Doubling of patients throws children’s hospitals into ‘crisis’

Non-essential work cancelled after big increase in children presenting with respiratory infections

Children’s hospital emergency departments say they are “in crisis” due to a recent doubling in the number of patients attending.

The number of children presenting to Dublin’s three children’s hospitals and the urgent care centre in Blanchardstown is up 50 per cent compared to the same period in 2019, which was their busiest year on record.

The units are under “extreme pressure” due to an early rise in seasonal respiratory illnesses, according to Children’s Health Ireland (CHI).

An average of 600 children a day are attending the hospitals, compared to a normal level of 300 to 400, it said.


Significant pressure

“The vast majority of these children do not require medical review and parents are advised to consider caring for their child at home or explore other care pathways such as their GP or local pharmacy if their child has milder symptoms and does not need emergency or urgent care,” said CHI.

Inpatient and intensive care beds are also under significant pressure because a small proportion of the children with severe symptoms caused by respiratory syncytial virus (RSV) and other viruses require admission.

The hospitals have cancelled some planned elective and routine inpatient admissions “in the coming weeks and over the winter period”.

CHI apologised to families whose children have had procedures postponed at short notice and said it would reschedule them “at the soonest possible opportunity”.

“Many emergency departments are currently overwhelmed but there has been a huge increase in the number of children presenting to CHI at Temple Street, Crumlin, Connolly and Tallaght,” said clinical director Dr Ike Okafor. “We are in a crisis right now with the numbers of patients attending our EDs and urgent care centre. Wait times are extremely long and our staff are doing their best but they are exhausted and we don’t have the space to accommodate the numbers presenting.”

Paediatrician Louise Baker said there had been a big increase in children presenting with fevers, which “usually aren’t serious”. Advising parents to manage children with mild viral illnesses during paracetamol or ibuprofen, she said such presentations were taking time and resources away from critically unwell children.

Trolley numbers

Meanwhile, hospital managers across the Health Service Executive have been ordered to take “immediate action” to deal with high trolley numbers. Last Monday’s count of 530 patients on trolleys, as measured by the HSE, was one of the highest figures for years.

Amid fears that next week could be even worse due to a post-bank holiday backlog, HSE chief operating officer Damien McCallion has instructed hospitals to activate their escalation plans for the winter and to ensure “all necessary actions are taken to mitigate the risks for patients over the coming weeks”.

“Of particular concern at present is the increased length of stay and the high numbers of patients in our hospitals where there are delays in the transfer of their care,” Mr McCallion stated in his letter to senior staff. “These patients require urgent attention in order to reduce these indicators in line with commitments given in our Winter Plan. Even small improvements in these areas would release capacity in our system.”

Mr McCallion called for a “key focus” on over-75s and a “redoubling of efforts” to ensure more staff were boosted against Covid-19.

The HSE warned patients they will face “significant delays” over the next week and it urged people to consider all other care options before attending an ED.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times