Children's Hospitals responds to surge in H1N1 cases

A surge in suspected cases of flu has forced a hospital in St. Paul to call in extra staff and open up some more treatment space for emergency room patients.

Over the weekend, Children's Hospitals and Clinics of Minnesota recorded its second-highest patient volume ever at its St. Paul campus. On Sunday, 195 patients came through the emergency room, and approximately half of those patients were suffering from flu-like symptoms.

Children's busiest emergency room day ever was just last May when 197 patients came through the St. Paul campus in a single day. That was during the first wave of H1N1 influenza illnesses.

Now, a second wave of flu has arrived and the emergency department's 17 rooms are in demand.

"Right now, if I look at the board, yeah, they're all full and there's approximately eight patients in the waiting room," said Robert Sicoli, an emergency medicine pediatrician at Children's.

Sicoli said hospital staff knew this second wave of illnesses was coming, but he said it still seems strange to be treating flu cases in October.

"You know we're a little surprised because we haven't seen this kind of volume before except this spring," he said. "So while we're, I wouldn't say shocked, but prepared."

The increase in patients last spring tested the limits of the Children's emergency department. That's why the hospital has now decided to open up non-emergency room space to treat patients faster. The extra clinic rooms are located one floor above the emergency room and down a long hallway.

During the day the space is used for regular pediatric office visits, but in the evening, Sicoli said the rooms are completely empty. And that's usually when the emergency room is the busiest.

"We have not had long wait times and certainly are prepared to deal with it when our volumes get high."

"They are general clinic rooms that are very well equipped with a very nice working space and in the evenings the space isn't completely utilized," he said. "So it was a good fit for us."

Patients getting care in these rooms will have some of the simpler conditions to treat - like strep throat or a sprained ankle. Children's has added a doctor, a nurse and three other workers to staff the 9 overflow rooms.

The hospital is fortunate to have the extra space right in its own building. Hospitals around the country have had to be creative in dealing with the pandemic.

"There are other children's hospitals in the U.S. that have the luxury of having warm weather and have set up tents outside of their hospitals and done triage and treatment out in tents outside," said Patricia Stinchfield, director of pediatric infectious disease at Children's. "I've heard of hospitals having as long as six-hour wait times to get into the emergency room. We have not had that here. We have not had long wait times and certainly are prepared to deal with it when our volumes get high."

Children's has also seen more patients than usual at its Minneapolis campus. So has the University of Minnesota - the other big children's hospital in the Twin Cities. Both hospitals say most of that increase is attributed to influenza, but neither hospital has had to open up overflow space yet.

In fact hospital sources say the number of flu cases would have to climb much higher before state officials would need to consider setting up alternative flu care sites such as armories and civic centers.