A simple visit to a toilet is not that easy for Covid-19 patients. In four months, doctors have noted multiple ‘fall episodes’, in some cases leading to fractures, as patients try to walk a few steps to the toilet.
Low oxygen saturation levels, acute weakness, no relatives at side, and hesitance of nursing staff to come to prompt aid in isolation wards have increased incidents of “fall” in hospitals in the last four months. ‘Fall episodes’, when a patient falls off bed or falls while walking to a toilet, are carefully recorded and registered as medico-legal cases. In the public sector with huge patient load, doctors say they inform casualty medical officers but the frequent incidents recently have made it difficult to report each case. “At most we record in the patient’s case paper,” a doctor in Bhabha Bandra hospital said.
On June 24 night, a 72-year-old Covid patient, resident of Gangawadi chawl, had walked to the toilet in Azad Nagar’s Covid Care Centre. When he did not return, the door was broken. He was found to have collapsed and was declared dead in Rajawadi hospital. In Jalgaon, two elderly Covid patients have died between May and June as they attempted to make their way to a toilet and collapsed. In one case, the body was discovered eight days later in the toilet.
In Bhabha Bandra hospital, a resident doctor has helped four patients, found collapsed in toilet, back to their beds. “We have staff shortage, and monitoring patients one-on-one is difficult. Many times patients from neighbouring cots notify us that a patient has not returned from his trip to washroom since 15-20 minutes,” the doctor said.
Before the pandemic, patients’ relatives were allowed to accompany them, help them when they needed water or a visit to the loo. With entry of kin barred in isolation wards, patients are on their own and staffers are too scared to touch them.
In SL Raheja hospital, seven incidents of fall have been recorded since March; in two cases patients sustained fracture. The hospital authorities said they usually record one or two such cases in a year. “We are short of staff. Resignations of ward boys and nurses continue,” a doctor said.
The fall episodes are higher in Covid-19 patients because almost all those hospitalised have poor lung functions and need oxygen support.
Once they remove their oxygen mask to visit the loo, they suffer giddiness or light-headedness. In KEM hospital, a resident doctor said he has found three patients passed out near toilets during his duty in Covid wards. “The nursing staff is not comfortable changing diapers due to infection risk. Bed pans are not available for every bed, and urinary catheter can cause infection if used for several days. Except those on ventilators, patients have to physically go to a toilet,” he said, adding, “It is sad to find collapsed patients on floor. We have not recorded deaths but they sustain injuries.”
In June, a 55-year-old male patient, in a delirious state, fell out of bed and hit his head in KEM hospital. A resident doctor said he suffered a cut in scalp and required stitching. “He was extremely weak and was trying to get out of bed. He died days later due to coronavirus,” the doctor said.
In Fortis hospital, to avoid this complication a bed pan is placed near every bed. Staffers have been directed to aid those patients who have mobility.
In Seven Hills hospital, there is one nurse for six patients in the general ward and one for three in ICU, but nurses do not always sit inside an isolation ward and only come when needed. In-charge Dr Balkrishna Adsul said he has officially recorded no fall episodes, but said, “there is less manpower and not every patient can be monitored 24×7. We have made arrangements; toilets are also close to cubicles of patients.”
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