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Swamped with flu patients, Dell Children's Medical Center sets up triage tents
Flu also causing staffing shortage in ER.
By Mary Ann Roser
AMERICAN-STATESMAN STAFF

Tuesday, September 22, 2009

Dell Children's Medical Center is seeing so many children sick with what is presumed to be swine flu, it expects to start treating some of them in tents starting today.

The hospital was on pace Monday afternoon for an all-time record number of patients after seeing more than 200 before 3 p.m. — the normal load for a 24-hour period, said Sister Teresa George, chief operating officer. During the school year, the busy time starts after 3 p.m., when schools are out, George said. Hospital officials said most of the children arriving at the emergency room are mildly to moderately ill with the H1N1 virus. The hospital isn't routinely testing to determine what type of flu patients have, but federal health officials say virtually all flu circulating now is H1N1.

The hospital ER has seen steady increases in patients over the past couple of weeks, but the past week has been especially grueling, with some days easily exceeding 300 patients, said Dr. Pat Crocker, chief of emergency medicine at the hospital. When 343 patients swamped the hospital Sunday, officials decided to set up the tents and triage patients with less severe flu there starting today, officials said.

"There's no question there's still a certain amount of panic" over the H1N1 virus, also known as swine flu (a combination of pig, bird and human viruses), Crocker said. He said most of the patients coming in are at higher risk for complications from flu: They are younger than 5, have asthma or other chronic conditions or need to be seen by a doctor because of trouble breathing or a fever persisting longer than three days or are sicker than they should normally be with flu. Most don't need to be hospitalized.

Since April, 44 people have died of swine flu in Texas, including seven children under 18.

Set up just outside the ER entrance, the two tents, which were sweltering Monday afternoon, were going to be air-conditioned by today at a cost of $2,000, George said. Crocker said the tents could accommodate eight to 16 beds.

Officials expect patient volumes to stay high, and seasonal flu could hit as early as next month. Right now, about half of the patients are complaining of flu, said Dr. Thomas "Tate" Erlinger, Seton's director of research administration, infection prevention and epidemiology.

The volumes are higher than expected, Erlinger said.

Stella Castillo, 46, of Pflugerville, who stood in the hospital foyer just outside a packed waiting room at Dell Children's on Monday with her 16-year-old daughter, said some primary care doctors are telling parents to go straight to the ER because they are too busy to see any more patients. Children wearing masks swarmed around a desk not far from Castillo, who said she had been waiting about three hours.

The hospital staff is grappling with its own bout of illness. About 10 to 15 ER nurses are out sick with flu, George said. Dell Children's and its parent, the Seton Family of Hospitals, is scrambling to staff the ER, George said.

Seton is paying bonuses to nurses willing to work extra shifts, borrowing staff members from other floors at Dell Children's and bringing in nurses from other Seton hospitals, including the new Seton Medical Center Hays, which won't open in Kyle until Oct. 1, George said.

Dell Children's also has asked CommUnityCare, the public clinic system operated by the Travis County Healthcare District, to help out by extending clinic hours so that patients who don't need to go to an ER can be seen in a less costly clinic environment.

"The hours aren't extended yet, but we will if we need to," said David Vliet, CommUnityCare CEO.

What is happening in the ER is a sign of what is going on elsewhere in Central Texas.

In the Hays consolidated school district, a spokeswoman said several campuses reported that more than 10 percent of students in a particular grade level were absent. One campus, Science Hall, had a 14 percent absentee rate.

Roxanne Evans, a spokeswoman for the Austin school district, said it has not had "extensive absences from any campuses due to flu."

"I think it's going to be a very busy flu season," Crocker said.

[email protected]; 445-3619

Additional material from staff writer Laura Heinauer.

Think you or your child has the flu?

Call or see a doctor if:

The child is younger than a year old.

The person is more ill than you would expect.

Fever persists more than three days.

Symptoms include lethargy that does not improve after taking Tylenol.

There is an existing chronic illness or some other risk factor, such as pregnancy.

Go to the emergency room if:

Symptoms include shortness of breath, chest pain, trouble breathing, persistent vomiting, seizures or confusion.

Source: Dr. Pat Crocker, Dell Children's emergency medicine chief