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Cristina Arrieta, del CEAR: “Nos fuimos aggiornando a las recomendaciones que existen a nivel mundial”

By revistabife /

Cristina Arrieta, jefa del Servicio de Clínica Médica desde hace 4 años, cumple la función no solo en ese área del Hospital Lucio Molas, sino también en el sector de Clínica Médica Respiratoria en el CEAR (Centro Emergente de Asistencia Respiratoria). También se desempeña junto a otros médicos como instructora en la Residencia de Clínica Médica.En esta época de pandemia el personal se tuvo que dividir para trabajar en ambos lugares, “somos un recurso humano pequeño para semejante demanda, pero nos hemos acomodado a las circunstancias para poder cubrir ambos lugares. Desde el inicio de esta pandemia tuvimos la colaboración de algunos médicos del sector privado que están ayudando en el servicio de Clínica Médica Respiratoria. También se sumaron en consultorios externos y otro médico en Terapia Intensiva, porque estos tres servicios son los que se vieron afectados particularmente en la pandemia”, expresó Arrieta.


El CEAR funciona en el lugar donde era el Centro de Medicina Nuclear, “lo equiparon y reformaron para que nosotros funcionemos. Es un lugar excelente, con la preparación y equipamiento necesario, más los lugares de circulación óptimos, para que el personal de salud no esté tan expuesto”.  


En este lugar se interna al paciente moderado a grave, el que está a un paso de terapia intensiva. “El enfermo leve se queda en aislamiento en los hoteles porque no requiere internación. El que es moderado requiere de oxígeno y un esquema de tratamiento con antibióticos y otras medicaciones endovenosas y subcutáneas. Cada paciente es individual, porque se comportan de maneras diferentes y por eso se va ajustando a la dinámica clínica de cada uno. En algunos momentos usamos oxígeno de alto flujo, paso previo a que pasen a la terapia intensiva”. 


Arrieta dijo que al inicio de la pandemia se veía a adultos mayores con COVID-19 y ahora la franja etaria es de una edad media entre los 35 a los 65 y el predominio es de sexo masculino. “En La Pampa podemos hacer tratamientos con plasma pero no cualquiera puede recibirlo, tienen que cumplir con determinados criterios médicos, porque suelen aparecer reacciones adversas en patologías muy graves”.
Por otra parte, señaló que los profesionales de la Salud se encuentran en una capacitación permanente, “porque es muy dinámico y va cambiando día a día, en el transcurso de estos meses nos fuimos aggiornando a las recomendaciones que existen a nivel mundial”.

Atención
El horario de ingreso de Enfermería es a las 6 y de los médicos a las 7. “Estamos divididos por grupos y por equipos. Nos preparamos para ver a los pacientes con un protocolo de vestimenta y también cómo debemos salir de atender a los pacientes, cómo hacer los lavados y sacarnos la ropa. La idea es no permanecer por más de 3 o 4 horas para disminuir la exposición a la carga viral. Es decir que los grupos se van recambiando, dependiendo de la demanda de pacientes”, describió Arrieta.


Atender a este tipo de pacientes con COVID-19 es muy diferente a las patologías a que los médicos están acostumbrados. “Demandan mayor tiempo y un estrés, es una adrenalina diferente la que uno vive. Y estar mucho más alerta a cómo tocamos las cosas, sobre cómo no exponernos al virus nosotros. Hay un modo de circulación que respetar, de los insumos que utilizamos por cada paciente, que no se pueden mezclar. De las muestras biológicas que se extraen requieren procedimientos invasivos, y por eso tenemos mucho cuidado de no contagiarnos. Las muestras se retiran embolsadas y selladas”.


Fuera de la sala siempre hay un veedor, “controlando cómo estamos trabajando y que no cometamos ningún error”. Y ejemplificó “si se nos desataron las batas, etc.”. Además, “hay otro circulante que se encarga de alcanzar cualquier insumo que nos falte”.


En la jornada de trabajo, en el CEAR se encuentra el equipo del Laboratorio y el equipo de Radiología de forma permanente, las 24 horas de guardia. “Interactuamos en conjunto, con los consultorios respiratorios, también interconsultamos con Terapia Intensiva, para que ellos evalúen los criterios para pasarlos. Es un equipo de trabajo muy lindo que se formò y que a pesar de esta etapa de pandemia, estamos muy contentos como estamos trabajando”. Y a todo el equipo de profesionales se le suma el equipo de limpieza “que están detrás nuestro, cuando salimos ellos ingresan a higienizar todo para dejar las superficies limpias, así como el equipo de Nutrición que trae los alimentos individualizados. Por eso es muy importante articular el trabajo de todos de esa manera”.

Recursos humanos e insumos
El personal cuenta con elementos de protección e insumos médicos, “hay stock para varios meses. La complejidad que requiere la tenemos y si necesitáramos estudios de mayor complejidad en los pacientes, los trasladamos cumpliendo todo el protocolo de seguridad y traslado”. 
En cuanto al recurso humano, señaló que “somos pocos. Una vez que personal de Salud se contagia o enferma, fractura al resto porque los aislamientos afectan a un grupo mayor de personas. Entonces quedamos muchos menos para trabajar. Por eso tratamos de cuidar lo mejor posible este recurso humano”.

Contención psicológica
Todo el personal tiene acceso a contención o ayuda psicológica. “Nos ha pedido el ministro de Salud, Mario Kohan, que organicemos y coordinemos grupos de charlas con asistencia psicológica para todo el equipo. En este sentido lo estamos gestionado, porque se ve que estamos desgastados y agotados. Y también se suma el no poder estar con los seres queridos por la carga horaria laboral o no poder ir a visitar a los padres para evitar exponerlos, situaciones que angustian más que la carga laboral”. 


Respecto a la responsabilidad social en estos momentos de pandemia, manifestó que “es entendible que la gente esté cansada de tanta cuarentena y cuando hay permisos de poder circular, es innato en el ser humano, se olvida de los cuidados mínimos. La gente tiene que seguir trabajando, pero pedimos a la sociedad que lo hagan con el máximo de los cuidados, que no compartan el mate, algo tan argentino, usar barbijo y bien puesto que cubra nariz y boca. Tener esos recaudos, en este momento es fundamental, tenemos que entender que es la única herramienta con la que contamos para hacer frente a este nuevo coronavirus. Y aunque sabemos que casos vamos a tener, nos ayuda a nosotros como profesionales de la salud, para que podamos dar respuestas a todos los que se enferman. Porque si vienen de manera masiva nos va a sobrepasar al recurso humano que tenemos”.


Señaló que hay camas disponibles y los espacios modulares aún no se están utilizando.

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