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The University of New Mexico Hospital’s Pediatric ICU was quiet on Tuesday.
Not because the situation wasn’t dire. It was quiet because the hospitalized children are so sick that most of them have been sedated and intubated, and at least one child was on extracorporeal membrane oxygenation, or ECMO, because of problems with respiratory viruses.
Like hospitals throughout the country, UNMH and other local health care facilities are dealing with a surge of patients, particularly young patients, because of multiple viruses that are circulating widely this year.
Hospitals operating above their licensed capacity, a shortage of staff, and a lack of equipment and some medicines are all causing problems locally, according to hospital officials. At UNMH, a 14-member National Disaster Medical System team has been deployed to help treat pediatric patients.
The team, or task force, is part of the U.S. Department of Health and Human Services, and includes a doctor, a nurse practitioner, respiratory therapists, registered nurses and paramedics. Members come from all over the country and were chosen because of their expertise working with pediatric patients.
“This team configuration had to be pediatric-specific,” said Paul Decerbo, the team commander. “We pulled team members from different teams that are out there in the United States so that we can provide the best pediatric care as a disaster team.”
The team, which started working last weekend, is working day and night in shifts to provide 24-hour coverage at UNMH for the 14 days.
In the past, Decerbo said he’s been on similar teams that responded to such major hurricanes as Sandy and Florence, and he was part of numerous missions during the COVID-19 pandemic.
The recent surge is manifesting into full pediatric units, where stuffed animals and toys sit next to the beeping machines.
Signs of the surge are easy to see.
Ashley Kamm, a registered nurse who works with patients on ECMO, said that, in a regular calendar year, about one or two children will receive ECMO at UNMH. This fall and winter, the hospital has given as many as eight children ECMO in a week, she said. The treatment requires a team of doctors, nurses and other specialists who must monitor the patient closely.
“It’s very much labor-intensive, lots of people helping to get these patients better,” Kamm said.
UNMH has operated above its licensed capacity for weeks, according to hospital officials. Several respiratory viruses – including influenza, COVID and respiratory syncytial virus, or RSV – are driving the influx.
Health care officials have said a reason for the increase is that such viruses as RSV and influenza did not circulate widely during the previous two winters because many people were taking precautions to slow the spread of COVID. But, as restrictions and mask-wearing have loosened, the viruses are making a resurgence.
“We’re seeing concurrent viruses. We’re seeing individual patients who really struggled to be able to clear all these secretions on their own having to be intubated,” Decerbo said. “That is where a lot of resource-taxing illnesses start to come into play because patients have to be intubated.”
But it’s not just staff and patient volumes that are affecting the hospital. There is also a shortage of equipment and crucial medicines, said Ellen Fernandez, a pharmacist in UNMH’s Pediatric ICU.
She said everything from children’s Tylenol and ibuprofen, antibiotics and blood-pressure medicines are in high demand.
“So we are having to utilize alternatives when possible, and when there isn’t an alternative, we do our best to get by,” she said.
It’s not clear if UNMH will request additional emergency assistance in two weeks when the team’s assignment comes to an end. The hospital, working with the state Department of Health, requested the federal assistance.
“The arrival of the NDMS team couldn’t come at a better time,” Dr. Anna Duran, associate chief medical officer of the UNM Children’s Hospital, said in a statement. “Our staff have been working very hard to provide the highest level of care to the sickest children in our state. But our staff are tired, many of them missed the holidays with their families, and they desperately need this help.”
