Saturation of pediatric emergencies: “the situation will not get better” – The HuffPost

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HEALTH – “Strong tensions” and growing concern. The emergencies pediatric French women are in crisis, alerted the Inter-Hospitals collective on Thursday, October 28, citing a lack of staff which makes it difficult to take care of all the children.

“There is no sorting” in pediatric emergency departments, however assured the Senate the Minister for Autonomy, Brigitte Bourguignon in response to the fear of certain professionals. This Friday morning, Gabriel Attal spoke of “strong tensions” at the hospital “, which” must have led to transfers “, but also assures him that there is” obviously no sorting “.

Contacted by the HuffPost, Professor Romain Basmaci, secretary general of the French Pediatric Society, takes stock of the emergency services situation. Even if he also believes that we can not speak of “sorting”, the concern is appropriate, because the situation in the services is likely to worsen soon.

The peak of bronchiolitis in three weeks

This crisis in emergency services has two major factors and the first is the epidemic of bronchiolitis. As every year (except that of 2020, under Covid), it makes its appearance during the fall and involves its share of consultations and admissions to pediatric emergencies. The catch: this year it hit faster and harder than expected.

“Currently, we have a about three weeks ahead of the bronchiolitis outbreak, explains Professor Basmaci. That is to say that the number of cases of bronchiolitis that we have this week corresponds to the figures that we generally have in mid-November, which is the period of strong ascent of the epidemic. The peak is usually reached in late November-early December. This is even more important for the number of emergency visits ”.

For comparison, the professor evokes an increase of 20% to 30% more visits to emergencies currently compared to a winter before Covid. “In 2019, at this time, there were 35 cases of bronchiolitis per day. This week we are at 70. And here we are not even at the peak of the epidemic, so it will not get better, ”he warns.

This influx of bronchiolitis can be explained in part by the relaxation of barrier gestures, believes the one who is also head of the pediatric emergency department at the Louis Mourier hospital in Colombes (Hauts-de-Seine). “It is assumed that the role of adults in the transmission of viruses is more important than we thought. In 2020, adults were masked and were careful not to infect themselves. Young children, who did not have a mask and were in a community, did not however circulate the bronchiolitis. This year, the adult masks are falling off and the children are getting sick, ”he explains to HuffPost.

Also, in 2020 children were less infected than usual and are therefore less immune, which raises fears of a stronger epidemic this year. He also specifies that bronchiolitis is not the only reason for entering the emergency room and that other pathologies (gastro, asthma, fevers …) must be treated in addition to this virus.

The difficulty of transferring babies

The lack of beds in the pediatric ward is the other major factor in this crisis. “We are very worried because the pediatric intensive care units are very often full, there are not many places”, regrets the secretary general of the French Pediatric Society. He mentions in particular the closing of beds in general pediatrics, this lack of nurses, auxiliary nursery nurses and pediatricians in sufficient number. More generally, approximately one in five beds is closed in large public hospitals, according to an investigation led by Jean-François Delfraissy unveiled on October 27.

A flight of caregivers observed long before the Covid crisis. “In the winter of 2019, Île-de-France suffered a major attack of bronchiolitis and nearly 25 children had to be transferred to pediatric intensive care outside the region for treatment, due to lack of space”, recalls the professor, who specifies that transferring patients is not easy for patients, families and the departments involved.

And still it is necessary that said transfer can be done. In the event of total saturation in Île-de-France, it is necessary to be able to send patients to nearby regions. But if the services of these regions are themselves under strain, the story becomes even more complicated.

For this year, the anguish grows. “We are starting to have trouble finding intensive care beds when we are not even at the peak of the bronchiolitis epidemic. When that happens, we risk running out of space, warns Romain Basmaci. For the moment we are coping, but the advance of the epidemic makes us fear that we will no longer find a place later ”.

To avoid overloading pediatric emergencies during this outbreak, your best bet is to avoid spreading the virus. Thus the barrier measures deployed during the Covid are still effective. It is also advisable not to approach a baby when you are sick, to avoid taking infants out too often in public places, to avoid contamination. Finally, preferably, come to the emergency room only in case of real concerns related to alarming symptoms.

The warning signs of bronchiolitis.

We recently dedicated a item signals that should alert parents.

• “The belly rises, the spaces between the ribs widen
• A flapping of the wings of the nose,
• Breathing faster than usual (exceeding 60 breaths per minute)
• A very high fever,
• A decrease in the quantities drunk per day (less than half of the quantity usually drunk in 24 hours),
• A deterioration of the general condition (smiles less, cries a lot, is very limp, etc.) ”

See also on The HuffPost: Covid in Guadeloupe: CHUs and intensive care services saturated