When a patient walked into the Emergency Department of Long Island Jewish Valley Stream about a month ago with a blood clot in his lungs and an oxygen saturation of 11 — a normal saturation level falls between 80 to 100 millimeters of mercury — the staff went to work to save his life.
Emergency Room Dr. Jason Yan gave him medicine for the blood clot, and called Cardiologist Kyriaki Poumpouridis and Associate Intensive Care Unit Director Dr. Darryl Adler, who mobilized Northwell Health’s ECMO To Go team. The machine, an extracorporeal membrane oxygenation device, uses a pump to circulate blood through an artificial lung and back into the bloodstream.
The patient was then transferred to the Long Island Jewish Medical Center in Queens, and was discharged about two weeks ago.
“The fact that he’s alive is incredible,” said David Seligman, executive director of the hospital, adding, “In the old days of Franklin General, this never would have happened.”
The medical center opened as the Franklin Hospital in 1963, and became a part of the North Shore-LIJ hospital system in 2002. In 2015, the system changed its name to Northwell Health.
That system came in handy during the heart of the pandemic, when the hospital exceeded its typical capacity by 35 percent and admitted more than 30 Covid patients a day. It had a maximum of 170 coronavirus positive patients, Medical Director Joseph Marino said, and a total of 225 to 240 patients at the peak. The hospital is usually only staffed to handle between 152 to 170 patients.
No two days were the same during the pandemic, Seligman said, calling the experience “organized chaos.”
In the ICU, Adler would put three patients on ventilators in an hour, he said, likening the experience to “treading water, going from one really sick patient to another extremely sick patient.”
“It was like wartime,” Adler said. “I’ve never seen so many patients come in at one point who are so sick.”
To make matters worse, the hospital is in the process of renovating its emergency department, though Executive Director David Seligman noted, “Even if we had our full emergency room, space would still be a problem.”
But with the help of Northwell’s load-balancing system, in which LIJ Valley Stream was able to transfer patients to any of the other 22 hospitals in the system with a larger patient capacity, the hospital never ran out of resources.
Seligman would make sure that all the staff members had sufficient personal protective equipment and knew how to use them, and Marino would find out how many patients were in the hospital at a given time and how many needed ventilators.
Additionally, hospital administrators implemented policies to help curb the spread of the coronavirus. It was one of the first to cancel elective surgeries and treat patients with steroids, Seligman said, and the administration even installed cameras that measure guests’ and staff members’ temperatures when they walk in. “I actually feel more comfortable when I’m at work, than I do when I’m not at work,” said Seligman, who had only started working at the hospital about seven months prior to the pandemic.
Some of these policies, Seligman noted, will likely continue, even as the number of coronavirus cases continue to drop in New York State. As of Monday, there were only 57 Covid-related hospitalizations in Nassau County, with 17 in Intensive Care Units and three on ventilators.
At the hospital, meanwhile, a day in which they admit two new coronavirus patients is a lot, Seligman said, and they now only have about 70 patients in the emergency room at a time.
“It’s drastically different, because things are back to normal,” Adler said. “It seems so hard to believe what we went through.” He added that the experience now seems like a blur.
All of the staff got up every morning, Seligman said, and asked, “‘What could I do to help?’”
“Nobody called in sick, nobody complained,” Marino recounted. “They were all scared, but they came in.”
They even started to get to know the patients and their families on a personal level, Seligman said, and offered family visits on FaceTime. About two weeks ago, the hospital also held a memorial ceremony for all those they had lost.
Now, however, he said, patients are starting to become more comfortable coming to the hospital, which started offering elective surgeries last month, and is continuing to educate its patients on precautions they could take to protect themselves from the coronavirus.
And the staff is now able to take time off for themselves.
“It’s been an interesting time,” Seligman said, with Marino noting, “God willing, we’ll never have to go through this again.”