There is no shortage of hospitals in the US that have excelled throughout the Pandemic

A mother in the hospital admits she is okay, but she is afraid to go see a doctor if she wants to go out of business

These days, staff at many children’s hospitals are breathing a sigh of relief. The brutal surge of pediatric illnesses over the fall and early winter – propelled by a tidal wave of common bugs like RSV and influenza – has waned. It became clear that there wasn’t enough hospital beds for parents who waited hours or even days for their child to be admitted.

Infants are at especially high-risk for severe RSV, but Kociolek says the fact that older kids were also getting really sick put added pressure on the health care system.

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. She started vomiting and felt unwell last week.

Mikalsen tried to find an adult bed for her daughter at the local hospitals, but was told she would still need a doctor’s appointment. She has a list of symptoms to keep an eye on – signs that her daughter’s condition could be worsening. And they have an upcoming appointment to see a doctor for a consultation, but no promise of upcoming surgery.

The person said it was nerve-wracking. “We had the surgeon on the phone last night and the doctor. They ran all kinds of tests on her in the ER and they were like, ‘well, she’s not dying. We are going to not prioritize a bed for her. “

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

“We don’t want to take a bed away from a baby, because that’s what’s really happening right now,” Mikalsen said. It is necessary for the very little ones coming in to have all the beds.

Delaying the surgery can pose risks. Gallstones can block the the tiny tubes that carry the digestive juices that are made by the gallbladder to the small intestine. That might lead to a lot of pain and an infectious condition, which can cause sepsis.

My instructions are to rest, eat, and take pain medication, and don’t have food or drink. She misses school and I miss work until we get this figured out,” Mikalsen said.

Texas isn’t the only state being impacted. The hospital in Rhode Island is 125% capacity and has had bed space issues for about a month.

The hospital says it is seeing double the number of patients they would normally see in October. The emergency department in most days is only about 200% of it’s physical capacity.

Bryant suggests that the toddlers had not been exposed to common viruses after a year or so of precautions. We didn’t see a lot of respiratory virus circulation for a couple of years.

The number of children in an intensive care facility is astounding, and why we are seeing so many children,” says Dr. Deanna Behrens

Hospitals in Illinois were told by the Illinois Department of Health that they are running out of intensive care beds for children. Only 4% of the beds remained open statewide as of Friday.

“That’s actually an optimistic number,” says Dr. Deanna Behrens, a pediatric critical care specialist at a children’s hospital in Chicago. She didn’t have the permission to talk about the shortage from her employer, so she asked that CNN not name the hospital.

The number of intensive care beds that can be available, but because of staff shortages, may not be as high as described by Behrens.

She said it was the most amount of kids she had ever seen with respiratory illnesses. “The number of kids we are seeing is very unusual.”

“Our total ER volumes are the highest they’ve ever been in our emergency department right now. 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.

“And then we ended up caring for people in non-traditional spaces like hallways or trying to start their care actually physically in the waiting room. She said they were squeezing people in as best they could.

A Journey Through Time at Children’s Healthcare: Mattie’s Emergency Room Overflow during the August Release of a Neurofibromatosis Patient

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. Because of where they’re growing, the tumors have paralyzed his diaphragm, the muscle that sits underneath the rib cage and controls breathing. He uses the help of his windpipe and machines to breathe.

Mattie’s condition will shorten his life, but McKoy says he could live five or 10 more years with good care. He takes an oral chemotherapy drug to slow the growth of his tumors and to space out his surgeries.

The scans are used to decide when it is time for Hospice. Is it a good time to have surgery? And to make those really gut-wrenching decisions,” McKoy said.

If Matties health suddenly begins to decline, his mom says she will have to rush him to the emergency room. 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.

Surge tents have been used for emergency room overflow since August when respiratory illnesses began an out-of-season climb. The tents are used for patients who have mild injury and illness. The emergency department waits on average three hours or more during the day.

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, a spokesperson for Children’s Healthcare of Atlanta, said that because of patient privacy laws, the hospital can’t comment on the specifics of this case, and “decisions about transferring patients are reassessed daily both within Children’s and with our partner hospitals as needed to ensure that care is provided expeditiously and safely.

McKoy said that he was terrified. “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 is my greatest fear.

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

Baby’s breathing problems and their parents, doctors and other medical conditions should be evaluated with a child’s pediatric pediatric anesthesiologist

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

Children with breathing problems pull their muscles so that they can see the outline of their ribs or their stomach in the air, which is not normally seen. 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.

“The other thing would be to watch for dehydration. Sometimes little kids can have trouble drinking, even if they have a good nose. 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.

It’s OK if they’re not eating, she said, as long as they’re still getting enough fluids. A baby needs many wet diapers every day.

How a Child’s Emergency Department fell Short during the January Omicron Surge in the U.S. During the Flu Season

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. The US Centers for Disease Control and Prevention states that all but six states are experiencing high or very high respiratory virus during the flu season.

During the week of Thanksgiving, the number of people admitted to the hospital for the flu more than doubled from the previous week. And the latest surveillance data probably does not reflect the full effects of holiday gatherings, as it captures only through November 26, two days past 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.

The family was on vacation in upstate New York which is close to Yale New Haven Children’s Hospital.

When Auerbacher loaded his son into the car to drive through the dark mountain roads, he didn’t know if the local ED would have the equipment to treat him.

“I was quite nervous going in, as a pediatric emergency physician,” he recalled. “Frankly, am I gonna have to treat him myself? Is that equipment they’re going to have?

“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. “And 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 fell short.

In fact, emergency departments receive what’s called 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.

A study published earlier this year found that if every department was prepared for children, more than 1,400 deaths could be prevented over a six-year period.

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. In general, EDs treat far more adults than kids.

But making sure kids can get the best possible care will also require big, systemic changes. Kociolek doesn’t think that the health care system can be sustainable without financial reforms. That includes changing how pediatric care is reimbursed, making it more affordable for medical students to choose a career in pediatrics and investing more hospital resources into caring for kids.

It’s hard to know whether hospitals will see a repeat of this past season anytime soon, says Dr. Kris Bryant, a pediatric infectious disease specialist at Norton Children’s Hospital in Louisville, Kentucky.

“But I suspect all of those viruses will continue to circulate and cause their own surges. She says that if they all happen at the same time, we will have to look for beds again.

She thinks that getting more kids vaccinations is a 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.

Lifeboats: Helping a child in a crisis through telemedicine — Auerbach on a visit to the donut shop in New York

Smaller emergency departments can serve as lifeboats, helping during a storm, according to Kociolek. For example, during this past surge, some children’s hospitals used telemedicine to give virtual, round-the-clock assistance to rural or smaller hospitals and EDs.

The hospital in rural New York where Auerbach’s son was being treated had taken some of the above steps. The partnership it had with the university hospital had the right equipment and staff trained to deal with the sickest kids.

“They rapidly assessed him, [and] began very appropriate breathing treatments and medical treatments,” Auerbach says. We were able to stop at the donut shop after about six hours of observation to see his mom and brother.