OHSU shifts to emergency mode amid rise in serious pediatric cases

Oregon Health & Science University is taking emergency steps to be able to admit more children to its pediatric ICU.

The hospital is one of just three in the state that provides intensive care, including ventilation, to children. OHSU’s Doernbecher Children’s Hospital has 20 pediatric ICU beds, about half of what’s available statewide. Legacy’s Randall Children’s Hospital and Providence St. Vincent also provide pediatric intensive care.

OHSU says it has no more pediatric ICU beds available and is formally shifting to what’s known as crisis standards of care mode.

The move comes amid a surge in the childhood respiratory virus RSV and a statewide nurse staffing shortage. In the past week, Oregon hospitals have transferred some of their sickest pediatric patients to Idaho because of a lack of pediatric ICU beds available in Oregon.

“The impetus for making this change is that we were concerned we wouldn’t be able to serve the next child who needed pediatric critical care,” said Dr. Carl Eriksson, a pediatric critical care expert at OHSU. “Every hospital will at times turn patients away. What we’re seeing now is that the collective group of hospitals is really at a point where we are concerned about our ability to serve the next patient.”

OHSU says staffing is the most critical issue. The emergency standards will allow managers to assign each pediatric ICU nurse more patients to care for at a time. Under normal standards of care, pediatric nurses care for only one to two patients.

The crisis standards took effect Monday at 7 p.m. The shift is driven by a surge in pediatric patients with RSV, a childhood respiratory virus that is particularly dangerous for infants, and a statewide shortage of nurses.

Health officials across the Pacific Northwest are warning people to be especially cautious this holiday season in the face of COVID-19, the flu and RSV.

While these viruses may cause mild infections, they can cause serious illness for young and older people, pregnant people, and those who are immunocompromised.

Children with RSV make up about 25% of the total number of patients in the pediatric medical units and in the pediatric ICU, according to Eriksson.

“Kids who need intensive care are kids who are working so hard to breathe that they need a ventilator to help them,” Eriksson said. “They often need really intensive nursing care, at levels you’re not able to provide in a regular inpatient medical-surgical unit.”

The number of RSV cases has increased dramatically in Oregon in recent weeks, and heath officials have predicted a spike in RSV hospital admissions. Cases of the flu are also picking up quickly in Oregon.

To combat these viruses, health officials encourage people to stay up to date on flu and COVID vaccines, wash their hands frequently, and stay home if they’re sick.

Most RSV infections go away on their own in a week or two and can be managed with proper nutrition, hydration, sleep and use of over-the-counter medication.

For parents managing babies with RSV at home, pediatricians say nasal suctioning is particularly critical. Babies have to breath through their noses, so keeping their nose clear with saline spray and a suction device can help them stay hydrated while they recover from the virus.