While the bronchiolitis epidemic sends thousands of children to the emergency room, pediatric services are still suffering from the hospital crisis. Difficulties not without consequence on the care and health of children…
Lack of staff, lack of means… and now “sorting of patients”. The formula was pronounced by a health professional and reflects the difficulties of hospitals to deal with the epidemic of bronchiolitis, 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 on RTL November 10. A reality described by other doctors and the Pediatrics Collective created in October 2022 to alert on the conditions of care for young patients in public hospitals. The bronchiolitis epidemic which is raging in France, in particular in Île-de-France, has added to the pain of health professionals.
With more than 6,800 hospitalizations recorded in one week according to the latest report from Public health France, the means and forces available to the medical teams for the care of patients, many of whom are under the age of two, are not sufficient. Worse, according to the head of pediatric Smur at the Necker hospital, Laurent Dupic, this affects the quality of care. “For three weeks, we have seen the system break down. Children in serious condition are kept in unsuitable places. Babies under oxygen masks, who should be in intensive care, remain in general pediatrics, in the emergency room, because they there is no more room”, he explains in the columns of Mediapart. For her part, pediatrician Julie Starck describes: “We do degraded treatments and we put [les enfants] very clearly in danger”.
After transfers… deprogramming?
A solution has been found to overcome the difficulties or the overload of certain establishments and to ensure the care of patients: transfers. In Île-de-France, more than thirty transfers have taken place to other hospitals in the sector and sometimes to other regions since October. But the maneuver involves distancing patients from their families, a delicate point when children under the age of two are admitted to hospital and fraught with consequences when parents have to follow. This solution also finds limits with a generalized epidemic throughout the territory which makes beds a rare commodity in many health establishments. Finding a place can sometimes take several hours, a time that patients do not always have and can be the cause of a tragedy. On November 2, two newborns waited for nine hours to be transferred to an intensive care unit and one of them did not survive. While the inquest has yet to confirm that the transfer delay was the cause of death, it is obvious that he was involved.
A new stage also planned in the white plan for hospitals is deprogramming and it is mentioned in certain services as proven by the Pediatrics Collective in a tweet. “Postponements” of patients or examinations are planned to deal with the emergency and the wave of bronchiolitis, but to the detriment of the health of other children sometimes suffering from acute health problems or chronic illnesses who are waiting or need certain operations and other medical examinations.
The obligatory triage of patients with bronchiolitis
While technical difficulties and the lack of beds in pediatric wards have already prompted health professionals to increase the number of young patients in hospital corridors, the continuous and heavy influx of patients now forces health professionals to sorting and therefore refusing or postponing the admission of patients, a subject which, as during the covid-19 crisis, raises particularly moral questions: “Which child should be given the last place in hospital, which one has priority for the last place in resuscitation, which surgery will be canceled, which care will be postponed”, question the pediatricians withnewsParis.
Pediatricians are sounding the alarm and demanding a debate
After several months spent sounding the alarm bell and while working conditions and especially patient care are deteriorating, pediatricians are demanding a response from the State. And a response other than that of the Minister of Health who considers the sorting of patients “inadmissible” and threatens to open an investigation “if ever such deviant practices were proven” according to his confidences in the Parisian. The Pediatrics Collective has already sent a letter to the President of the Republic signed by more than 7,000 health professionals and is now asking for a public debate to be held with the authorities and the government on November 20, 2022, International Children’s Rights Day. .