Pediatrician offices, urgent cares, hospitals are deluged with young patients seeking care for viral illnesses, mental health needs and important routine care.
Itasca, IL--In light of a national surge in respiratory infections among children, the American Academy of Pediatrics has published two sets of interim guidance on prophylaxis for children at high risk of complications from respiratory syncytial virus (RSV) and in handling the surge of patients filling hospital beds, emergency departments, and doctor’s offices.
The AAP offers updated interim guidance on caring for patients during a surge, which at this time has been compounded by the ongoing crisis in children’s mental health. The guidance aimed at inpatient and outpatient settings observes the need to enhance emergency readiness on a day-to-day basis in all settings to avoid interrupting continuous care of children’s physical and mental health care needs.
Children with special health care needs, inclusive of children with medical complexity, are especially impacted during surge events, which right now consists of a combination of outbreaks of influenza, RSV, COVID-19 and other infectious diseases, as well as a pediatric influx of patients with mental health concerns, the guidance notes.:
In updated RSV guidance, the AAP supports providing eligible infants with more than five consecutive doses of palivizumab in regions with widespread and intense RSV circulation. According to the AAP, palivizumab, a monoclonal antibody to prevent severe lung infection, may be given to eligible infants throughout the 2022-23 RSV season, which began earlier and has persisted longer than in previous years. The AAP will continue to monitor RSV cases or trends and update the interim guidance further as needed.
Children who are eligible for palivizumab include some pre-term infants in their first RSV season and some infants with certain chronic conditions. It is a preventive medication that can reduce the risk of severe disease in the most high-risk patients. Other ways to prevent RSV include keeping infants away from large groups, sick people and secondhand smoke, as well as washing hands thoroughly.
There is no cure for RSV, and medications like antibiotics and steroids are not effective against the virus. Most children with RSV, influenza and other respiratory illnesses recover on their own and can be managed safely at home, said Sean O’Leary, MD, MPH, FAAP, chair of the AAP Committee on Infectious Diseases.
“For most children, treating RSV at home is similar to treating a bad cold,” said Dr. O’Leary. “In children older than 6 months, acetaminophen or ibuprofen can help with low-grade fevers. If your child seems to be struggling to breathe – such as if they seem to be breathing too fast or their chest is sucking in with each breath – you should call your pediatrician right away.”
Dr. O’Leary also urged families to be vaccinated against influenza and COVID-19. Both vaccines are effective at preventing the most severe disease and hospitalization.
In the AAP’s interim guidance on caring for patients during a surge, the AAP notes there should be no delays in routine pediatric care, chronic disease management or immunizations. Staff who typically care for adults can be cross trained to prepare them to provide care for pediatric patients. During a surge, referral to hospitals should be reserved for children whose illness severity or associated medical disorders require a higher level of care to avoid emergency department overcrowding, extended patient waiting times and delay of care.
On Monday, the AAP and the Children’s Hospital Association urged President Biden and Health and Human Services Secretary Xavier Becerra to declare an emergency to support a national response to the alarming surge of pediatric respiratory illnesses, along with the continuing children’s mental health emergency.
The emergency declarations requested would allow waivers of certain Medicare, Medicaid or Children’s Health Insurance Program (CHIP) requirements so that hospitals, physicians, and other health care providers may share resources in a coordinated effort to care for their community and have access to emergency funding to keep up with the growing demands, specifically related to workforce support.
The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.