Some Portland area hospitals move to crisis care standards for pediatric care | HealthWatch

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PORTLAND, Ore. — Oregon health officials are putting a few Portland-area hospitals on crisis-care standards.  They’re also asking people to act to lower risks for child respiratory illnesses. 

Children’s hospitals in the Pacific Northwest are struggling to maintain enough space for young patients. Some report being beyond capacity due to a surge in respiratory illness and hospitalizations. Three Portland hospital have moved to crisis standards of care. OHSU’s Doernbecher Children’s Hospital and Randall Children’s Hospital at Legacy Emanuel have pediatric intensive care units.

Providence Health & Services says today it is experiencing a high number of babies and young children with RSV, or respiratory syncytial virus, requiring hospitalization. It says it is seeing the increase only in the Portland area in Oregon and, “In order to maximize the number of pediatric patients we can care for, Providence St. Vincent Medical Center’s pediatric intensive care unit, pediatric unit and neonatal intensive care unit are moving into crisis care standards, as specified by the Oregon Health Authority. This will help us manage capacity to address the overwhelming demand for hospital services.”

Providence notes that the Oregon Health Authority (OHA) says this status change is activated when patient care resources are severely limited, the number of patients presenting for care exceeds capacity, and there is no option to transfer patients to other acute or critical care facilities.  Providence says, “Today, in the Portland metro region, we meet that criteria.”

In neighboring Washington state, health officials in King County, home to Seattle, have reported the first death of a child from flu complications this season. 

RSV hospitalized baby, CDC 2012.png

RSV hospitalized baby, CDC

State health officials also are asking people to take immediate, urgent and individual action to protect children. Oregon health officials expect RSV cases to peak after Thanksgiving, which OHA says, “will further strain pediatric hospital intensive care units in the Portland area that are already at their limit.” 

In response to Oregon’s acute shortage of pediatric intensive care beds, state health officials recommend that people:

  • Stay home when sick.
  • Cover coughs and sneezes with the inside of your elbow, or with a tissue that you immediately throw away after use.
  • Clean and disinfect all high-touch surfaces, including doorknobs, faucets, chairs, countertops and tables.
  • Regularly wash hands with soap and water or use hand sanitizer, especially after coughing or sneezing into a tissue.
  • Get a flu shot and stay up to date on COVID-19 vaccinations, including new bivalent boosters. There is no vaccine for RSV.
  • Consider wearing a mask in crowded indoor spaces. 

Doernbecher Children’s Hospital and Randall Children’s Hospital notified OHA they enacted crisis standards of care for their pediatric intensive care units. Crisis care standards allow hospitals to adjust their staffing to help treat as many critically ill children in the state as possible. 

RSV is circulating among Southern Oregon kids, public health officials say

Oregon Health Authority Director Pat Allen said, “Oregon children’s hospitals are pushed to the limit. If you have young children and they get sick, there may not be a hospital bed for them.” 

Providence St. Vincent Medical Center’s Genevieve Buser, MDCM, is a pediatric infectious disease specialist. She says, “Children have been especially hard hit, and we are caring for unprecedented numbers of very sick young people in our hospitals, immediate care facilities, and clinics. Right now, more than half of our kids sick enough to be hospitalized have RSV (respiratory syncytial virus), and almost all of those are babies less than 6 months of age.” 

Dr. Buser added that because Oregon is in a crisis for critical pediatric hospital beds, “we should do what we can as a community to slow transmission to our most vulnerable neighbors,” including getting COVID and flu vaccinations. “Older adults, too–especially those with chronic lung disease–can become very ill with RSV, in addition to COVID and flu.” 

State health officials are working with hospitals to get additional nurses into Oregon from out of state. OHA officials also are pursuing health care volunteers through the state’s emergency volunteer registry Serv-OR. OHA says it also is providing hospitals with recent legislatively appropriated funds to support staffing. 

OHA says parents of children younger than 5, especially newborns to 6-month-olds, are especially advised to take precautions that keep their children safe and help to limit the spread of RSV and influenza in coming weeks. Young children, as well as older adults – people 65 and older – are at higher risk of severe illness from these respiratory viruses, including hospitalization and death. Data showing that the RSV hospitalization rate for children quadrupled between October 29 and November 19, from 2.7 to 10.8 children per 100,000 population. RSV hospitalizations are expected to rise more during the next few weeks. 

RSV is a common contagious virus that infects the human respiratory tract. 10.25.22 Credit NIAID.png

RSV image, 10.25.22, Credit NIAID

OHA says a rapid increase in influenza cases around the state are contributing to more hospitalizations. OHA’s weekly Flu Bites influenza surveillance report says the percentage of positive influenza tests has doubled each week since mid-October – it was 1% the week ending October 22, 2% on October 29, 4.5% on Nov. 5, 9.3% on November 12 and 16.4% on November 19. 

A 5% positivity rate for influenza tests is considered a threshold for significant influenza circulation. 

OHA advises, “RSV is a common respiratory virus that usually causes mild, cold-like symptoms, such as runny nose, coughing and sneezing. Most infections go away on their own in a week or two. Almost all children will have had an RSV infection by their second birthday. 

People experiencing mild RSV symptoms should: 

  • Stay home from work or school, and avoid indoor and outdoor holiday gatherings and events.
  • Manage fever and pain with over-the-counter fever reducers and pain relievers.
  • Drink plenty of fluids to prevent dehydration.
  • Make sure to talk to your health care provider before giving your child over-the-counter cold medicines which are typically not indicated for this age group.

While cold-like symptoms are more typical of RSV infections, some children can experience severe symptoms requiring immediate care. Parents should call their pediatrician or seek care right away if child has any of the following symptoms: 

  • Difficulty breathing or increased work of breathing.
  • Symptoms of dehydration, or fewer than one wet diaper every eight hours.
  • Gray or blue color to tongue, lips or skin.
  • Decreased activity and alertness.

Some children with RSV may be at increased risk of developing a bacterial infection, such as an ear infection. Call your pediatrician if your child has: 

  • Symptoms that worsen or do not start to improve after seven days.
  • A fever of 100.4°F or higher if they are younger than 3 months old (12 weeks).
  • A fever that rises above 104°F repeatedly for a child of any age.
  • Poor sleep or fussiness, chest pain, ear tugging or ear drainage.

For more information about RSV, visit OHA’s RSV page. Information about influenza is available at OHA’s Flu Prevention page.”

Human Respiratory Syncytial Virus (RSV) Credit NIAID.png

Human Respiratory Syncytial Virus (RSV), 10.26.22, Credit NIAID

Some Portland area hospitals move to crisis care standards for pediatric care | HealthWatch

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