An emergency room for a child whose asthma is a toddler and whose vaccination against Covid-19 and influenza has failed to be vaccinated

Parents who need to take a child to the emergency room are facing agonizing waits in many parts of the United States because of a shortage of hospital beds.

To make the most of hospital capacity for kids, public health officials are urging parents to protect their children from respiratory infections by making sure children have recently been vaccinated against Covid-19 and influenza and being cautious to prevent sharing germs.

Her daughter hasn’t been able to eat or drink since Thursday because of a sharp pain in her abdomen that gets worse after she eats. Last week, she began vomiting and having chills.

“What’s happened with my daughter is, she should have been admitted last night, as someone who can’t eat or drink and is in pain and is a child,” Mikalsen said Monday.

Normally in a case like this, the hospital would put the person on the surgery schedule and keep her hydrated and comfortable until the procedure. But there aren’t any available beds, so her daughter is waiting at home.

She asked CNN not to name her employer because she wasn’t authorized to speak on their behalf. She did not want to use her daughter’s name to protect her privacy.

What is going on in Seattle children’s hospital? The kids in Seattle and Hasbro aren’t going to school, but they need all the beds

We don’t want to take a bed away from a baby because that’s what’s happening right now “Very little ones coming in who are suffocating, so they need all the beds.”

There’s a chance of risks with delaying the surgery. Gallstones can block the the tiny tubes that carry the digestive juices that are made by the gallbladder to the small intestine. That may lead to an swelling, intense pain and an infection, which can trigger sepsis.

My instructions include bed rest, no food, only fluids, and pain medication, so we have to do that. She doesn’t go to school and I don’t work when she isn’t.

Texas isn’t the only state being impacted. A spokesperson for Hasbro Children’s Hospital in Rhode Island told CNN the hospital is at 125% capacity and has been having issues with bed space for about a month.

Seattle Children’s Hospital says that it is seeing more patients than usual in October. On any given day, for most of the day, it’s at about 200% of its physical capacity in the emergency department.

Bryant thinks it’s possible that the toddlers weren’t exposed to common viruses after a year or two of social distance and precautions. We didn’t see a lot of respiratory virus circulation for a few years.

The Illinois Children’s Hospital Emergency Department is Running Out of Pediatric Intensive Care Nurses, Says Dr. Deanna Bhrens

The Illinois Department of Health alerted hospital systems in the state that they are running out of pediatric intensive care beds. As of Friday, just 6% of the 289 PICU beds remained open statewide.

The number is an optimistic one, says Dr. Deanna Bhrens, a critical care specialist at a children’s hospital. She asked that CNN not identify the hospital because she didn’t have permission from her employer to talk about the shortage.

Behrens says that 289 refers to the number of licensed intensive care beds available, but because of staff shortages, hospitals may not have enough nurses to keep that many beds open for patients.

She said that it was the biggest amount of children she had dealt with with respiratory illnesses. The number of kids we are seeing is very unusual.

Our ER volumes are at the highest they have ever been. So our overall number of patients per day,” said Dr. Marissa Hendrickson, a pediatric emergency medicine physician at M Health Fairview Masonic Children’s Hospital in Minneapolis.

During the most recent wave of illnesses, the specialized hospitals were quickly overwhelmed. “We were seeing that a patient that might require time-critical interventions, was now waiting for those interventions, sometimes six, eight, 12 hours in that community [emergency department] setting,” Auerbach says.

Mattie McKoy: When is it time for hospice or for surgery? The case for emergency room overflow at Children’s Healthcare of Atlanta

Mattie has a rare genetic condition called spinal variant neurofibromatosis type one, which causes tumors to grow on his spinal cord and compress his nerves. The tumors have put the muscles under the rib cage that control breathing in danger. He breathes with help of a tube in his windpipe.

He could live five to 10 more years with good care because of his condition. He takes the oral drug to fight tumors and free up space for his surgeries.

“We’re using these scans to decide, when is it time for hospice? When is it time for surgery? McKoy said to make those really gut-wrenching decisions.

If Mattie’s health suddenly declines, his mom says, she’ll have no choice but to take him to the emergency room for care. His immunity is low because of his underlying health conditions and his cancer treatment, so if he catches an infection while waiting in the ER, it could kill him.

Children’s Healthcare of Atlanta has been using surge tents for emergency room overflow since August, when respiratory illnesses began an out-of-season climb. Children’s says the tents are for mild injury and illness, not only RSV patients. Wait times in the emergency department vary through the day but average around three hours or more.

The doctors started making calls and eventually secured a spot in a hospital bed that would normally have been reserved for someone who needed rehabilitation. The McKoys took it because nursing coverage was better for those beds, but it wasn’t the same level of attention he would have gotten in the intensive care unit.

Alhough his family says they are grateful for the incredible medical team at Children’s, the level of care he needs is very difficult to get right now.

Allyson Wright said that because of patient privacy laws, the hospital couldn’t comment on the specifics of this case, and that decisions about transferring patients were reviewed daily at both Children’s and partner hospitals.

I’m terrified, I’m told by McKoy. “I’m afraid of him dying this flu season because he gets sick and the infrastructure of the hospital system in general isn’t able to care for him because there are so many other sick kids and there’s no bed available for him. That’s my deepest fear.”

Source: https://www.cnn.com/2022/10/25/health/childrens-hospital-beds-delayed-care-long-waits/index.html

Why Children Can’t Sleep at 7:30 am and What Kinds Can They Expect? A Pediatric Emergency Medical Physician Explains the Role of Wet Diapers in Infants with Stuffy Necessary

Children should not wait. Respiratory symptoms that require urgent medical attention include fast or labored breathing. That might mean that a baby’s nostrils flare with every breath, or that their head may bob as they try to breathe.

“When children are having trouble breathing, they pull in the muscles so that you can see their ribs outline with every breath or you can see their stomach sucking in and out in a way that it doesn’t normally do. Or the muscles in the neck and that go up by their shoulders over the collarbone can pull in with their breath,” said Hendrickson, the pediatric emergency medicine physician in Minneapolis.

There are two things that would be to watch for. So sometimes, little kids – even a baby with a stuffy nose – can sometimes have trouble drinking. It’s hard to drink a bottle if your nose is stuffy. And so sometimes, they just sort of give up, and they don’t drink enough,” she said.

She said that it was alright if they weren’t eating, as long as they got enough fluids. Keep an eye on the number of wet diapers a baby has every day.

Pediatric Emergency Medicine in the Upstate New York During the December January Omicron Flu Outburst: A Letter to the Governors of the United States

Hospitals have been more than 70% full for the vast majority of that time. But they’ve been 80% full at only one other point: in January, during the height of the Omicron surge in the US.

The broader respiratory virus season is in full swing across the US. All but six states are experiencing “high” or “very high” respiratory virus as seasonal flu activity remains “high and continues to increase,” according to the US Centers for Disease Control and Prevention.

The number of people admitted to the hospital for flu during the week of Thanksgiving was nearly double the number of admissions during the week before. The latest data doesn’t reflect the full effects of holiday gatherings since it only covers the two days after Thanksgiving.

In a letter to the nation’s governors last week, HHS Secretary Xavier Becerra noted that flu and other respiratory viruses are “increasing strain” on the country’s health care systems. Becerra wrote that the Biden administration “stands ready to continue assisting you with resources, supplies, and personnel” – but he stopped short of making a formal emergency declaration, as requested by children’s health leaders last month.

Their family was on vacation in the Adirondack Mountains in upstate New York – hours from Yale New Haven Children’s Hospital, where Auerbach works in pediatric emergency medicine.

But as Auerbach loaded his son into the car and started driving through the dark mountain roads, he had no idea if the local ED would be fully equipped to treat his child.

“I was quite nervous going in, as a pediatric emergency physician,” he recalled. I don’t know if I will have to treat him myself. Is they going to have the equipment?

“During a surge, when [patient] volumes may double or even more in some communities, that leaves a gap — a major gap,” says Dr. Larry Kociolek, medical director of infection prevention and control at Lurie Children’s Hospital in Chicago. Children suffer the consequences of that.

He knew a child’s survival rate is four times higher at an ED that’s well-prepared to care for critically-ill kids. He was aware that there were too many emergency departments that were short.

Emergency departments get a weighted Pediatric Readiness Score. It’s a way to assess whether a department has the right equipment, staffing, training policies and patient-safety protocols to care for severely-ill and injured children.

If every ED department had been well-prepared for kids, more than 1,400 deaths would have been prevented over the course of six years.

Auerbach stresses that most children do get good care – and parents shouldn’t hesitate to bring their kids in if there is an emergency – but the reality is that children “were not at the focal point ” of the country’s ED system as it developed. EDs treat a lot more adults than kids.

But making sure kids can get the best possible care will also require big, systemic changes. Kociolek doesn’t believe that the health care system can be sustainable if there are no major financial reforms. Changing how the care is reimbursed is a part of that, as is investing more hospital resources into caring for kids.

It is difficult to know if a repeat of this past season will happen soon, says Dr. Kris Bryant, a children’s infectious disease specialist.

“But I suspect all of those viruses will continue to circulate and cause their own surges. And if they all happen at the same time, we will be pressed for beds again,” she says.

Getting more kids vaccination is one way to keep them out of the hospital. “If we don’t increase the number of kids who are vaccinated, we’ll see outbreaks of vaccine-preventable diseases,” she says, citing the recent measles outbreak in Columbus, Ohio that sickened nearly 100 kids and hospitalized more than 30.

In the meantime, better treatments are also on the horizon: The Food and Drug Administration could approve Pfizer’s RSV vaccine later this year, and other antibody therapies are likely to become more widely available.

Children’s Hospitals During a Storm: Aiding auerbach in New York during a Public Emergency Medical Emergency Department at a New York Hospital

Community hospitals and emergency departments can help during a storm, Kociolek says. During this past surge some children’s hospitals were able to give round- the-clock assistance to rural and smaller hospitals.

To Auerbach’s relief, the hospital in rural New York where his son was treated had taken just these kinds of steps. It had the right equipment and staff to deal with seriously sick kids, because it had partnership with a big hospital.

They quickly assessed him, and began to provide appropriate breathing treatments and medical treatments. After six hours of observation, we stopped at a donut place on our way home to see his family.