MONTREAL — As Montreal’s two pediatric hospitals experience overflows in their emergency rooms, parents are asked to stay home if their child does not require immediate care.
For the entire month of October, patients with minor health problems, who are in categories P4 and P5, represented more than 50% of emergency visits at the Montreal Children’s Hospital. Similar scenario at CHU Sainte-Justine, where these categories of patients represented 40% of emergency visits.
The average occupancy rate of the emergency department at the Montreal Children’s Hospital was 140% for the month of October. At CHU Sainte-Justine, it stood at 120%, with a marked increase in traffic during the last week of October, when the average occupancy rate reached 142%.
“The pediatric network is already a little saturated, even in other secondary hospitals. We cannot manage to treat in a way… I would say ideal for patients,” shared in an interview Dr. Antonio D’Angelo, medical head of the emergency department at CHU Sainte-Justine.
It is mainly viruses and respiratory infections which cause great pressure on emergency rooms. Dr. D’Angelo reminds that children who have a cold, flu or gastroenteritis and who have mild symptoms should expect to wait several hours before seeing a doctor.
“We are still in the fall, but the winter viruses are already starting to take hold and we also have infections such as atypical pneumonia which are a little more present this year,” he said. This means that we have more patients occupying stretcher places and sick patients in the emergency room and also in the hospital. We are hospitalizing a lot more patients these days, so the hospital is very full.”
Depending on the time of day, traffic rates can be particularly high. Some patients “easily” wait up to 12 hours, Dr. D’Angelo reported. “In all the patients we see, there are many patients who are less sick, who simply have a cold or a stomach bug who do not necessarily require emergency care, so they wait longer.”
The medical director of the emergency department at the Montreal Children’s Hospital, Dr. Harley Eisman, emphasizes that emergency services must be reserved for people whose state of health requires immediate care. He invites parents to come to walk-in clinics or call 8-1-1 if their child is not seriously ill or injured.
The two pediatric hospitals, however, want to be reassuring: no child requiring medical care will be refused. They advise going to the emergency room, among other things, in the event of a fever in a baby less than four months old, if a child has difficulty breathing or if he or she shows signs of dehydration due to vomiting or diarrhea.
A consequence of the lack of access to the front line
The current situation in pediatric hospitals is not unique to this year. “As soon as it starts to get cold, viruses arrive and there are many parents who worry about the condition of their child. And it’s understandable, I sympathize with the parents, assures Dr D’Angelo. They are often young parents with new babies. They don’t have a lot of experience and there’s not a lot of support in the community necessarily or resources for them.”
The medical head of the emergency department at CHU Sainte-Justine recognizes that many children do not have a family doctor. For those who have one, parents sometimes have difficulty getting a medical appointment because access is difficult. They turn to the emergency room if the available appointments are too far away.
However, the emergency room is not a good option for minor illnesses, repeats Dr. D’Angelo. The care units are full, he said. In the emergency room, a section is reserved for sicker patients awaiting hospitalization. “And that’s also full of patients. So we are really saturated. […] If it were just these patients, we would be able to treat them well. What happens is that there are a lot of patients at our doors who are not very sick,” he explains.
The CHU Sainte-Justine currently sees between 250 and 280 patients each day in the emergency room and an increase is anticipated as the flu season approaches.
“When we put a lot of resources into sorting patients, we have fewer resources to treat patients,” emphasizes Dr. D’Angelo. There is always a lot of traffic between October and April, but he hopes that the collaboration of parents will help relieve emergency room congestion during this critical period.
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