Thursday, February 15, 2001

Winter's ills blitz children, caregivers

By Tim Bonfield and Susan Vela
The Cincinnati Enquirer

        For 17-month-old Ty Grubb, the misery began Monday with a cough that progressed into loss of appetite, lack of sleep and finally labored breathing, which prompted an ambulance run to Children's Hospital Medical Center.

        When Ty arrived at about 12:20 p.m. Wednesday, he became one of more than 200 sick children to seek emergency care that day for pneumonia, rotavirus, influenza and other common winter maladies that doctors say are running at or near peak levels.

[photo] Registered respiratory therapist Phil Stutler examines 17-month-old Ty Grubb at Children's Hospital Medical Center on Wednesday.
(Glenn Hartong photo)
| ZOOM |
        In fact, Children's Hospital tied a monthly record in January, with an average of 288 patients a day treated at its emergency department. Normal is 220. Busy is 250. On Monday, the ER saw 350 children, said Dr. Richard Ruddy, emergency department physician at Children's Hospital.

        “Monday was outrageously high. Every (pediatrician's) office in town has been swamped,” Dr. Ruddy said.

        Ty, a blond, blue-eyed boy of about 30 pounds, was suffering from respiratory syncytical virus (RSV), which causes mild colds and coughs in adults but can lead to severe problems such as bronchitis and pneumonia in young children.

        The virus caused a grating, rough-sounding rattle in Ty's chest and made him weaker than he ever had been before, said his parents, Tim and Chris Grubb of Norwood.

        “He's had the sniffles, but this has been the worst,” Mrs. Grubb said.

        Concerned, they took him to a doctor Wednesday, who ordered the emergency transport after discovering that the child's oxygen level was well below normal. At the hospital, he received “breathing treatment” for about two hours as staff monitored his blood oxygen level.

    Not every cough, cold and fever needs medical care. Here are some signs of illness that merit calling a doctor and possibly seeking hospital care:
    • Lethargy. When a child's energy level is sharply below normal.
    • Dehydration. Signs include refusing liquids for hours, a dry mouth, a lack of tears when crying, or going more than 8-10 hours without a wet diaper.
    • Difficulty breathing. Signs include wheezing and retracting of skin between ribs or the abdomen sucking in as the child strains for breath.
    • Coughs that get worse or stay heavy for several days.
    • Unusual rash, especially when the color does not appear to clear when the skin is pressed by a finger.
    • Trust your instincts. When in doubt, call the doctor. If a doctor can't be reached, go to the hospital.
   Source: Children's Hospital Medical Center
        “That's my boy!” Mr. Grubb said, joking that it took more than one grown man to place an oxygen mask on Ty during the ambulance trip.

        The winter mix of bacterial and viral infections has been felt all over town.

        Already this month, St. Susanna School and Landmark Christian School in Mason, and St. Agnes School in Fort Wright were closed for two days each after illness caused spikes in absentee rates.

        In West Chester Township, the TutorTime child-care center had as many as one-third of its 150 children out sick in the past two weeks, said Jill Ann Tsueda, assistant director.

        “It's getting a little better now. It seems like there's only one thing going around instead of five different things,” she said.

        At Children's Hospital, the busy season has reached beyond the emergency department. With a staffed capacity of about 300 beds, the hospital census has been running at 280 to 285 patients a day for weeks, said Dr. Mike Farrell, chief of staff.

        In response, the hospital has held some patients overnight in the ER and in post-surgery recovery rooms because regular rooms have not been available. But so far, the hospital has not needed to cancel elective surgeries, Dr. Farrell said.

        “The house is packed,” he said. “It's not one illness. The hospital has been busy across the board.”

        Routine injuries, busy surgery schedules, overflowing psychiatric units and repeat visits from chron ically ill patients has contributed to the situation, Dr. Farrell said.

        When Ty went home Wednesday afternoon, doctors told his parents he would have a cough for another two weeks as the virus ran its course.

        But for Children's Hospital, the peak of winter illness is likely to continue for four to six weeks — longer if a late-blooming influenza season picks up steam, Dr. Farrell said.

        And the general increase in activity may last much longer. In addition to seasonal bugs, more children are surviving extremely premature births, cancer and other once-untreatable diseases. But hiring staff to meet rising demand keeps getting harder.

        “As the baseline keeps going up, it gets harder to accommodate the peaks,” Dr. Farrell said.


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