Some of the nation’s largest children’s hospitals are being overwhelmed by an unprecedented surge in sick children, forcing them to keep families waiting for hours in emergency departments, cancel surgeries and move some teens to nursing homes. Adults.
An unusually early rise in respiratory syncytial virus (RSV) infections is partly to blame. But other problems, including the inability of many families to find primary care providers and shortages of over-the-counter fever and pain medications for infants and children, are adding to the crisis.
With emergency rooms caring for far more critically ill children than normal pediatric inpatient and intensive care units at or near capacity, doctors say they aren’t sure how the health care system will cope when the Cold and flu season will peak in the next few years. months.
Canada is not making the most of its family doctors’ time in the face of critical shortages
“People are coming together and are positive about it, but there is a limit to what we can do with the resources we have,” said Karen Gripp, medical director of children’s health in the emergency department at Children’s Hospital at the Science Center. Of the health. in Winnipeg. “This winter is going to be very difficult.”
Dr. Gripp said the emergency department at the children’s hospital was designed to see 100 patients a day, but has been treating about 180 in each of the last four days.
“Everyone is under a lot of pressure right now,” he said. “I don’t think any emergency department in Canada is unaffected.”
RSV is a very common seasonal virus, but it can cause serious infections in babies and even require hospitalization in a small number of cases. Dr. Gripp said the virus doesn’t appear to be more severe this year than in the past, but she said the volume of infected children has changed. Some of them had not previously been exposed to RSV and other viruses as a result of pandemic protocols such as school closures and mandatory mask wearing. Their lack of immunity partly explains the uptick in pediatric patients.
Dr. Gripp said that most children who arrive at the emergency room have a fever and have difficulty breathing or are experiencing other problems related to respiratory viruses. And a higher than normal proportion are seriously ill.
Before the pandemic, he said, about 60 percent of pediatric patients in his hospital emergency room were low-acuity, meaning their cases were not urgent and could be seen by doctors outside the hospital. Now the situation has changed: About 60 percent of patients are being classified as high-acuity, meaning they need urgent medical attention.
The pediatric intensive care unit at Dr. Gripp’s hospital is also overflowing with capacity, and the hospital is transferring some patients to the neonatal ICU, he said.
At the Children’s Hospital of Eastern Ontario in Ottawa, the ICU was operating at 160 percent capacity Wednesday. While the hospital may send some teenage patients to adult hospitals, the vast majority of children in the ICU are under the age of two, Mona Jabbour, the hospital’s interim chief of pediatrics, said in a briefing with reporters.
“We really need to do what we can to take care of those kids here,” Dr. Jabbour said. “We really can’t send them anywhere else.”
Toronto’s Hospital for Sick Children said in a statement that it still has ICU capacity, but a small number of ICU patients over the age of 14 may be transferred to adult facilities to ensure there is enough space for children who require specialized pediatric intensive care. A memo this week from the Ontario Intensive Care Command Center directed hospitals to accept pediatric ICU patients aged 14 and older due to widespread capacity issues.
Limited access to ICU beds also forced SickKids to cancel some surgeries, but the hospital did not say how many.
McMaster Children’s Hospital, in Hamilton, Ontario, said in a statement that it is approaching 135 percent inpatient occupancy and children are waiting longer than normal for care. The situation is so critical that the hospital is temporarily limiting inpatient pediatric surgeries to one case a day, or fewer than five a week, down from the 15 a week it normally performs.
Andrew Lynk, chair of pediatrics at the IWK Health Center in Halifax, said the hospital has seen an increase in RSV cases in the past week, and another cold virus has also kept staff members busy this fall. . A busy 24-hour period for IWK’s pediatric emergency department would typically mean caring for 120 children. On Thursday, the hospital treated 169 children, Dr. Lynk said. The facility is over capacity, its ICU is nearly full and staffing is a challenge as workers deal with their own illnesses and sick children, he added.
“If you add COVID, flu and RSV, it’s like the perfect storm,” he said.
He would like to see a return to public health protocols, such as wearing masks indoors, to prevent the crisis from worsening this winter.
“I don’t think it’s too much to ask people to wear masks in public places or in schools if it means preserving the health care system and protecting people,” he said.
Emily Gruenwoldt, president and CEO of advocacy group Children’s Healthcare Canada, said pediatric care across the country was in dire need of a fix even before the pandemic, with insufficient hospital beds and long wait times for certain services.
“This is a hands-on kind of problem,” he said.
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