Faced with the considerable increase in the number of seriously ill children due to the circulation of respiratory viruses, the Montreal Children’s Hospital (MCH) has resigned itself to placing up to two patients per room in its intensive care unit, an “unprecedented” situation for the establishment.
Five of the 12 rooms in the MCH’s pediatric intensive care unit have been redesigned to accommodate two patients if needed, something never seen before for this hospital. At the moment, a single room houses two patients, however, specifies the establishment.
“The MCH is currently experiencing very high traffic, not only for consultations [aux urgences]but also because there is an increased number of more severe cases that require hospitalization, ”says one of its spokespersons, Christine Bouthillier.
However, the hospital claims to have followed “a precise protocol for infection prevention and control”, ensuring that the two patients present in the same room must have the same virus and not be intubated at the same time.
“Never have two intubated patients been entrusted to the same nurse. […] The sickest patients require two nurses; otherwise, the ratio is one patient per nurse, particularly if he is intubated,” says Christine Bouthillier.
A terrible winter
“Yes, there are risks in doing it, but the risks are even greater in not doing it,” summarizes the associate director of professional services at the Montreal Children’s Hospital, Dr.r Robert Barnes.
The overflow of pediatric hospitals is explained by the unprecedented number of young children infected with respiratory viruses, an indirect consequence of the health measures adopted during the pandemic.
Every winter we have children who are regularly sick, but right now we have a lot. It’s a terrible winter, and it’s not winter yet. It’s even earlier than usual and much more intense.
The Dr Robert Barnes, Associate Director of Professional Services at the Montreal Children’s Hospital
As the situation is “unprecedented” at the HME, “it is therefore difficult to predict how long it will last”, says the establishment.
In response to this situation, the MCH had to transfer teenage patients to its partner adult hospital, the Royal Victoria Hospital. Children whose condition allows it are also transferred to the intermediate care floor, which however is also overflowing.
If the situation requires it, the Children’s believes that it would be able to “enhance” the intermediate care floor in order to accommodate more children requiring intensive care. The opening of a space specially dedicated to this care elsewhere in the hospital is also envisaged, but as underlined by Dr.r Robert Barnes, personnel issues arise.
“Nor do we have an unlimited number of caregivers with these skills to [traiter] these sickest children. We don’t want to divide them in two […]. That’s why right now, we’re over our dozen [de lits en soins intensifs] at the same location. »
Other overwhelmed hospitals
This situation is not unique to the MCH, says the Dr Robert Barnes. “It’s already everywhere in Quebec, we’re not the only ones at all. All pediatric intensive care units are busy. »
A network has been set up through the province’s four university hospitals (there are two in Montreal, one in Quebec and another in Sherbrooke) to quickly determine where a child in a critical situation should be sent if the establishment where he first goes is overwhelmed.
At the Soleil mother-child center of the CHU de Québec-Université Laval, the head of the pediatrics department, Dr.r Marc-André Dugas, indicates that we have not yet been forced to place two children in the same room in the intensive care unit, even if this has already been done in the past. But “I wouldn’t be surprised if, by tonight, we have to do it,” he adds.
“It’s an additional stressor for families. When one of the two children is less well, these are situations that are far from ideal,” he explains, adding that it is possible to resort to this solution only for infants, because it is not there is not enough space for two children’s beds.
At the CHU Sainte-Justine, where the situation seems better under control, the available space has made it possible to set up a new temporary 8-bed pediatric care unit.
The establishment also claims that it has not yet resorted to transferring patients to adult establishments.
In Sherbrooke, the CIUSSS de l’Estrie-CHUS pediatrics department is also overflowing, says its director, Dr.r Jean Sebastien Tremblay Roy. At the moment, it has six intensive care beds, but the number of children being treated there is currently seven and “we are preparing to have up to twice as many”, warns the latter.
Remember that Quebec Public Health is now recommending that citizens start wearing a mask again in busy public places, in the context where a “trio of respiratory viruses” circulating in the province is already exerting increased pressure on hospitals in the approaching the holidays.