AHS to brief health-care workers on triage protocol in case 'dire situation' should occur

Alberta Health Services plans to brief health-care workers on triage protocol this week in case of a "dire situation" where demand for life-sustaining critical care support outstrips resources, CBC News has learned.

Rules guide response when need for critical care support outstrips resources

Health-care workers put on protective equipment at a COVID-19 testing facility in Alberta. (Alberta Health Services)

Some Alberta health-care staff will be briefed this week on a protocol for deciding which patients get potentially life-saving care if hospitals become overwhelmed with COVID-19, CBC News has learned.

An Alberta Health Services memo sent to staff said the Alberta Critical Care Triage Framework is a protocol that would be used in the event of a "dire situation" where demand for life-sustaining critical care is greater than the resources available.

The memo — which was shared with CBC News — describes the framework as a provincewide guide for the "difficult determination" of allocating those resources to critically ill patients when there are not enough for everyone.

"That they're going to be briefing people on that protocol this week suggests that they think this could get a lot worse," said Dr. James Talbot, Alberta's former chief medical officer of health.

He is now the co-chair of the Edmonton Zone Medical Staff Association strategic COVID committee.

1st time AHS has prepared to use protocols, says doctor

Alberta has the highest rate of active COVID-19 cases in Canada.

As of the last provincial update on Tuesday, there are 635 people in hospital with COVID across the province, 143 of whom are in intensive care.

The province recorded its highest testing positivity rate on Tuesday at 11.4 per cent, and is nearing its all-time high active case count, with 20,721. 

Talbot said he believes this will be the first time AHS has briefed staff how to use the protocols since the pandemic began.

He said it is something no heath-care worker ever wants to use.

"Say you have a young person … who looked like they were going to survive, and needed an ICU bed and a respirator, and they're all occupied," Talbot said.

"[This protocol is] how do you make the decision about who comes off."

AHS has 'adequate capacity,' spokesperson says

At a press conference on Wednesday, Premier Jason Kenney said he understands AHS is working to update existing triage protocols with advisory groups.

Should it be necessary, Alberta has the capacity to fully staff 425 ICU beds, Kenney said.

Additional targeted health measures are being considered for jurisdictions with climbing case numbers, such as the Town of Banff and the Regional Municipality of Wood Buffalo, he said.

"To be clear, right now, we have capacity to deal with this surge," Kenney said. "We cannot take that for granted, but … we worked very hard through AHS to give them all the resources they need to expand ICU capacity."

AHS spokesperson Kerry Williamson told CBC News there is no plan to activate the protocols at this time.

"AHS has adequate capacity for both hospitalized and ICU patients. We are constantly monitoring case numbers and preparing our health-care system to ensure it can meet demand," Williamson said in a statement. 

"This includes adding both ICU and acute care spaces, as well as, if necessary, redeploying staff and reducing services as we did during the first and second waves." 

'It's just a matter of time'

AHS has announced it will cut back scheduled surgeries in Calgary, Edmonton and the northern zone to make room for a possible influx of COVID-19 hospitalizations.

The province has also set up a 100-bed field hospital at the University of Alberta in Edmonton that has not yet been used. A field hospital in Calgary has been used as an extension of the Peter Lougheed Centre's emergency department.

According to Talbot, Alberta needs to enforce stronger restrictions — and its citizens need to get vaccinated quickly — to reverse its trajectory.

"Unless something is done to change the rate at which the cases are increasing, it's just a matter of time before we end up exceeding capacity in Alberta," Talbot said.

With files from Charlotte Dumoulin, Jennifer Lee and Sarah Rieger


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