ER visits up, doctors consider incoming H1N1 tide

Colorado Springs hospitals have seen an increase in patients with H1N1 symptoms — up as much as 30 percent each day at Penrose-St. Francis Health Services. 

And, while doctors at the city’s other hospital system, Memorial Health System, also say they’ve seen a significant jump in ER visits, doctors at both hospitals say they can handle the extra load, for now.

“We can handle a 30 percent increase,” said Penrose ER doctor Michael Roshon. “But we can’t handle a 300 percent increase – like they are seeing in some parts of the country, without changing the way we do things.”

Some emergency rooms in the East and Southeast parts of the country are setting up tents outside hospitals to triage patients who have flu like symptoms, in some cases keeping people in their cars. The goal is to keep sick patients from spreading the virus to people in emergency rooms who might have heart or lung diseases.

“We’re not to that point yet,” Roshon said. “But we could get there.”

Memorial has a separate location outside the emergency department to treat H1N1 patients, and Penrose has isolation measures in effect as well. But both hospitals say there is little they can do to cure the disease — they can only alleviate symptoms.

“We can treat the symptoms if people have shortness of breath, high fevers or dehydration,” Roshonsaid. “But we are limiting the amount of Tamiflu we give – we’ve already seen some resistance to it.”

Roshon said giving Tamiflu this early in the season could mean that flu strains become resistant by November or December, leaving hospitals without any drugs to treat the flu at the height of the season.

But are huge numbers of people actually coming down with swine flu, or is media hype feeding fears of becoming ill with the virus? Roshon said it’s a mixture.

“Sometimes we see people with just cold symptoms who are worried,” he said. “That’s why we’re encouraging people to stay home unless their symptoms are worse, or if they are at risk – the very young, the very old, pregnant women, people with other illnesses.”

Memorial currently has hospitalized only three people with the flu, and Roshon said the hospitalizations at Penrose were a “tiny, tiny fraction.” That echoes what other hospitals are reporting nationwide.

The Colorado Department of Public Health and Environment says increased ER visits are seen around metropolitan areas in the state. Health officials are urging people who are not considered “high risk” to stay at home.

“For most people, the H1N1 flu is an unpleasant illness, similar to the seasonal flu, but an illness they can weather at home with rest, fluids and over-the-counter fever medications,” said Dr. Ned Calonge, the state’s chief medical officer. “While we certainly want individuals who are very ill, or are at high risk for complications, to see the medical care they need, we want to encourage other individuals to call their physician before making a trip to the office or emergency room.”

The Centers for Disease Control and Prevention is not only asking that tamiflu be used in specific, serious cases only, they also recommend not testing for H1NI.

“For one thing, if you tested everyone, the cost would be billions of dollars nationwide – just for testing,” Roshon said. “And there really isn’t anything doctors would do differently, so we are only testing in specific cases.”

That makes the number of H1N1 flu cases hard to determine, but there definitely has been an uptick in patients with the flu, he said, many of them due to H1N1.

“Along with the increase in outpatient visits, we are also seeing an increase in hospitalizations,” Calogne said. “This is an unfortunate reminder of how vital it is for parents to keep sick children home from school, in order to mitigate the impact of the flu while we await the availability of the vaccine.”

The following people are at risk for complications due to the flu virus:

- infants and young children
- pregnant women
- people 65 years of age and older (seasonal flu only – H1N1 doesn’t seem to affect this population)
- people of any age with lung disease, asthma, heart disease or weakened immune systems
- people with kidney disease, diabetes or neurological and neuromuscular diseases
- People younger than 19 years old with diseases requiring long-term aspirin therapy

See a health care provider if you have the following symptoms:
- difficulty breathing or fast breathing
- bluish or gray skin color
- fever lasting more than three days
- dehydration
- severe or persistent vomiting
- not waking up or not interacting
- very irritable
- flu-like symptoms improve, but return with fever and worse cough