RSV and flu cases in kids are hammering children's hospitals : Shots - Health News - NPR

Waiting for their crook successful the ER, dazed-looking parents successful wintertime coats bounce crying children successful their arms, trying to drawback the oculus of Dr. Erica Michiels. Us! Pick america next! they look to plead with bushed eyes.

Michiels directs pediatric exigency medicine astatine Corewell Health Helen DeVos Children's Hospital in Grand Rapids, Michigan. Lips pressed unneurotic successful a bladed line, she surveys what she calls the "disaster" area.

"People person been retired present waiting for a mates hours, which is heartbreaking," she says.

Typically, the ER astatine Devos Children's sees astir 140 kids each day, according to Michiels, but connected a caller Tuesday successful mid-December, they saw 253.

"I hatred erstwhile we person a wait," sighs Michiels. "But for close now, we can't bash it immoderate different way."

Like truthful galore different children's hospitals crossed the nation, the unit astatine DeVos Children's has been stretched beyond capableness by waves of patients with RSV and, increasingly, the flu.

This surge of sick kids is coming aft years of immoderate U.S. hospitals cutting back connected pediatric beds — successful portion due to the fact that it is typically much profitable to dainty big patients.

The remaining pediatric beds are progressively concentrated successful municipality areas, leaving families successful agrarian areas to travel longer and longer distances to get the attraction their kids need.

When the section ER can't assistance

When Staci Rodriguez brought her nine-month-old lad into the ER successful their tiny municipality of Shelby, Michigan, she was desperate. Santi, who has large brownish eyes and agelong eyelashes that everybody gushes over, had been sick for days.

First Santi stopped eating, truthful she took him to urgent care. Then helium started sleeping 20 hours a day, truthful she went to the pediatrician. Rodriguez says everyone told her Santi was conscionable warring a virus, and sent them home.

Within hours of leaving the pediatrician though, Santi "was truthful overmuch worse," she says. "His fever was mode excessively high. I couldn't get it down." She took him to the ER, wherever doctors told her Santi had RSV, and that his oxygen saturation levels were dangerously low.

Rodriguez says unit astatine the Shelby infirmary told her they couldn't springiness him the attraction helium needed, that they didn't person the due equipment.

Out of 130 acute attraction hospitals successful Michigan, lone 9 presently person pediatric ICUs, according to the Michigan Health and Hospital Association.

The ER wanted to transportation Santi immediately, but Rodriguez says that archetypal determination was an agonizing hold portion the aesculapian squad deliberated wherever to nonstop him: Muskegon was overmuch closer, but DeVos could connection much intensive care. "So they sent america to DeVos, and helium had to thrust successful the ambulance."

The travel took an hour. "I thought I was going to beryllium capable to clasp him," Rodriguez says.

But for safety, Santi needed to beryllium strapped to the stretcher. "Luckily, helium conscionable benignant of stared astatine maine the full time, and past yet fell asleep."

Rodriguez watched the beeping monitors arsenic she recounted their communicative successful the infirmary country astatine Devos Children's, which has been partitioned to marque country for different sick babe and his family.

Moments before, six unit members had assembled astir Santi's bed, speaking successful brushed tones arsenic they worked to thread a tiny feeding conduit done his nostril. Next they held down his chubby arms, and kept him inactive adjacent arsenic helium wailed, truthful they could instrumentality an x-ray to corroborate the conduit had been placed properly.

Now Santi lies comfortably connected his mother's chest, a tiny oxygen conduit taped to his face. His breathing is labored, and helium struggles against sleep, keeping some his eyes connected his dad, Saul Botello.

"I hatred seeing him similar this," Botello says, his hands successful his sweatshirt pocket, his ain eyes glued to his son. Eventually, Santi's dense lids close, and helium slips into a fitful slumber successful the infirmary crib. His ma rubs his back, shushing him softly.

"He'll beryllium fine, conscionable person to enactment him done [this]" says Dr. Andrea Hadley, main of pediatric medicine astatine DeVos.

Turn kids away, oregon agelong unit adjacent further?

Hadley is the 1 who gets the hopeless calls from smaller hospitals oregon freestanding ERs successful agrarian areas, asking if they tin transportation their patients to DeVos Children's. "I person had galore calls travel successful wherever they said 'We've called 15 different places and they've each said no.'"

Big children's hospitals similar DeVos regularly get transportation requests. But successful caller weeks, the calls are coming from a overmuch larger geographical area, including parts of Illinois. Patients who unrecorded successful Michigan's Upper Peninsula typically spell to Wisconsin for care, Hadley says. But now, those hospitals are full, too.

In response, DeVos Children's has doubled up their rooms, squeezing 2 patients (and their families) into rooms meant for one. The infirmary is besides allowing nary much than 1 genitor oregon guardian to enactment overnight. Even with those changes, Hadley says, the infirmary lone has capableness to attraction for the sickest children.

"We've had to say, 'We spot you, we're going to enactment you, but we can't bring you present yet.'"

Hadley says that successful the past, they'd instrumentality each the referral requests.

Across the wellness attraction industry, pandemic-era staffing shortages are adding to the strain. Michigan has mislaid 1,700 staffed infirmary beds since 2020, according to the Michigan Health & Hospital Association. That's near children's hospitals scrambling during this RSV and influenza surge.

At the Children's Hospital of Michigan successful suburban Detroit, there's lone capable unit to screen astir 60% of the beds, according to main aesculapian serviceman Dr. Rudy Valentini. With 40% of beds unavailable, children who request to beryllium admitted person to hold successful the ER until a furniture opens up.

"So we person ICU patients successful our exigency section that can't get up to our ICU, due to the fact that either there's nary disposable beds, there's nary disposable unit beds," Valentini said December 6th.

The sheer fig of pediatric patients, the furniture closures, and the staffing shortages person created a cleanable tempest for children's hospitals, leaving them with hard decisions.

"There's besides a motivation distress associated with the thought of having to crook patients away," Hadley says. "And however bash we equilibrium that distress that comes with knowing potentially, if we arsenic a strategy don't agelong a small more, that determination mightiness beryllium patients that are turned away?"

But stretching unit who are already "on the brink of burnout" comes with its ain risks, explains caregiver manager Jamie West. On her level astatine Helen DeVos Children's Hospital, determination are capable nurses to safely attraction for a full of 18 patients. But recently, West says they've had to agelong the aforesaid fig of nurses to attraction for up to 33 earnestly sick patients. They don't person capable physics monitors for each diligent either, Hadley adds.

"These kids are conscionable truthful overmuch sicker [than we typically spot during RSV season,]" West says. "And erstwhile you deliberation astir nurses that are already successful precise ample diligent assignments, nurses are precise disquieted that their child's going to spell downhill precise quickly, that they're going to possibly miss thing due to the fact that they're dispersed truthful thin."

'You're not going to nonstop america home, right?'

In the exigency section astatine DeVos Children's, Dr. Michiels is simply a changeless blur of motion. One moment, she's doing a sepsis work-up for a 12-year-old lad whose fever won't break. The adjacent moment, her pager goes disconnected and she's striding down a agelong linoleum hallway to the country that's been designated arsenic the "resuscitation room." Staffers effort to support that 1 country open, Michiels says, for "the adjacent bluish baby" who's rushed in.

In a country astatine the extremity of the hall, Caitlyn Houston hovers implicit her seven-week-old daughter, Parker, arsenic nurses necktie a tiny set astir the baby's flailing arm. Parker's reddened look bunches up successful distress, her cries filling the tiny room. We're going to admit her, Dr. Michiels tells Houston, and astir apt to the pediatric intensive attraction unit.

Still Houston can't assistance but ask: "But you're not going to nonstop america home, right?"

No, Michiels reassures her softly. The 2 of them tin stay. Houston says they've spent the past respective sleepless nights successful and retired of the ER.

"There's truthful galore kids successful present that they person to instrumentality the ones that are truly bad," Houston says.

"And adjacent 2 nights agone successful the mediate of the night, the ER was packed. So we were determination for 2 hours, waiting."

Being told your babe whitethorn request lifesaving aesculapian involution is ne'er bully news, but for parents similar Houston, being admitted to the infirmary brings a feeling of relief. Their kid volition astatine past get a bed.

This communicative comes from NPR's wellness reporting concern with KHN (Kaiser Health News) and Michigan Radio. It was edited by Carrie Feibel, with photograph editing by Max Posner.