While the bronchiolitis epidemic sends thousands of children to the emergency room, pediatric services are still suffering from the hospital crisis. Difficulties not without consequences for the care and health of children…
Lack of personnel, lack of means… and now “patient sorting”. The formula was delivered by a health professional and reflects the difficulties of hospitals in dealing with the bronchiolitis epidemic, no offense to the Minister of Health François Braun who condemned the speech. “We are forced to sort the children,” regretted the pediatric resuscitator at Trousseau Hospital, Julie Starck Hon rtl extension November 10th. A reality described by other doctors and by Pediatrics Collective created in October 2022 to warn of the care conditions of young patients in public hospitals. The bronchiolitis epidemic raging in France, particularly in Île-de-France, has added to the pain of health workers.
With more than 6,800 hospitalizations recorded in one week according to the latest report by Public health France, the means and forces available to medical teams for the care of patients, many of whom are under the age of two, are not sufficient. Worse still, according to Laurent Dupic, head of the Smur pediatric ward at the Necker hospital, this affects the quality of care. “For three weeks we have seen the system collapse. Children in serious condition are kept in unsuitable places. Newborns with oxygen masks, who should be in intensive care, remain in general pediatrics, in the emergency room, because there is no more space, “he explains in the columns of Mediapart. For her part, pediatrician Julie Starck describes: “We do degraded treatments and put [les enfants] very clearly in danger”.
After the transfers… deprogramming?
A solution has been found to overcome the difficulties or overloading of some facilities and to ensure patient care: transfers. In Île-de-France, more than thirty transfers have taken place since October to other hospitals in the sector and sometimes to other regions. But the maneuver involves removing patients from their families, a delicate point when children under two are hospitalized and fraught with consequences when parents have to follow up. This solution finds its limits even with a generalized epidemic throughout the territory which makes beds a rare commodity in many healthcare facilities. Finding a place can sometimes take several hours, a time that patients don’t always have and which can be the cause of a tragedy. On November 2, two newborns waited nine hours to be transferred to an intensive care unit and one of them did not survive. While the inquest has not yet confirmed that the delay in transfer was the cause of death, it stands to reason that he was involved.
A new stage also envisaged in the white plan for hospitals is being deprogrammed and is being discussed in some services as testified by the Pediatrics Collective in a tweet. To deal with the emergency and the wave of bronchiolitis, “postponements” of patients or tests are foreseen, but at the expense of the health of other children, sometimes suffering from acute health problems or chronic diseases who await or need certain operations and other medical visits .
Mandatory triage of patients with bronchiolitis
If the technical difficulties and the lack of beds in the pediatric wards have already pushed healthcare operators to increase the number of small patients in hospital corridors, the continuous and heavy influx of patients now forces healthcare operators to sort and then refuse or postpone the hospitalization of patients, a topic which, as during the covid-19 crisis, raises particularly moral questions: “Which child should have the last place in the hospital, which one has priority for the last place in resuscitation, which surgery will be cancelled, which treatment will be postponed”, ask the pediatricians withactually Paris.
Pediatricians are sounding the alarm and asking for a debate
After several months of ringing the alarm bell and while working conditions and especially patient care worsen, pediatricians are asking the state for an answer. And a different response from that of the Minister of Health who considers the sorting of patients “unacceptable” and threatens to open an investigation “if such deviant practices were ever proven” according to his confidences at the Parisian. The Collective of Pediatrics has already sent a letter to the President of the Republic signed by more than 7,000 health professionals and is now calling for a public debate to be held with the authorities and the government on November 20, 2022, International Children’s Rights Day. .
