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ICU Nurses and Doctors on Frontline of Battle Against the Coronavirus
Part of an ECMO machine. (Wikimedia Commons)

ICU Nurses and Doctors on Frontline of Battle Against the Coronavirus

Buffeted by the pandemic, health care professionals lead the fight to save lives

Hospitals around the world are being pummeled by an unceasing surge of people ill with COVID-19. Patients are filling up coronavirus wards, including in some cases the hallways of those wards, and many require intensive care treatment.

Patients, physicians, nurses and families are all suffering.

Just this week, social media in Egypt was abuzz with reports that COVID-19 patients allegedly were dying in hospitals due to lack of supplemental oxygen. A video was posted by a man whose family member allegedly died after not receiving oxygen therapy, while another person was quoted as saying that another hospital in Egypt also could not supply enough oxygen to keep its coronavirus patients alive.

In Israel a video also circulated, this one showing an elderly COVID-19 patient lying on the floor in a puddle of his own urine after falling out of a chair in one of the country’s hospitals. According to another patient in the ward, the gentleman lay on the floor for at least 30 minutes.

Nurses are the professionals who work minute by minute to closely provide care for patients. The coronavirus pandemic has created immense challenges for these members of the staff who have most of the primary, one-on-one contact with patients. They are the people, alongside paramedics and emergency room personnel, at the most risk of infection.

For intensive care unit nurses working with critically ill COVID-19 patients, it is even more difficult.

“There are more and more difficult cases coming in every day. Terribly complicated ones that we must be aware of every day and every shift. We need to keep ourselves and our staff aware of every change and modify our treatment programs,” said Valery Nudelman, a registered nurse with a master’s degree in health administration, the head nurse of the General ICU at Sheba Medical Center, located outside Tel Aviv.

It is not easy, she told The Media Line, because ICU nurses are at a premium, and there are not enough to completely staff every shift. Hospitals, understanding the stress and the need for more manpower, allot nurses from other divisions to the ICUs to assist every shift.

“This,” Nudelman shared, “can only go so far. ICU nurses have specialty training that others do not. The reinforcement helps, but we are still missing ICU-trained personnel.”

The shortage is most felt in the use, operation and treatment of patients with ECMO machines.

ECMO (extracorporeal membrane oxygenation) technology is similar to that of heart-lung bypass machines used in open-heart surgery. It pumps and oxygenates a patient’s blood outside the body, allowing the heart and lungs to rest. The machine does the work when the body cannot.

For COVID-19 patients, it increases their chances to live.

At Sheba Medical Center there is one RN per ECMO patient, all the time. Due to the workload entailed in treating an ECMO patient, each nurse is on for three hours then off three hours, twice during a regular 12-hour shift.

Only nurses who have successfully completed a special training program can work with ECMO. They must pass written as well as hands-on tests and are certified after an accompanied practicum.

The nurses on ECMO duty are required to perform all bedside treatment, including moving the patient, ensuring the machine is working optimally, changing medications and treatment parameters, physical therapy and suction, and everything needed to help the patient.

“This is difficult, complex work, especially considering the risks of our exposure to the coronavirus,” said Nudelman.

There also is a high financial cost to keeping patients on ECMO machines, sometimes for weeks at a time.

There are more and more difficult cases coming in every day. Terribly complicated ones that we must be aware of every day and every shift. We need to keep ourselves and our staff aware of every change and modify our treatment programs

Meanwhile, supply of and demand for the special machines must also be taken into consideration.

For example, Sheba Medical Center has 11 ECMO machines spread out among the General ICU, Pediatric ICU, Heart Surgery ICU and Coronavirus ICU wards.

“We always need to keep one spare for another emergency. Our policy is to use these machines only in last-ditch cases and I am very, very aware of trying to keep their use to a bare minimum,” said Dr. Yael Haviv Yadid, head of the General ICU and the Coronavirus ICU at Sheba Medical Center.

“A year into the pandemic does not mean that all the ECMO machines go toward the coronavirus,” she told The Media Line. “It does mean that we have to always think how best to utilize them.”

As long as the region and world continue to see hospital caseloads rise, the situation will continue to be dire.

Here is a look at the regional coronavirus pandemic numbers for this week:

CountryConfirmed casesDeathsRecoveredActive Cases
Afghanistan53,3322,25743,2917,784
Algeria101,1202,78668,30329,951
Bahrain94,28435391,4312,500
Cyprus25,7811382,05723,586
Djibouti5,855615,75836
Egypt145,5907,975115,97521,640
Iran1,268,26355,9331,050,553161,777
Iraq600,75512,869551,12736,759
Israel466,9663,527399,01964,370
Jordan302,8563,955282,72716,174
Kuwait152,978938148,2393,801
Lebanon199,9251,550136,56661,809
Libya103,5151,55878,26823,689
Mauritania15,11137312,8051,933
Morocco447,0817,618418,74420,719
Oman130,0701,505122,5566,009
Pakistan495,07510,511450,51534,049
Palestinian Territories145,2021536127,49516,221
Qatar145,271245142,3142,712
Saudi Arabia363,4856,278355,0372,170
Somalia4,7261303,639957
Sudan23,3161,46813,5248,324
Syria11,9887475,7535,488
Tunisia149,8815,004111,59933,287
Turkey2,283,59122,0702,164,04097,821
United Arab Emirates218,766689195,52022,557
Yemen2,1026101,40389
Total7,956,885152,6847,098,258706,212

This holiday season, we ask you to give the gift of trusted news…

Dear friends,

The Media Line is always there to report to you the stories and issues of the Middle East – completely and in context: TML is the source you can trust.

Know The Media Line to Know The Middle East!

Please support our ad-free, nonprofit news agency. Our seasoned journalists reporting from the Middle East are working day and night during these challenging, yet defining times; and our student interns are honing their knowledge and skills, preparing to emerge as tomorrow’s journalists.

You rely on us and we’re relying on you! Make your online tax-deductible donation here and contact us regarding donations through appreciated stock, donor advised funds, qualifying IRA distributions and other charitable instruments.

Thank you and best wishes to you and yours this holiday season.
Felice Friedson
Founder, President

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