HSC Children's Hospital postponing surgeries due to increase in critically ill kids

Reassigning staff and postponing surgeries are just some of the steps being taken at HSC Children's Hospital to deal with a spike in critically ill pediatric patients.

Dr. Shawn Young, the chief operating officer of HSC Winnipeg, said in a 48-hour period that ended Monday, 10 infants and children were admitted to the pediatric intensive care unit (PICU) and the neonatal intensive care unit (NICU).

Each patient was dealing with severe respiratory symptoms linked to influenza A and RSV bronchiolitis.

Those admissions pushed the number of critically ill children to 21, which is far above the baseline of the PICU, which is nine. There are also 48 patients in the NICU, which has a pre-pandemic baseline of 50.

Young said more beds have been opened in the PICU and 10 to 15 staff have been reassigned in the last couple of months, but he said more help is needed.

"In the last day, and earlier today, we have put out a call for nurses with pediatric critical care experience, who may be working in other positions, to see if they can pick up shifts in the PICU," said Young.

That call for help isn't just at HSC but has been put out across the health-care system.

Young said there isn't a specific number of nurses that they are looking for.

"The demands are shifting by the hour, if not, certainly by the day. So the absolute number is not going to be a fixed number, it's going to change almost continuously."

Another step being taken to provide additional support is reducing the pediatric surgical slate. Young said they will continue to focus on life-saving surgeries, but any non-urgent surgeries will be postponed starting Thursday.

"Clinical leadership will assess and review each surgical case with postponements focused on patients who are able to safely remain at home until their surgery and where a short stay will not result in negative medical outcomes."

The postponements will mean 4.7 full-time equivalent surgical nurses will be assigned to the PICU, there will be less pressure on the unit with fewer surgical stays and it will prevent kids from having to travel or stay at the hospital before their surgery, therefore decreasing their chances of also getting sick, according to Young.

At the moment, Young noted there is no impact on adult surgeries, but it is always a possibility depending on what happens in the coming days and weeks.

The postponement of surgeries is scheduled to last into the new year.

Even though there is a current spike in PICU patients, there appears to be some slightly good news coming from the emergency department.

For the first 10 days of December, there have been 142.7 patients per day in the emergency department, compared to 170.3 patients per day in November.

Dr. Elisabete Doyle, the section head of pediatric emergency medicine at HSC Children's, said despite lower numbers there are still high admission numbers – 18 on Tuesday.

"So normally, we see between 10 and 12 admissions a day and we're up to 18 and the acuity of the patients that we're seeing is much higher," said Doyle.

She said the majority of cases being seen right now are RSV and influenza, but there are some cases of COVID-19 as well.

"In November of this year, we saw 196 cases of influenza in emergency. This is about four times the number that we were seeing in pre-pandemic times in 2019. And in December, we have already seen 87 cases of influenza. So currently at this pace, we're set to see about 245 cases, which would be higher than any flu season in the past five years."

She said nearly half of all patients are being treated for an influenza-like illness.

Doyle was asked why this year is such a strong virus season compared to pre-pandemic years.

She said there are multiple factors for this.

"Through the pandemic, because of isolation, the viruses were not replicating and spreading, we had a lot of restrictions during the pandemic," she said. "We also have this young group of children who didn't get exposed to the virus and now are getting affected by the virus and it's coming with a vengeance. It's also disrupted our seasonal variation in viruses. So instead of the viruses respecting their seasons, they're all coming at the same time."

These reasons are why Doyle said parents and households should be doing everything possible to prevent their young ones from getting sick, including getting the flu shot.

"Taking preventative steps is also going to help, making sure to wash your hands frequently, stay home when you're sick, masking indoors and in large crowds. So judicious use of masking and cleaning high-touch areas like doorknobs and counter surfaces. Doing these things are going to help protect your health and most importantly, the newborns who are not able to get vaccinated."