‘It is Torture to Intubate Patients Without Sedating Them, As is Being Done in Cuba Now’

“All this about the shortage of sedatives is terrible, very worrying,” denounces a Cuban doctor. (Twitter / @ DiazCanelB)

14ymedio bigger14ymedio, Luz Escobar, Havana, 22 August 2021 — “Imagine your mouth being forced open to shove a tube down your throat and all this without a sedative.” The Cuban doctor asks to keep his name in reserve before telling 14ymedio about his traumatic experience with Covid-19 patients in collapsed hospitals, without oxygen, without medicines for patients and without means of protection for healthcare personnel.

“It is torture, and the patient can even die in this whole process because if intubation is complicated, he dies from hypoxia,” adds this doctor who works in a hospital in Havana.

It is not an isolated case, but rather several testimonies collected by this newspaper in recent days, both in Havana and in the provinces. In the absence of the usual sedatives in Cuba, such as midazolam, propofol, atracurium or pancuronium, doctors must make very difficult decisions when connecting a patient in serious condition to an artificial respirator through intubation.

“All this about the shortage of sedatives is terrible, very worrying. There are many ventilated patients now in the country and it is an ethically very complex situation. You are faced with the dilemma of either I intubate him to try to save him or I do not intubate him and he dies,” explains a doctor from Cienfuegos, who speaks of “chaos” in the therapy rooms between the lack of oxygen and medicines.

“There are patients who are so bad that they put up only a minimal resistance but there are others who do not, there are others who have to suffer it, open their mouths, sometimes there are even broken teeth, sometimes they survive, sometimes not,” laments another doctor from Havana, very affected by this situation.

“When you put the patient on the ventilator without sedation, they are tied to the ventilator and there is a ventilatory discomfort that causes the patient’s ventilatory rate to go one way and the ventilator the other.” He adds that “if the patient were sedated, the frequency of the patient would be the same as that of the ventilator and better breathing can be achieved because otherwise the objective, which is to ventilate the patient well, is not achieved.”

The nightmare of testing positive for covid and “having to enter a hospital because your symptoms worsen” can begin “from the moment you call an ambulance and it does not appear,” Eloisa, a young woman who survived covid after spending 21 days in a therapy room.

“When you think the worst has happened and you are already in an intensive care room, you realize that the nightmare is not over, that it is just beginning. The dead passed through the corridor every half hour and that was terrifying, luckily for me I did not have to be intubated because I responded well but my family had to bring everything, even the oximeter to measure the oxygen saturation in the blood because there were none in the hospital,”he complains.

“Those rooms are a total disaster, the doctors work with all their strength but with very few resources and with the minimum means of protection. Some days I saw how the doctors had to deal with oxygen blackouts of up to two hours,” adds the young man.

In the midst of the oxygen crisis in almost all the country’s hospitals the local Cienfuegos press said that 20 “concentrators had arrived in the province “to support the fight against the pandemic.”

Dr. Duniesky González Rodríguez, director of the Provincial Medical Supplies Company in that province, explained that they come from Mexico and that “flights from China are being expected in the next few hours” with more equipment of this type. “You know the real situation that the province has today, not only with the high incidence of covid cases but with the lack of oxygen,” he added.

As reported this Saturday by the official press, in the last two days a “more stable” supply of oxygen has been achieved for the hospitals of the capital, an improvement that allows “ensuring continued coverage for the almost 500 admissions that require it; 128 of them are treated with artificial ventilation in intensive care units and 369 in general wards.”

The report detailed that health care institutions such as Freyre de Andrade, known as Emergency, and Joaquín Albarrán, located on Avenida 26, “had experienced a tense situation in the coverage” of oxygen and that for that reason they were “especially benefited with a group of containers that ensure the existence of this product for 8 to 10 days.”

Dr. Emilio Delgado Iznaga, provincial director of Health, assured this Saturday during a meeting with the authorities of Havana, that “the delivery of medicinal oxygen and compressed air” to the 82 polyclinics in the capital was resumed, “to attend to the patients with acute respiratory infections or other illnesses that need this drug.” The official’s statement reaffirms the controversial use of compressed air as a substitute for medicinal oxygen, which has generated so much criticism.

Delgado Iznaga also announced that this Saturday the province received 95 oxygen concentrators “for home distribution,” which, together with another 10, will be able to “serve the hundred convalescents who need it daily in their homes.”

Recently dozens of Cuban doctors denounced through videos shared on social networks, the health collapse that the country is experiencing and demanded supplies they need to carry out their work. They also protested against the criticism of the sector launched by Prime Minister Manuel Marrero.

“Our patients need help,” said angiology and vascular surgery resident Julio C. Hernández. “We also need help, we do not want more people to die,” adds the doctor in his brief complaint dated August 16.


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