JPS limits nontrauma transfers amid flu surge

01/15/2014 6:53 PM

01/16/2014 11:05 AM

As influenza continues to inflict misery on North Texas, John Peter Smith Hospital is rescheduling elective surgeries and staff members are working extra shifts to deal with the crush of patients.

Tarrant County’s public hospital issued a “code yellow” at 6:30 p.m. Tuesday and stopped accepting nontrauma patients from other facilities, a JPS spokeswoman said Wednesday.

MedStar ambulances are making an average of 42 additional calls per day with “flu-related medical conditions,” said Matt Zavadsky, a MedStar spokesman.

“The flu volume is affecting everybody,” Zavadsky said.

The JPS emergency department can handle 300 patients daily but has averaged 334 in January. The number increased to 359 on Sunday and 351 on Monday.

“They’re seeing a lot of people with respiratory issues, shortness of breath,” spokeswoman Kristen Newcomer said. “Many of these are patients with existing health problems, such as congestive heart failure and asthma, having difficulty breathing because they are sick with respiratory illnesses.”

On Wednesday, JPS had 12 flu inpatients, including three in the intensive care unit on respirators.

“Code yellow” is the hospital’s term for emergency status to deal with surges of patients, staff shortages or in-house problems such as a water leak. JPS hadn’t issued the code in more than a year.

As the county’s Level I Trauma Center, JPS must reserve enough capacity to accommodate trauma patients, such as people seriously injured in wrecks or shootings.

“With the exception of trauma patients, we are not accepting patient transfers from other hospitals,” Newcomer said. “Clinical staff members who are able to work extra shifts are signing up to do so and being assigned according to their skills and experience.”

Doctors were making rounds more often to help patients get home as soon as possible, she said.

On Tuesday night, MedStar ambulances waited as long as 90 minutes before crews could transfer patients into some emergency rooms, Zavadsky said.

“With all of the hospitals, the challenge is when the patients [in ambulances] get to the hospital. They have to put those patients somewhere, and that overflows into the ER boarding area,” Zavadsky said.

The larger hospitals are affected more, he said.

To address the backlog, MedStar is prepared to deploy specialized paramedics to emergency rooms so ambulances can leave patients at hospitals and respond to other calls.

The Tarrant County public health department has reported five deaths from flu-related illnesses since flu season began in the fall.

The unofficial tally is based on voluntary reporting by the county’s hospitals. State law requires hospitals to report children’s flu deaths only. Five child deaths have been reported in the state, none in North Texas.

Most of the positive flu tests reported in Tarrant County — about 98 percent — are for Type A, which includes the H1N1 virus, also known as swine flu, according to public health records.

At other hospitals

At Texas Health Resources hospitals, situations varied, a spokeswoman said

At Texas Health Harris Methodist Hospital Fort Worth, “census is high and we are seeing a larger number of flu patients than we have in the past few years. However, the hospital is not 100 percent at capacity,” spokeswoman Laura Van Hoosier said.

At Texas Health Arlington Memorial, seven patients were admitted with flu-like symptoms. The emergency department had not reached capacity but “wait times are longer than normal because of the high volume,” Van Hoosier said.

The emergency department at Texas Health Harris Methodist H-E-B has been at capacity for a month, and many of the patients are experiencing flu-like symptoms, she said.

At Cook Children’s Medical Center in Fort Worth, the number of patients had been lower than at the same time last year until the last five days, which saw a jump of 75 to 100 patients daily.

“The majority of patients [arriving in the emergency department] in the last few days have had flu-like complaints, including fever, cough, congestion and body aches, said Sarah Riley, assistant director of the emergency department.

“The fluctuating weather recently also has triggered asthma and allergies.”

‘Pockets’ of flu

Not everyone is seeing a surge in patients.

At North Tarrant Family Practice in far north Fort Worth, the onslaught of flu patients slowed this week.

“This week, we’re still seeing a few cases,” said Dr. David Haefeli, but none were his patients.

“Right after Christmas, we saw a ton of it, and this week we’re still seeing a few cases,” Haefeli said. “It all has to do with vagaries of transmission. A lot of it is based regionally. It can be calm in Northeast Tarrant County, but that doesn’t mean there isn’t a pocket in downtown Fort Worth and a pocket in downtown Dallas where it’s going like crazy.”

Haefeli said the office was slammed with patients immediately after Christmas. On the Saturday after Christmas, 19 of the 20 patients he saw tested positive for the flu. Five of them had gotten flu shots.

“Either the flu shot didn’t cover it very well this year, or this is a very virulent strain,” Haefeli said.

That’s why he urges patients to see a physician as soon as symptoms develop.

“It’s hard to know if it’s going to be a mild case,” Haefeli said. “I’ve had probably four or five patients who developed secondary infections like pneumonia. Even healthy people can get pneumonia with this.”

Rick Antonisse, executive director of the North Central Texas Trauma Regional Advisory Council, which serves 19 counties, said that a few hospitals have requested ventilators but that this year’s flu season isn’t affecting everyone the same way.

“While this season’s flu surge is creating problems in individual places, it is not systematically wiping out the system equally,” Antonisse said.

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