The two hospitals providing the vast majority of Oregon’s pediatric intensive care capacity have transitioned to crisis care standards, the state’s latest health system step to tackle an influx of respiratory disease cases among children.
The crisis standards, developed by the Oregon Health Authority, help hospitals decide which patients receive care when resources are very limited and allow them to relax staffing standards so that nurses can attend to more patients.
The main culprit for sending infants and children to the hospital is RSV, or respiratory syncytial virus. The virus is particularly dangerous for infants and the number of children hospitalized with it has increased significantly in recent weeks. The influx of patients combined with continuing staff shortages have put a strain on hospitals.
The two hospitals, Doernbecher Children’s Hospital at Oregon Health & Science University and Randall Children’s Hospital at Legacy Emanuel, account for most of the state’s pediatric intensive care unit beds. Hospitals have a combined capacity of 44 beds, but the actual number of staffed beds fluctuates. Providence St. Vincent has four additional pediatric intensive care beds and can be expanded to six if needed, a Providence spokesperson said.
A week ago, there were a total of 40 staffed pediatric intensive care beds statewide, three of which were available, an Oregon Health Authority spokesperson said at the time. The OHA will release updated hospital capacity numbers on Wednesday.
In announcing its decision on Tuesday, Randall Children’s Hospital said it was postponing elective pediatric procedures, asking staff to work additional shifts and using “creative staffing options” to provide care. A spokesperson for Legacy Health did not say how many of its pediatric intensive care beds are available.
“This has been an unprecedented respiratory virus season, both in timing and in the number of children affected,” Randall Children’s Hospital Vice President and Chief Nursing Officer Cindy Hill said in a statement. announcing the transition. “We are implementing safe solutions to meet community demand for pediatric beds. »
Doernbecher activated crisis standards at 7 p.m. Monday. An OHSU spokesperson said its pediatric intensive care unit was at “full capacity.” The hospital does not yet triage care, but it uses crisis standards to allocate its resources more efficiently.
According to standards issued by the state in January of this year, hospitals can move to crisis care standards if their “critical care resources are severely limited, the number of patients presenting for critical care exceeds capacity, and there there is no option to transfer patients to other critical care facilities.
The hospital steps come just over a week after Governor Kate Brown declared a state of emergency due to rapidly rising hospitalizations among children. The declaration could free up resources for hospitals and give them more flexibility in staffing hospital beds. A recent OHSU forecast predicts hospitalizations for RSV will peak Nov. 30, at 129 admissions, up from 77 the week ending Nov. 9.
— Fedor Zarkhin
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