‘Incredibly challenging’: All hands on deck as children’s hospital faces 12-hour emergency queue

‘Incredibly challenging’: All hands on deck as children’s hospital faces 12-hour emergency queue

December 6, 2022

Key points

  • The Royal Children’s Hospital reported 375 presentations at its ED on Monday, with the high demand leaving 100 people waiting for care at 9pm.
  • By 7am Tuesday, the number waiting had been reduced to 14, thanks to staff who volunteered to extend their hours and work extra shifts.
  • The chief of medicine, Associate Professor Tom Connell, said the hospital was seeing an unseasonable number of viral infections on top of the “usual mixed bag”, while dealing with staff absences due to COVID-19.

Hundreds of patients sought emergency treatment at Melbourne’s Royal Children’s Hospital on Monday in a surge described as “incredibly challenging” by the hospital’s chief executive officer.

The hospital reported 375 presentations at its ED throughout the day, with the high demand leaving 100 people waiting for care at 9pm, and 90 there at 1am. However, by 7am the number in the department had been reduced to 14, thanks, in part, to staff who volunteered to work extra shifts or extend their working hours.

Royal Children’s Hospital chief executive Bernadette McDonald.Credit:Getty Images

“We will always treat the most seriously ill children first, which unfortunately means some patients with less serious conditions may experience longer wait times,” a hospital spokesperson said on Tuesday.

RCH chief executive officer Bernadette McDonald told ABC Radio the longest any patient had to wait for care was about 12 hours.

She said the patients presented for a variety of reasons, some of which could have been treated by their GP or a nurse-on-call service.

“Last night was particularly challenging. We ended up having about 375 presentations in total yesterday, which is very, very high numbers for us,” McDonald said.

“Unfortunately, the waiting room is not supposed to hold quite as many patients as we had last night.

“[It was a] mixed bag [of presentations]. My clinicians tell me [there were] gastro-like symptoms, some respiratory illnesses, viruses … some fevers … we were also seeing some very unwell children presenting and then the usual sort of injuries that children succumb to.”

The hospital asked prospective patients to use the nurse-on-call service (1300 60 60 24) or telehealth options, such as the Victorian Virtual Emergency Department, as possible alternatives to presenting at hospital.

RCH staff volunteered to work extra shifts on Monday and a call went out for doctors to come in on their days off.

“With extremely high levels of acuity of our already admitted inpatients, it is not safe to discharge patients to free up beds,” a statement from the hospital said.

Chief of medicine Associate Professor Tom Connell told ABC Radio Melbourne that the hospital was seeing an unseasonable number of viral infections on top of the “usual mixed bag that presents to the emergency department”, while dealing with continued staff absences due to COVID.

Royal Children’s hospital chief of medicine Tom Connell.Credit:Joe Armao

He said the rate of presentations at the hospital in November was about 15 per cent higher than it would have been pre-pandemic.

“In the time just before I came on [on Monday], we had 10 patients arrive in 10 minutes,” Connell said.

“The children aren’t presenting with COVID, but there is obviously some staff who have COVID,” he said, adding that the number of staff furloughed had been stable over the past month.

“We will continue to see all the children who are brought to the hospital if they’re unwell, it’s just we’re trying to make people aware of this – given the current number of presenting, there may be wait times,” Connell said.

The hospital experienced a similar surge in demand in August, during the winter wave of COVID-19 and other respiratory illnesses, when there was a six-hour period where children arrived at the Parkville building on average at one every two minutes, many suffering from respiratory viruses.

A long queue of sick children and their parents overflowed outside the emergency department.

At the time, the hospital’s critical care chief, Dr Stuart Lewena, said: “While we’re out there in the community trying to live a normal life, in our acute hospitals, it’s far from normal.

“We’re under a lot of pressure. There’s a lot of illness in the community at the moment. And last night was no exception to that. It was just a broad spectrum of trauma, mental health, medical illness, the whole spectrum.”

As the end of the third year of the pandemic approaches, Victoria’s healthcare system remains under extreme pressure from coronavirus, related staff illness and delayed care as a result of the pandemic.

Ambulance Victoria declared a code red at the weekend due to a severe shortage of ambulance crews that saw some “lights and sirens” calls delayed.

Ambulance Victoria has about 140 staff furloughed because of COVID-19 infections, up from just 30 staff who had the virus at the start of October.

More than 700 Victorians are in hospital with COVID-19. This represents about one large metropolitan hospital.

A recent surge in hospital numbers prompted health authorities last week to lift the state’s health response setting to “stage three”.

The new setting allows ambulance crews to rapidly offload patients and could result in leave being cancelled for hospital staff, increased telehealth appointments and additional meetings to discuss case management.

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