The 2017-2018 influenza season has been one for the record books. With another 2+ months to go, the flu has already become widespread across the U.S., put more than 11,00 people in the hospital, and left many facilities scrambling to handle overcrowded emergency rooms.
Children have been particularly hard hit, with the CDC reporting 37 flu-related deaths as of January 31.
Respiratory therapists are on the front lines, and nowhere is that more true than in the pediatric setting.
400 kids per week
“We are testing approximately 400 children a week,” said Aracely Bigelow, BSHCM, RRT, RPFT, pulmonary function lab manager at Driscoll Children’s Hospital in Corpus Christi, TX. “Twenty-five percent are flu positive.”
For November and December, the hospital saw an 80 percent increase in respiratory-related patient encounters in the emergency department. The hospital has also seen an increase in flu-related hospitalizations and some admissions to the PICU, but thankfully no deaths so far.
The respiratory care department is working overtime to keep up with the demand.
“Our staffing needs were increased by 2.0 FTEs,” Bigelow said.
That has been tough, given RTs and their own families are being sidelined by the flu as well in this season of low vaccine effectiveness.
“The amount of staff available has varied day by day as the flu was finding its way to our staff and their families,” she said.
Taking a toll
Suzi Westmoreland, RRT-NPS, manager of respiratory care services at The Children’s Hospital in Greenville, SC, says the influenza crisis has taken a toll on her department too.
“We have had real issues with staff testing positive for the flu,” Westmoreland said. “Our employee health requirement is that if they test positive, they must be out at least five days post positive test and 24 hours with no fever.”
The recommendations call for clinicians who work directly with children to be out seven days.
That’s left her department shorthanded at a time when the need for their services is soaring.
Ready to go
Influenza – and respiratory conditions in general – have been on the rise at Children’s Hospital of Colorado in Denver as well, says Joyce Baker, MBA, RRT-NPS, AE-C, pulmonary therapist IV and asthma liaison for the respiratory care department and Breathing Institute.
Since mid-December the hospital has seen an increase in not only the flu, but in cases of coronavirus and RSV too.
“Our emergency department capacity has been high over the past several weeks and just in the last several days we are seeing high organizational capacity,” Baker said. “We are seeing increased number of kids who have a history of asthma being admitted with viral pneumonitis.”
In many cases, kids with mild to moderate respiratory disease are requiring noninvasive ventilatory support with modalities like CPAP and BiPAP, and respiratory therapists are also providing inhaled bronchodilators, positive pressure ventilation, and other therapies as well.
Education is an important component, with therapists taking the time to ensure patients and families are up to speed on nasal suctioning, inhaled bronchodilator therapy at home, and recognition of worsening signs and symptoms.
The season has been a bad one, but Baker says her department was ready for it.
“Our department has prepared for this respiratory season like any other, with an aggressive hiring plan for permanent staff and onboarding travelers for the season,” Baker said.
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