What Physicians are Seeing in Children's of Alabama Emergency Department

By Laura Freeman


What Physicians are Seeing in Children's of Alabama Emergency Department

By Laura Freeman

When asked what conditions she encounters most, Alicia Webb, MD, a Pediatric Emergency Physician at Children's of Alabama, says "we are still seeing too many serious injuries from children riding ATVs. They aren't designed for someone small with a child's motor skills and judgment. So many turnovers cause devastating injuries or death.

"In terms of illness, the top three reasons patients come to our emergency department are the same that pediatric emergency facilities are seeing across the country--respiratory problems, seizures and psychological issues, particularly in adolescents.

"One surprise this summer is the high numbers of younger children with respiratory syncytial virus (RSV). This infection tends to occur in babies and toddlers. It's usually mild, but it can cause lung issues. We typically see this virus during the cold months, and we don't know why it's showing up in summer. With winter ahead, we're concerned about the potential for more infections.

"What complicates matters is that parents are often afraid it is Covid-19 and they bring their children to the ED to be tested. It's very, very important that parents know not to come to the ED for that. Get in touch with your pediatrician or check the Alabama Health Department website for a list of locations where you can get a test.

"With the COVID surge, our waiting room has been very crowded and waiting times are longer than usual. You don't want to be sitting a long time in a waiting room with a sick baby around other sick children who may be positive for a variety of illnesses.

"You should come to the ED if your child develops serious symptoms. Watch for difficult breathing, dehydration, fever, seizures and other symptoms that indicate something serious might be going on."

It appears that the pandemic is having an affect on other health issues. "Before the pandemic we often saw injuries from abuse against children," Webb says. "Now, with isolation and financial uncertainty, increasing stress may take a toll. Pandemic related stress is also having an effect on children who tend to have anxiety, depression and other mental health issues."

Another concern is that the pandemic is causing delays and interruptions in routine care that may lead to future emergencies.

"When parents put off pediatrician visits, they may be missing vaccinations that could lead to an outbreak of preventable diseases like measles," Webb says. "Also, children in Alabama have high rates of diabetes and asthma. If developing symptoms are missed, they may not be detected until there's a life-threatening emergency."

As of press time, Children's of Alabama has adequate rooms to move admitted patients from the emergency department, but numbers are trending upward.

"We're getting calls from across Alabama as well as surrounding states asking for beds," Webb says. "The delta surge is creating a desperate situation throughout the region. We are specially equipped and trained to care for children, and young patients referred to us are arriving by plane, helicopter, ambulances and in some cases their parents are driving hundreds of miles."

The unfamiliar environment of a hospital can be frightening for a child who is sick and uncertain about what is happening. To ease their fears, Children's' of Alabama has a child life team that works with children when they are admitted and spends time with them to help them and their parents understand what's going on and what to expect.

Pediatrics has benefitted from the same advances in technology and treatment as other fields of medicine, but Webb says there is a simple tool that will likely determine what happens next in the our children's health.

"As of now, masks are the only defense we have for children under 12, so wear them and teach children when and how to wear them," she says. "In addition to reducing the risk for COVID-19, they also help to prevent flu, colds, RSV and can be protective against some of the allergens that could trigger an asthma attack.

"If your child is old enough to qualify for the vaccine, please get them vaccinated. The Delta surge seems to be hitting younger people harder than previous variants. Children can and do die from this and could develop long term health problems.

"We're always listening for news of advances that will make vaccines available for all children, but as of now, we don't know how long that will be. We have to build a circle of protection around them with masks, washing hands, social distancing and making sure everyone around them who qualifies for vaccination does their part."