Children’s National Hospital in D.C. is among hospitals nationwide that are seeing a significant increase in emergency department visits and admissions.
As a result, the hospital is warning families with non-urgent issues that they may experience long waits before they are seen.
The increase in emergency department visits and admissions is due, in part, to a spike in viral respiratory infections, including Respiratory syncytial virus, or RSV, and the flu.
While measures have been implemented to accommodate the higher volumes to deliver safe care, hospital volumes are expected to remain near capacity in the near future, the hospital said.
“When a child in our hospital or emergency department is facing a life-threatening emergency, there is no wait time,” Children’s National said in a statement.
There are many options and resources available for children who are sick but not in severe distress.
“We certainly aren’t invalidating you or saying your child isn’t sick or doesn’t need some medical attention. It just might not need to be emergent, or ‘right now’ medical attention,” said Dr. Sarah Ash Combs, a pediatric emergency medicine attending physician and director of outreach for the emergency department at Children’s National Hospital.
Parents who have a regular pediatrician for their children can call the pediatrician’s office.
“Every pediatrician should have an after-hours call line. That might be a nurse who is staffing that, they will be able to get back to you and give you some over-the-phone triage advice,” that might include scheduling a next-day visit, Combs said.
Visiting an urgent care center might be an option for families outside the immediate D.C. area or who are away from home.
“Symptoms that are mild can stay at home,” she said. “If your child is coughing, but is still able to speak in full sentences, play, not have trouble breathing, regardless of whether that cough is COVID or RSV, you are OK to manage that at home. You can give them plenty of fluids, plenty of rest.”
A child with a fever might be more comfortable if treated with an over-the-counter medicine.
“Bear in mind, it’s a sign your child’s immune system is actually working to drive out the virus. So, it is a sign things are going right within your child’s body. And, if you can bring that fever down with an over-the-counter medication (such as) acetaminophen or ibuprofen, then your child might feel better just by having their temperature brought down a little bit at home.”
When is it time to seek immediate professional care?
Combs said it’s an emergency when a child’s ailment includes signs of respiratory distress. She has advice for what to look for.
“You need to see what’s going on with their belly and underneath their rib cage. If they are sucking in air, meaning you will see their belly pushing in and out, you will see between their rib cage, the skin is folding in and collapsing with every breath — that is a sign of what we would call respiratory distress,” she said.
“Certainly, if your child is changing colors, going bluish purple around the lips; if they are at the point of trouble with breathing, such that they are close to fainting or really having trouble going about their usual activity, unable to even form a full sentence, if they’re at the age where they normally do that — those are the red-flag signs.”
The hospital said that the current surge in illness is exacerbated by the national health care workforce shortages. As reported by The New York Times, some hospitals have responded by closing pediatric inpatient beds and even closing pediatric ICU beds.
“We can’t 100% prevent respiratory viral illness or flu, and we can’t 100% prevent the spread. But we do have ways to mitigate it,” Combs said. “We had really low numbers of respiratory viral illnesses at the peak of the pandemic, when we were masking, hand-washing, social distancing. So, if you can keep doing those things as much as possible, that would be helpful.”
Also, every child 6 months and older is eligible for a flu shot and COVID-19 vaccine.
“And make sure your entire household is vaccinated, particularly if you have a baby in that under-6-month age group because then, they cannot get the vaccination themselves. So you need to protect their surroundings for them,” Combs said.
