation with somebody, and they said, “You know, the real problem is the shortage of nurses.”

And I said, “I’m not gonna argue that the shortage of nurses isn’t part of the problem.”

But the issue is — say you have a 20-bed ICU, but you only have enough nurses for 10 beds. If you have 10 COVID patients in those beds — something that’s now preventable by vaccines — then you don’t have any beds to take anyone else. But if those patients had been vaccinated, then you might still have nine beds for other things.

Twice in the last two weeks we’ve had to go on diversion for admissions because somebody called in sick. I mean, we’re at a point where our hospital is full enough right now that if one nurse on a shift calls in (sick), we can’t add any more patients to the hospital.

Then (patients are) stuck with — there’s nowhere else to go.

If a patient came to the ER and they needed to move to (an inpatient bed in) the hospital … we didn’t have the staff or a bed for them. So then our ER is tied up trying to find a bed (at a different hospital).

Our ER is staffed with a nurse practitioner and a nurse and a tech, usually. So we have three people to take care of anything that comes into the ER. So they don’t really have time to be spending hours on the phone.

Llopis-Jepsen: What are families supposed to do if their loved one is transferred far away?

If you have the resources (so) you can take off and get a hotel room and drive several states away to be with a family member, great. But most people don’t have those resources. And then depending on what happens while (the patient is) there, you’ve got to get that patient back. So either they’re alive and you’ve got to get them back, or they pass away and you’ve got to get that body back. And so it just adds extra layers of complications.

The vaccines are safe … they’re effective.

We’ve got to keep doing the things we can to prevent spread, because there’s nowhere to go if you get sick.

Celia Llopis-Jepsen reports on consumer health for the Kansas News Service. You can follow her on Twitter @celia_LJ or email her at celia (at) kcur (dot) org.

The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy.

Kansas News Service stories and photos may be republished by news media at no cost with proper attribution and a link to ksnewsservice.org.

I'm the creator of the environmental podcast Up From Dust. I write about how the world is transforming around us, from topsoil loss and invasive species to climate change. My goal is to explain why these stories matter to Kansas, and to report on the farmers, ranchers, scientists and other engaged people working to make Kansas more resilient. Email me at celia@kcur.org.
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