A Cold Patient on a Diversion? Raegan Sizemore and the UH Rainbow Babies and Children’s Hospitals of Connecticut

When Sizemore and her family went to celebrate her birthday last week, she wanted her daughter Raegan to try swimming. The 15-month-old was not herself on Saturday.

Sizemore took her to the urgent care where he told them that she had a cold, which was caused by the respiratory syncytial viruses, orRSV, a common cold-like virus.

As soon as they saw her vitals, the staff at UH Rainbow Babies & Children’s Hospital in Cleveland knew they had to admit Raegan, her mom said. She needed to breathe.

Most kids catch RSV at some point before they turn 2, the US Centers for Disease Control and Prevention says, and it’s usually mild. A common cold can include symptoms like a cold nose, cough, sneezing, itching, and wheeze. They typically last a week or two, and clear up with rest and fluids.

There aren’t many treatments and it can require several days of supportive care in severe cases, meaning that it can fill hospitals even in regular seasons.

CNN analysis of data from the US Department of Health and Human Services shows that hospitals are more full than they have been. But as respiratory virus season surges across the US, it’s much more than Covid that’s filling beds this year.

UH Rainbow Babies went on diversion for a few days in October because it couldn’t take any emergency admissions because of the surge in patients. It is taking patients again, but is still slammed with RSV cases.

There has been such such a dramatic increase in cases in Connecticut that Connecticut Children’s Hospital has been coordinating with the governor and public health commissioner to determine whether it should bring the National Guard in to expand its capacity to care for these young patients.

How have you been sick? Tell me what you’ve been doing lately, and what we can do about it, but what will I do next?

“I don’t know how but she slept with those ice packs on top of her,” Zoey Green said, holding an exhausted Lindy at the hospital. She said they’re trying to keep her hydrated so she doesn’t have to go back on an IV.

She said that the census numbers were high because of how many sick people were in the community.

Positive tests for the flu in the United States stood at 25 percent in late November, according to the US Centers for Disease Control and Prevention, compared to 8 percent at the same time of year in 2019. Respiratory syncytial virus has cause some children’s hospitals to be overcrowded. There are rising Covid hospitalizations. It’s the tripledemic that epidemiologists feared—those viruses, with the help of a few other seasonal recurring ones, are working together to fuel weeks of coughing, runny noses, and fevers. So if your kids, your coworkers, and everyone you know has been feeling sick, that’s why.

At UH Rainbow Babies, staff are hoping things don’t get much worse. If we aren’t peaking, then holy hell, said Amy Edwards, associate medical director for pediatric infection control.

Insufficiency Gap Between the 2020 and 2021 Seasons of Coronavirus (RSV): When Families Get Their Hands Weaken

When everyone stayed home in 2020 and 2021 to prevent the spread of the coronavirus, it seemed to change the typical RSV season. The insufficiency gap was created by low case counts.

It’s generally such a mild illness that adults often don’t realize they have it, or they think it’s nothing more than a cold or allergies and go on to interact with others.

“It’s not a fatiguing virus the way influenza or Covid is, so you really do feel fine,” Edwards said. “And then what happens is, your neighbor has that beautiful baby, and you bring over a casserole, and you kiss that little baby because you feel fine. You don’t feel sick. And unfortunately, you pass it on to them, and sometimes they end up at the hospital.”

Pediatricians say a trip to the ER may be necessary if a baby is dehydrated; if they have difficult, labored, shallow or rapid breathing; if they have a high fever or bluish skin; or if they become unresponsive. The CDC says that most can go home after a few days if they receive supportive care.

“Hand hygiene is the single most important thing that we can do to keep ourselves and others safe,” said Davis, of the children’s hospital in Grand Rapids. She tells people to never touch their faces unless they recently washed their hands.

When kids or grownups are sick, they need to do one thing and one thing only, she said: “Stay home when you are sick so you won’t spread whatever respiratory illness you have.”

“I would like other parents to know they shouldn’t watch their child’s cough lightly and take symptoms seriously,” she said. If we hadn’t gotten Raegan’s help, this could have been a lot worse.

Her daughter has been unable to eat or drink because of the pain in her abdomen that will get worse after she eats. Last week, she began vomiting and having chills.

Mikalsen even tried to get her daughter an adult bed at local hospitals, but they were told she still needs pediatric care. She has a list of symptoms to keep an eye on – signs that her daughter’s condition could be worsening. They have a doctor’s appointment for that day, but no word on whether or not they will have surgery.

It is nerve- racking, according to Mikalsen. We had the surgeon and the doctor talk to each other. They ran all kinds of tests on her in the ER and they were like, ‘well, she’s not dying. We’re not going to prioritize a bed for her.’ “

The State of Emergency Medicine, the Children’s Hospital, and Washington, D.C., U.S. News, 10/15/2003

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

I don’t want to take a bed away from a baby, that’s what’s happening right now The little ones are suffocating and need all the beds.

There are risks involved with delaying the surgery. gallbladder stones can block the small tubes that carry the gastric juices to the small gut. That could lead to inflammation, pain, and an infectious disease which could cause sepsis.

“My instructions are strict bed rest, no food, just fluids and pain medication, so that’s what we have to do. She misses school and I miss work until we get this figured out,” Mikalsen said.

Texas is only one of the states 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 it is seeing double the number patients they would normally see in October. On any given day, for most of the day, it’s at about 200% of its physical capacity in the emergency department.

The hospitals are reporting a shortage of staff. Rhode Island has the highest number of hospital beds in use with more than 85% of beds occupied in other states: Massachusetts, Georgia, Missouri, West Virginia and Oregon.

Hospitals can have very limited number of intensive care beds open if they don’t have enough nurses.

The ER volumes have never been higher, and right now they are. The M Health Masonic Children’s Hospital in Minneapolis has an average of 50 patients a day.

It’s our job to get people who are more ill and need more immediate attention back to their rooms as quickly as possible. “But sometimes, when things are busy enough, we aren’t even able to do that.

Managing an Overflow Emergency Room in the Atlanta Children’s Healthcare System: A Case Study for a Patient with Spinal Variable Neurofibromatosis

There is a rare genetic condition called spinal variant neurofibromatosis type one, it causes tumors to grow on his spine 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 breathes with the help of a tube in his windpipe and machines.

According to McKoy, he could live at least a few more years if he had the right care. He takes an oral drug to slow the growth of his tumors.

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

If his health goes down, his mom will have to take 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.

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. The tents are used for mild injury and illness, not just patients with the respiratory syncytial virus. The average wait in the emergency department is around three hours.

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.

“Honestly, I’m terrified,” McKoy said. “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

The consequences of dehydration for infants in the early stages of astrophysics, and a pediatric pediatric pediatric neuropsychiatric emergency care

Some kids shouldn’t wait. Respiratory symptoms that require immediate medical attention include fast breathing. In a baby, that might mean that their nostrils flare with every breath, or 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. The muscles in the neck can pull in with their breath if they are put there by their shoulders over the collarbone.

“The other thing would be to watch for dehydration. Sometimes small children with a stuffy nose can have trouble drinking. It’s hard to drink a bottle if your nose is stuffy. She said that sometimes they give up, and they don’t drink enough.

It’s OK if they’re not eating, she said, as long as they’re still getting enough fluids. Keep an eye on the number of wet diapers a baby has every day.

Vaccines are sweeping through young children: How do people become more susceptible to viruses? A recent Krauland research assistant professor at the University of Pittsburgh

These viruses are sweeping through young children who have no prior exposure to them and no immunity. Older people and the immunocompromised are at higher risk too. Experts aren’t recommending dropping all guards to build immunity. But they do note that social distancing and masking measures played a role in throwing other viruses off their historical patterns. Mary Krauland is a research assistant professor in the school of public health at the University of Pittsburgh and says that by doing that, you prevent all things that are less infectious. “Over time, people are a little more susceptible.”

Hospitals have been more than 70% full for the vast majority of that time. During the Omicron surge in the US in January they were only 80% full.

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. 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.