Adult and pediatric ICUs partner up to alleviate pandemic pressures in Quebec
As Quebec enters the seventh wave ICU doctors at the MUHC’s adult hospitals say they’re better prepared to face future crises now thanks to the way their pediatric colleagues pitched in to help them during the darkest days of the pandemic.
They highlight in particular, how the Montreal Children’s Hospital (MCH) adopted an open door policy and unusually, admitted adult patients to compensate for a lack of beds.
“It was clear that our adult colleagues were struggling to provide services and were very overstretched,” in the fall of 2020, recalls Dr. Saleem Razack the Director of the ICU at the Montreal Children’s Hospital.
“We’re very thankful for the efforts,” said Royal Victoria Hospital (RVH) intensivist, Dr. Patrick Melanson, explaining that offering that “safety valve” was the Children’s initiative.
The idea proved to be a game-changer, easing the strain at a time when adult ICU doctors were faced with the most difficult of decisions - who might live and who might die.
“There was a possibility that the capability for ICU beds would be overwhelmed in the province and that we would have to give those beds to those who had the greatest chance of survival,” recalls Melanson, referring to the government’s ICU prioritization protocols.
“So when this project came along it was very reassuring to us that we were doing everything that we could to maximize our capabilities,” he said.
AGES 27-75, TREATED AT THE CHILDREN’S
Ultimately, 13 critically ill adults were treated by pediatric intensivists and nine were tended to by general pediatricians.
A portion of the patients had illnesses other than COVID-19, while others had COVID and were intubated.
“We chose patients really carefully to make sure these are problems we would be comfortable dealing with,” Razack said.
“And I do like to joke a little that surprise, surprise, the enzymes and the drugs don’t change miraculously when you turn 18 so that there is a lot of overlap in the way care is done and the way diseases work.”
The patients ranged in age from 27-75, which did require a change in some bedside habits.
“It was kind of funny, like I would normally refer to the patient’s family member who’s there, I’d say that’s mom but it wasn't mom, it was wife,” said Razack.
What didn’t change in the MCH, however, was the level of medical care the adult patients received.
“When we started out the project some of us went over here to sort of give them (pediatric specialists) information sessions about what they could expect and what they could look out for,” Melanson said.
But it “became clear they could do it…it worked out very well,” he said.
The two teams set up open lines of communication, including with the sub-specialists and spoke daily to review any concerns.
“I have seen into their world and I have learned a fair bit,” Razack said, and “there’s room for a lot more collaboration.”
One example both men cite is the need for both hospital communities to help improve the care for chronically ill patients who are transitioning from the pediatric to the adult sector.
“Bridges that we built allow for better communication and better transition hopefully,” Melanson said.
Near the end of the fourth wave, the adult ICU team was able to reciprocate when respiratory syncytial virus (RSV) returned and infected a higher number of children than expected.
The RVH took on two teenage patients for about two months.
“In a lot of ways it feels like we went through a war together all of us,” Razack said.
They have all emerged “strengthened,” said Melanson.
CTVNews.ca Top Stories
More than 115 cases of eye damage reported in Ontario after solar eclipse
More than 115 people who viewed the solar eclipse in Ontario earlier this month experienced eye damage after the event, according to eye doctors in the province.
Last letters of pioneering climber who died on Everest reveal dark side of mountaineering
George Mallory is renowned for being one of the first British mountaineers to attempt to scale the dizzying heights of Mount Everest during the 1920s. Nearly a century later, newly digitized letters shed light on Mallory’s hopes and fears about ascending Everest.
Toxic testing standoff: Family leaves house over air quality
A Sherwood Park family says their new house is uninhabitable. The McNaughton's say they were forced to leave the house after living there for only a week because contaminants inside made it difficult to breathe.
Decoy bear used to catch man who illegally killed a grizzly, B.C. conservation officers say
A man has been handed a lengthy hunting ban and fined thousands of dollars for illegally killing a grizzly bear, B.C. conservation officers say.
Sophie Gregoire Trudeau on navigating post-political life, co-parenting and freedom
Sophie Gregoire Trudeau says there is 'still so much love' between her and Prime Minister Justin Trudeau, as they navigate their post-separation relationship co-parenting their three children.
An emergency slide falls off a Delta Air Lines plane, forcing pilots to return to JFK in New York
An emergency slide fell off a Delta Air Lines jetliner shortly after takeoff Friday from New York, and pilots who felt a vibration in the plane circled back to land safely at JFK Airport.
B.C. seeks ban on public drug use, dialing back decriminalization
The B.C. NDP has asked the federal government to recriminalize public drug use, marking a major shift in the province's approach to addressing the deadly overdose crisis.
'I was scared': Ontario man's car repossessed after missing two repair loan payments
An Ontario man who took out a loan to pay for auto repairs said his car was repossessed after he missed two payments.
First court appearance for boy and girl charged in death of Halifax 16-year-old
A girl and a boy, both 14 years old, made their first appearance today in a Halifax courtroom, where they each face a second-degree murder charge in the stabbing death of a 16-year-old high school student.