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<<   作成日時 : 2009/05/04 19:33   >>

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 今週、咳・喉の痛み・熱を訴えて記録破りの患者がERに押し寄せている。
 特に乳幼児は呼吸器疾患にかかりやすいため、こども病院で急増した。病院によっては、職員を増員配置してトリアージ計画を立てた。ERでの待ち時間が重症者でも長くなった。症状がない患者も押し寄せている。カリフォルニア・ベーカーズフィールドのSan Joaquin Community Hospitalには、火曜日に今までの記録となる188人がER受診したが検査を施行する基準を満たすような患者はいなかった。
 こうした現象は確認患者が出た州に限らない。イリノイのシカゴ子ども病院には通常の2倍以上の患者がERに殺到した。通常は170人程度だが、水曜日に392人、木曜日に369人で、通常1-2時間待ちが最大6時間待ちとなった。他の部署から職員を引き抜いて配置したが、スタッフが疲れずにいつまで現在のレベルに耐えられるかが明らかでないと言う。
 ニューヨークのNorth Shore-Long Island Jewish Health Systemsの12の救急室は今週1,100人の患者が押し寄せた。検査室は1日20時間稼働し、今週6日間で2ヶ月分の仕事をしたと言う。
 米国で唯一の死者を出したヒューストンのテキサス子ども病院では、最近3日間は患者が40%増加し、戸外の駐車場でスクリーニングを行っている。近くのMemorial Hermann病院は50%増加した。
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Emergency Rooms Fill With Record Numbers, but Many Aren’t Ill, Just Afraid
By KEVIN SACK
Published: May 1, 2009
http://www.nytimes.com/2009/05/02/us/02er.html

画像Michael Stravato for The New York Times
Yetzabeth Arellano, 2, with her parents, Saul and Yuriana, received a nasal swab to check for flu symptoms Friday in Houston, in a parking garage used for triage.

Some hospital emergency rooms have seen record-breaking numbers of patients this week as those with coughs, sore throats and fevers ― and sometimes no symptoms at all ― have sought reassurance that they do not have the deadly H1N1 virus, also known as swine flu.
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Although the pattern is far from universal, the surges have been particularly heavy at children’s hospitals, presumably because the young are so susceptible to respiratory diseases with comparable symptoms. Some hospitals have had to increase staffing and enact specialized triage plans. Waiting times have billowed in some emergency rooms, even for the seriously ill.

In many instances, patients are showing up at hospitals, sometimes referred by their doctors, even though they do not have symptoms, like fever and nausea, that could indicate swine flu.

At San Joaquin Community Hospital in Bakersfield, Calif., none of the 188 patients ― a daily record ― who arrived at the emergency room on Tuesday had symptoms that met the criteria to even be tested, said Jarrod B. McNaughton, the hospital’s vice president.

“It’s a major drain on resources,” Mr. McNaughton said.

The burden has not been limited to states with confirmed cases. For instance, in Illinois, where the first three cases were confirmed only on Friday, Children’s Memorial Hospital of Chicago has been treating more than twice its usual volume of emergency room patients this week, said Dr. Sally R. Reynolds, the department’s medical director.

“We usually see about 170 patients a day this time of year, sometimes as low as 150, and we had 392 on Wednesday and 369 on Thursday,” Dr. Reynolds said. “I think our previous record was 275.”

Dr. Reynolds said some patients had waited as long as six hours to be seen, compared with normal waits of an hour or two.

“Some of them have legitimate worries, like a fever and cough, but a lot of them just have a cold and no flu-like symptoms,” she said. “It’s hard for us because when you’re overwhelmed like that the goal is to sort out who’s really sick.”

The hospital has increased emergency room staffing by plucking doctors and nurses from other departments, Dr. Reynolds said, but it is not clear how long she can sustain current levels without exhausting her staff. “I have a plan through Monday,” she said.

In New York, the 12 emergency rooms operated by North Shore-Long Island Jewish Health Systems had more than 1,100 visits this week by patients complaining of flu-like symptoms, said Terry Lynam, a spokesman.

“Our laboratories were getting overrun with specimens being sent in so we had to bring in additional staffing and expand hours up to 20 hours a day,” Mr. Lynam said. “Over six days this week, our largest laboratory, in Lake Success, N.Y., did two months’ worth of work.”

At Texas Children’s Hospital in Houston, site of the only death caused by swine flu in the United States, emergency room volume increased by at least 40 percent in each of the last three days, said Dr. Joan E. Shook, the medical director of the emergency department. A neighboring hospital, Memorial Hermann, saw 50 percent increases, said Dr. James J. McCarthy, the emergency department medical director there.

The death, Dr. Shook said, had made families understandably anxious.

“People come in saying they had a fever a while ago or they thought they had a fever or they just want to be tested,” she said. “They just want to know. They just want to feel safe.”

Because of record numbers at Texas Children’s, and the need to segregate anyone infected with the virus, patients complaining of flu symptoms are receiving initial screenings in an open-air parking deck, Dr. Shook said.

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