Swine Flu: Heavy at Some Hospitals, Mild at Others

"You take all of our volume, all of the things we need to deal with in the [emergency department], and you throw on something where we are maybe seeing 20 or 30 more patients a day, it pushes that situation closer to the breaking point," he said. "I think the concern that all of us have is, 'How much more can you absorb?'"

Two of the cases at Ohio State University Hospital were severe enough to have required a technique known as extracorporeal membrane oxygenation, or ECMO -- a step up from the usual intensive care which is reserved for patients whose lungs are so severely damaged that they can no longer function properly.

A couple of miles across town, Dr. Dennis Cunningham, medical director of the epidemiology department at Nationwide Children's Hospital in Columbus, Ohio, said staff there have also been working hard to deal with the bump in emergency department visits.

"I will say that we have increased the staffing in our emergency department to more than our usual level, even during the winter," he said. "We're doing OK with space, but it is hard on the staff because people are working longer hours than they normally would."

Will It Get Worse?

But even as medical centers in Ohio appeared to be dealing with elevated activity from the virus, there were hints that the flu activity could be tailing off, at least slightly. According to Nationwide Children's Hospital, the combined number of patients who sought care at the hospital's emergency department and four urgent care centers peaked on Oct. 12 at 958 before it began to trend downward. On Oct. 22, the combined patient volume was only 661 -- still higher than the typical October average of 476, but a marked improvement over past weeks.

Satkowiak noted that not all of the patients with flu-like symptoms now pouring in to emergency departments around the country actually need to be there.

"We are seeing kids who do have the flu or flu-like symptoms, but the other thing we're getting is families who are pressing the [emergency department] button earlier because of what they're seeing in the news," he said. "We are also seeing a lot of primary care physicians who are pushing the ED button when their patients are seeing them with flu symptoms."

But with flu season around the corner, doctors agree that it is no time to relax.

"When you talk to infectious disease experts, what they will always say is that the only thing that is predictable about influenza is that it's unpredictable," Cunningham said.

"I've been doing this for 21 years, and there's just no way to predict what will happen with influenza," Satkowiak agreed. "We have no idea what the seasonal flu is going to do."

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