The National Coordination Center for Patient Distribution (LCPS) has started preparations for the black scenario, in which the number of incoming patients exceeds the number of beds. There is no acute emergency, it is just an exercise.
According to outgoing corona minister Hugo de Jonge, code black is not easily achieved. “We are not there, we are not nearly there, we are not there yet. At the same time, we are preparing for all situations,” he responded this afternoon at the exit of the Council of Ministers. Code black, officially phase 3, is proclaimed by the Minister of Health.
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Yesterday there were 881 people on the ICs, of whom 413 corona patients. That number will increase further in the coming weeks.
Maximum 1350 beds
“Let’s underline that it is very busy in healthcare,” says De Jonge. “We are in the process of scaling up to 1150 beds. After that we can scale up even further to 1350 beds. Meanwhile, other care is scaling down, especially knee and hip operations. The planable care that must be given within 6 weeks because otherwise it will lead to health damage, is only occasionally scaled down in a few hospitals.”
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Next Friday there will be a digital exercise by the LCPS with the involved authorities, just like a year ago, in which the scenarios are reviewed.
The exercise is as a precaution and in the hope that we do not have to put it into practice, the LCPS says when asked. “But we have to be prepared should the situation arise.”
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Step-by-step plan for code black: who gets priority?
Only when the pressure on the ICs becomes so great that a distinction can no longer be made on the basis of medical considerations between who does and who does not need an IC bed, do doctors switch to a script drawn up by the KNMG medical federation and the Federation. Medical specialists. Then selection takes place on the basis of non-medical considerations.
Stap A
Only patients who meet certain medical criteria are still admitted to the intensive care unit. Patients with a very small chance of survival are no longer admitted to the ICU.
Stap B
The admission criteria are becoming stricter. For example, CPR is no longer given to patients in the IC. If that is not enough, patients are compared before admission. Only if doctors consider one patient’s chance of survival at least 20 percent greater than that of another, will the patient with the highest chance of survival be included.
Step C
If even the above criteria are not enough, it gets even stricter. In that case, a switch is made to ‘non-medical admission criteria’ when two or more patients are entitled to an IC bed. Then successively:
- Priority is given to the patient with the shortest expected length of stay,
- If both patients have approximately the same expected length of stay, healthcare personnel take precedence,
- Then the age group is considered. Patients aged 20-40 then take precedence over patients between 40-60,
- If no distinction can be made in this either, a lottery will eventually be drawn.
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