EMERGENCY PLANNING
Calm approach toCOVID-19 crisis in the Falklands Islands
Martyn Barlow, Estates and Engineering manager at the Falkland Islands Government’s King Edward VII Memorial Hospital (KEMH), describes some of the particular challenges for he and his team with the outbreak of the COVID 19 epidemic – including maintaining a sufficient oxygen supply for wards and general clinical use, protecting elderly and especially vulnerable patients, and reconfiguring or isolating ventilation supply and extract systems as a new ‘zoning’ system was implemented to keep those with COVID-19 away from other patients.
Located in the Islands’ capital, Stanley, the King Edward VII Memorial Hospital is used to dealing with whatever comes through the door, and usually has the ability to evacuate the seriously ill or patients who need specialist care. This all changed when the COVID-19 epidemic started, as international borders closed, and flying to other countries became more difficult. The staff at the KEMH are bracing themselves to receive patients exceeding 300% of what the hospital is designed for, with limited support.
There are 14 British Overseas Territories in various locations around the world, one of which is the Falkland Islands, located in the South Atlantic Ocean, and lying some 8,000 miles from the UK. The KEMH is a small 29-bedded hospital that serves a small civilian population of about 3,000 people, as well as a significant number of military UK Ministry of Defence (MOD) personnel who are based 35 miles from Stanley at RAF Mount Pleasant. Patients who require specialist care are generally flown to either Chile or the UK, and in the event of some acute cases, emergency evacuation (or ‘Aeromed’) will mean that if a Civilian Air Ambulance is not available, then the RAF will fly those patients to Uruguay. In such cases KEMH will provide clinical and engineering support to meet patient and equipment needs.
Samples must be flown to the UK KEMH does not have the facility to carry out testing for COVID-19 (although this is likely to change in the near future), so samples must be flown to the UK for analysis. With flight disruption, followed by transit time, and the time to process samples, this has at times meant a delay of up to 10 days in some cases. This means patients who present symptoms expected of pandemic victims must be treated as confirmed coronavirus cases until proven otherwise.
As the engineering team started to look at the extra resource requirements needed to support COVID-19 patients, it
24 Health Estate Journal June 2020 Spare beds ready in the ITU. The rear of the King Edward VII Memorial Hospital in Stanley from the air.
became quickly evident that, due to the numbers of expected patients, we should expect to lose team members as they become incapacitated. The impact of such a scenario is potentially even more significant due to the small number of trained engineers at the hospital; key staff loss in such a small team could mean an inability to maintain life- supporting systems such as medical oxygen plant. To mitigate this risk, engineers with previous hospital engineering experience have been drafted in ready to replace critical team members on an emergency call-out basis. Other individuals with high levels of technical competence and engineering aptitude have joined the
team and trained on various systems and procedures, the intention being that they will augment the main engineering team for the duration of the COVID-19 threat, thus allowing any reduced engineering capacity due to sickness to be absorbed by these extra members of staff.
Need for extra medical equipment The structure of the KEMH means that procurement of medical equipment is an engineering responsibility, alongside our remit for Capital Projects. However, all such projects remain suspended at the moment. It was clear early on that in order to meet the threat of COVID-19, the KEMH needed to secure extra medical
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