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Texas: Dell Children's MC swamped with flu patients, sets up tents

Gert van der Hoek

In Memoriam - Editor, Senior Moderator
Swamped with flu patients, Dell Children's Medical Center sets up triage tents

Flu also causing staffing shortage in ER.


By Mary Ann Roser

AMERICAN-STATESMAN STAFF

Tuesday, September 22, 2009

Dell Children's Medical Center is seeing so many children sick with what is presumed to be swine flu, it expects to start treating some of them in tents starting today.

The hospital was on pace Monday afternoon for an all-time record number of patients after seeing more than 200 before 3 p.m. — the normal load for a 24-hour period, said Sister Teresa George, chief operating officer. During the school year, the busy time starts after 3 p.m., when schools are out, George said. Hospital officials said most of the children arriving at the emergency room are mildly to moderately ill with the H1N1 virus. The hospital isn't routinely testing to determine what type of flu patients have, but federal health officials say virtually all flu circulating now is H1N1.

The hospital ER has seen steady increases in patients over the past couple of weeks, but the past week has been especially grueling, with some days easily exceeding 300 patients, said Dr. Pat Crocker, chief of emergency medicine at the hospital. When 343 patients swamped the hospital Sunday, officials decided to set up the tents and triage patients with less severe flu there starting today, officials said.

"There's no question there's still a certain amount of panic" over the H1N1 virus, also known as swine flu (a combination of pig, bird and human viruses), Crocker said. He said most of the patients coming in are at higher risk for complications from flu: They are younger than 5, have asthma or other chronic conditions or need to be seen by a doctor because of trouble breathing or a fever persisting longer than three days or are sicker than they should normally be with flu. Most don't need to be hospitalized.

Since April, 44 people have died of swine flu in Texas, including seven children under 18.

Set up just outside the ER entrance, the two tents, which were sweltering Monday afternoon, were going to be air-conditioned by today at a cost of $2,000, George said. Crocker said the tents could accommodate eight to 16 beds.

Officials expect patient volumes to stay high, and seasonal flu could hit as early as next month. Right now, about half of the patients are complaining of flu, said Dr. Thomas "Tate" Erlinger, Seton's director of research administration, infection prevention and epidemiology.

The volumes are higher than expected, Erlinger said.

Stella Castillo, 46, of Pflugerville, who stood in the hospital foyer just outside a packed waiting room at Dell Children's on Monday with her 16-year-old daughter, said some primary care doctors are telling parents to go straight to the ER because they are too busy to see any more patients. Children wearing masks swarmed around a desk not far from Castillo, who said she had been waiting about three hours.

The hospital staff is grappling with its own bout of illness. About 10 to 15 ER nurses are out sick with flu, George said. Dell Children's and its parent, the Seton Family of Hospitals, is scrambling to staff the ER, George said.

Seton is paying bonuses to nurses willing to work extra shifts, borrowing staff members from other floors at Dell Children's and bringing in nurses from other Seton hospitals, including the new Seton Medical Center Hays, which won't open in Kyle until Oct. 1, George said.

Dell Children's also has asked CommUnityCare, the public clinic system operated by the Travis County Healthcare District, to help out by extending clinic hours so that patients who don't need to go to an ER can be seen in a less costly clinic environment.

"The hours aren't extended yet, but we will if we need to," said David Vliet, CommUnityCare CEO.

What is happening in the ER is a sign of what is going on elsewhere in Central Texas.

In the Hays consolidated school district, a spokeswoman said several campuses reported that more than 10 percent of students in a particular grade level were absent. One campus, Science Hall, had a 14 percent absentee rate.

Roxanne Evans, a spokeswoman for the Austin school district, said it has not had "extensive absences from any campuses due to flu."

"I think it's going to be a very busy flu season," Crocker said.

maroser@statesman.com; 445-3619

Additional material from staff writer Laura Heinauer.

Think you or your child has the flu?

Call or see a doctor if:

The child is younger than a year old.

The person is more ill than you would expect.

Fever persists more than three days.

Symptoms include lethargy that does not improve after taking Tylenol.

There is an existing chronic illness or some other risk factor, such as pregnancy.

Go to the emergency room if:

Symptoms include shortness of breath, chest pain, trouble breathing, persistent vomiting, seizures or confusion.

Source: Dr. Pat Crocker, Dell Children's emergency medicine chief

http://www.statesman.com/news/content/news/stories/local/2009/09/22/0922swineflu.html

thanks to: http://twitter.com/Crof
 
Re: Texas: Dell Children's MC swamped wit flu patients, sets up tents

Re: Texas: Dell Children's MC swamped wit flu patients, sets up tents

Thanks for the link Dutchy!
 
Re: Texas: Dell Children's MC swamped wit flu patients, sets up tents

Re: Texas: Dell Children's MC swamped wit flu patients, sets up tents

Twitter updates from the hospital doctors:


Yesterday a whopping 68% of patients tested by our flu research group with ILI symptoms tested positive for type A flu. A new high rate.


Katie Couric CBS will cover our flu tent area tomm evening on her show, and CBS Early Show will do live spot from flu tents tomm morning.
 
Re: Texas: Dell Children's MC swamped wit flu patients, sets up tents

Re: Texas: Dell Children's MC swamped wit flu patients, sets up tents

TV: Flu 'widespread' across Texas; Dell Children's opens tent clinics

[SIZE=-1]05:45 PM CDT on Tuesday, September 22, 2009

[/SIZE]
[SIZE=-1]By CLARA TUMA / KVUE News & The Associated Press[/SIZE] Dell Children's Medical Center opened two tents outside its emergency room doors Tuesday to try and take some pressure off its ER, which has been inundated with patients complaining of flu-like symptoms.
<!--Start_Local_Custom_Inc--> <!-- sidebar insert start -->
September 22nd, 2009
KVUE's Clara Tuma reports
Related links:



<!-- sidebar insert end --> <!--End_Local_Custom_Inc--> In the first hour and a half, doctors in the tents treated 12 patients.
In order to be treated in the tents, patients must be older than 24 months but have had symptoms less than 48 hours.
The tents are open from 3 p.m. to 11 p.m., typically an especially busy time of day for the ER.
But not every patient complaining of the flu needs to see a doctor.
Pediatrician Kelly Thorstad, of Lone Star Pediatrics, says children under 5 or those with severe flu symptoms should seek medical help immediately.
"Most healthy children can be at home and just get a lot of chicken noodle soup and tender loving care," she said. "Their bodies need time to heal. It's younger children or severe symptoms we need to see."
She says many patients can be treated by bed rest and over-the-counter drugs to handle symptoms such as fever and aches and pains.
She says her practice is seeing many more cases of the flu than is normal for this time of year.
"Yesterday in the morning there were seven positive flu's, just in the morning," Thorstad said.
She says the H1N1 strain of flu is mild in most people, but can be serious, and even deadly, in some patients.
"We had a 7-week-old with the flu last week, that's been my youngest," she said.
Thorstad says the best flu prevention is well-known by now: Wash your hands a lot and don't go out when you're sick.
The Texas Department of State Health Services says a preliminary report shows flu is "widespread" across the state.
Department spokesman Doug McBride said Tuesday that it's assumed that most of that flu is the H1N1 strain, also known as swine flu.
Widespread -- the highest classification -- means there have been reports of an increase in flulike illnesses and lab-confirmed flu cases in at least half of the state's regions.

The seasonal flu shot is available now. The swine flu vaccine should be available by mid-October but will first be given to high-risk groups.
McBride says both shots are recommended as it's expected the cases of seasonal flu will increase.

http://www.kvue.com/news/top/stories/092209kvue_flu_widespread-cb.1a693c15d.html

credits dbg
 
Re: Texas: Dell Children's MC swamped wit flu patients, sets up tents

Re: Texas: Dell Children's MC swamped wit flu patients, sets up tents

"Twitter" update from Dell Hospital:



First afternoon in the tents was awesomely efficient. 343 total ED visits, 45 seen in the tents. Most all patients happy with the quick care

http://twitter.com/setonh1n1
 
Re: Texas: Dell Children's MC swamped wit flu patients, sets up tents

Re: Texas: Dell Children's MC swamped wit flu patients, sets up tents

Kids with H1N1 Camp Out at Hospital

Austin Facility Sets Up Tents Outdoors to Deal with Huge Influx of Flu Patients

(CBS) Since April, 44 people in Texas have died from the H1N1 virus. Now, some parts of the state are being overrun by people who have it. And one hospital in Austin has taken an unusual step to treat this new wave of patients.

CBS News correspondent Don Teague reports that the Dell Children's Medical Center has been bombarded with patients complaining of flu-like symptoms. So to deal with the influx, the hospital has set up tents outside.

Teague reports doctors at the hospital are seeing more than 200 people a day for flu symptoms alone.

Dr. Pat Crocker, chief of Emergency Medicine at Dell Children's Medical Center, said the tent triage area is used to treat "very low acuity patients." He said the tent serves as a place where people can get the evaluation and care that they need.

Patients, Teague added, are checked for symptoms, tested for flu and treated with Tamiflu, if necessary. The tent takes pressure off the primary emergency room, and helps get help faster for kids with flu symptoms, Teague said.

The tents were initially set up, Teague reported, because computer models indicated their flu situation was about to get worse.

Crocker added on "The Early Show" the hospital is concerned about the volume of patients.

"We can scale this up," he said. "But I think we're just at the very front of this. And we'll probably take four weeks to peak."

This giant influx of patients, Crocker said, aren't from panic, but rather legitimate health concerns.

"We have seen a large number of patients. And most of them actually meet the (Centers for Disease Control and Prevention) criteria for treatment and evaluation," he said.

However, Crocker said many of the people who are coming to the hospital for flu symptoms by and large do not require a hospital stay.

"The nice thing we've learned about the swine(H1N1) flu virus is it seems to be a mild to moderate flu," he said. Most people really don't even need to see a doctor. We're starting to see a very small increase in the number of flu-related hospital admissions. But it's not been with critically ill patients."

And who is getting sick?

Crocker said the influx is among children under 14 years old, but now, another demographic is being affected.

He said, "We're just starting to see a few cases in the older population."

source: CBS news
 
Re: Texas: Dell Children's MC swamped wit flu patients, sets up tents

Re: Texas: Dell Children's MC swamped wit flu patients, sets up tents

Source: http://www.statesman.com/blogs/cont...2009/09/29/third_flu_tent_opens_today_at.html


Third flu tent opens at Dell Children?s as volumes stay high

By Mary Ann Roser | Tuesday, September 29, 2009, 11:34 AM

Doctors and nurses are now seeing patients in a third tent outside the emergency department at Dell Children?s Medical Center to handle steady high volumes of children complaining of flu.

The tents, which went up Sept. 21 after swine flu cases spiked at the hospital, have proved to be ?awesomely efficient,? hospital officials said, with the average patient being treated and sent home in about 30 minutes.

Most patients who come to the ER complaining of flu are not very ill and are not hospitalized at Dell Children?s or at most hospitals in the Austin area, doctors said.
In general, the H1N1 swine flu virus causes a mild to moderate illness and can be treated at home. But there are times when a person needs a doctor or a hospital (more on that later).

With three tents now open, the hospital is using one to triage patients and two for treatment. There are six cots in each of the two treatment tents, said Matilda Sanchez, a spokeswoman for the Seton Family of Hospitals, which owns Dell Children?s.

Less severe patients are seen in the tents, and Seton is putting out brief reports on what?s happening there on Twitter, a Web site for sharing short blasts of information.


A Tweet today says that the ER is detecting a ?slight decrease in elementary students and a slight increase in high school student illness.?

In the past 24 hours, the ER saw 353 patients with more than 70 percent with flu or flu-like illness.

Schools in the Austin-area say their attendance is in the 90-something percent range and not unusual. No schools in the area have closed because of flu, but some in Texas have, including the following school districts: Huntsville, New Boston, Chisum and Lovejoy, according to the Texas Education Agency?s Web site. North Hopkins school district closed this month because of H1N1 but has reopened and so has Alief Montessori Community School, according to the TEA.


Now, back to the question about when to seek medical treatment with swine flu. I?m stealing this from a Q&A we ran Sunday.

Adults should go to an ER if they have trouble breathing; purple or blue lips; persistent vomiting; dizziness when standing; inability to urinate; seizures; loss of consciousness; altered thinking; or chest pains. Take a child who has fast or labored breathing; has bluish or gray skin; is not drinking enough fluids; is not waking up or interacting with others; is too irritable to be held; has symptoms that won?t go away; has a fever with a rash; or more illness than seems reasonable for flu.

Call a doctor if the sick person is under age 2; is pregnant; is over 65; has a fever more than three days; has a chronic health condition; or is on chronic aspirin therapy or other medicine that can affect the immune system.
 
Re: Texas: Dell Children's MC swamped wit flu patients, sets up tents

Re: Texas: Dell Children's MC swamped wit flu patients, sets up tents

From Twitter:

http://twitter.com/setonh1n1

Dell saw almost 400 patients again yesterday, the majority with flu or ILI.

Some are predicting 6 more weeks of very high volume. Me too.
 
Re: Texas: Dell Children's MC swamped with flu patients, sets up tents

From Twitter; october 8

Sudden decrease in flu/ILI patients yesterday.

Down to 114 from over 200 daily.

Too soon to say what it means in terms of flu pandemic.


http://twitter.com/setonh1n1
 
Re: Texas: Dell Children's MC swamped with flu patients, sets up tents

Snipped from http://www.statesman.com/news/content/news/stories/local/2009/10/09/1009fludeath.html

Hospital officials said earlier this week that they are seeing a slight increase in college-age people and adults with swine flu in their emergency rooms. But ER visits by children have fallen this week, prompting doctors to wonder whether the illness has peaked locally in children 15 and younger, according to Dr. Pat Crocker, chief of emergency medicine at Dell Children's Medical Center.

Dell Children's reported that it had experienced a sudden decrease in flu illness Wednesday, seeing just 114 people compared with more than 200 a day in recent weeks.
 
Re: Texas: Dell Children's MC swamped with flu patients, sets up tents

Twitter, today oct 19 2009:

Past 24hrs 257 patients at Dell ED. Still about 20% above normal volume for this time of year, but definitely some decreased flu activity.

Using the model we were able to treat most patients in under 30mins from arrival at the hospital to discharge.


The Dell Flu tents are closing as the volume of patients with Flu/ILI is now manageable without them. Weha!

http://twitter.com/setonh1n1
 
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