Attendances at Dublin’s children’s hospitals are up almost half at present on previous record levels due to an “unprecedented” rise in severe respiratory infections.
“We are up 42 per cent on emergency department attendances in 2019 and that was our busiest winter on record,” according to Prof Adrienne Foran, clinical director at Children’s Health Ireland.
“We would have been in black escalation in 2019 if we had seven kids in the ED waiting for admission. Now, some days, we have 15 or 20. We are using eight day ward beds as inpatient beds at the minute, which is something we’ve never had to do before.”
The increase in attendances is largely attributed to a sharp rise in respiratory syncytial virus (RSV), which particularly affects children, and related secondary infections.
“They’re definitely sicker,” Prof Foran told The Irish Times. “We’ve never seen intensive care so busy with bronchitis. We’re not sure if it’s a combination of a fallout from Covid and kids who weren’t as exposed and therefore don’t have the resilience to fight it themselves, or if it’s a new strain of the (RSV) virus.”
Australia has recently experienced severe wave of respiratory infections in its winter, she pointed out. “We thought we were prepared but we didn’t appreciate the onslaught.”
Consultant neonatologist at CHI Dr Ann Hickey described the rise in cases as unprecedented and extraordinary.
She said CHI’s neonatal transport service, which is normally filled with babies requiring surgery, is at the moment retrieving “loads” of children with bronchiolitis.
Prof Foran said staff were also seeing some toddlers, who wouldn’t normally be ill but are currently “a lot sicker” with secondary strep A infections and sepsis. “It’s a worrying trend. Normally, if there was a two- or three-year-old with bronchiolitis you wouldn’t be that worried about them.”
The two doctors were speaking after the launch of a new neonatal service at Our Lady’s children’s hospital in Crumlin, including six new high dependency unit (HDU) beds for newborns.
The development doubles the number of HDU beds for babies with additional care needs in Dublin’s three children hospitals – Temple Street hospital already has a six-bed HDU unit.
Prof Foran said it was hoped to open a mini paediatric intensive care unit in Crumlin next year – the first in one of the children’s hospital.
Neonatal staff are being recruited, trained and consolidated in preparation for the move to the new national children’s hospital at St James’s, which will have an 18-bed paediatric ICU capable of performing surgery on newborns.
“All the evidence from around the world show that if a baby is cared for in a neonatal intensive care unit, the outcomes are much better,” she explained.
“All inpatient beds in the new hospital will be single occupancy, giving newborns and their families privacy during what can be a very difficult time,” according to Dr Hickey. “Dedicated neonatal areas, such as the NICU, will also have a different appearance to other parts of the hospital – dimmed lighting and sound control, among other features, reduce stress as newborns adjust to life outside the womb.”
Last year, the neonatology service at Crumlin and Temple Street cared for over 460 babies, many of whom have to stay in hospital for months.
