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Flu Outbreak Strains Arkansas ICUs

LITTLE ROCK, Ark. — Many intensive-care units at central Arkansas hospitals have been full or near capacity in recent weeks because of a heavy outbreak of influenza combined with other seasonal illnesses.

As a result, smaller hospitals are waiting longer than usual for approval to send patients to larger facilities, and patients at larger hospitals are stuck longer in emergency rooms before they can be moved to ICU beds.

Baptist Health Medical Center-Heber Springs, for example, has been forced to delay transfer of critically ill patients to centers in Little Rock, Baptist Health System spokesman Mark Lowman said.

“Their delays are in terms of additional hours, not days,” Lowman said. He said the wait times were “quite a bit longer than normal,” but he couldn’t say how much longer.

Several hospitals, including Baptist Health Medical Center-Little Rock, believe this year’s flu season has struck them hard.

Medicaid flu claims last week were about double the average for the same time in the years 2004-07, Arkansas Department of Health officials said. The flu season had a late start this year, officials have said, and this year’s vaccine doesn’t fight two common strains of the flu virus.

Doug Weeks, a senior vice president at Baptist Health Medical Center-Little Rock, said ICU beds at that campus have been “pretty tight in the past three or four weeks.” Because February isn’t over, Weeks didn’t have a month-end report of admissions to compare with February 2007, but he expects them to be higher this year.

Adding to problems created by the flu season, Baptist has had 37 fewer beds than normal available for about three months because of a change in ownership in a long-term acute-care hospital on its Little Rock campus. Five of those beds were opened Wednesday, three more were expected to open by the first of next week, and additional beds will open as fast as appropriate staffing is found.

Christy Hockaday, chief executive at St. Anthony’s Medical Center in Morrilton, said that in the past few weeks it had been taking four to six hours after a request was made to hear if a hospital could accept St. Anthony’s patients. Then the patient must be transported.

Throughout the year, the hospital expects a typical wait of two to three hours before a bed is confirmed, she said.

In Searcy, White County Medical Center has eight intensive-care beds.

“Those probably have been 95 to 100 percent occupied at all times,” said LaDonna Johnston, vice president of patient care services. “I had one day — maybe — in the past month that I’ve had a free bed open.” When a bed is open, she said, “usually it is full within two to six hours.” The hospital has received calls from other Arkansas facilities looking for such beds and saying their next option was Memphis, Johnston said.

Ann Gasper, a spokesman for Hot Spring County Medical Center in Malvern, said the hospital has “had some problems recently getting patients transferred to the larger hospitals in Little Rock. There’s been some times when we’ve had to wait several hours to get a patient transferred, but we’ve always been able to get them transferred.” Paul Cunningham, senior vice president of the Arkansas Hospital Association, saw the tight bed situation personally after his father suffered a mild heart attack a few weeks ago and was taken to a Little Rock hospital early in the afternoon.

After receiving a stent, “he needed to go into ICU for a couple days, just mainly for observation,” Cunningham said. “They had to keep him in the emergency room for almost the balance of the day, well into the night. They just didn’t have an ICU bed available, and obviously he wasn’t the only one who needed an ICU bed.” At St. Vincent Infirmary Medical Center in Little Rock on Tuesday morning, ICU beds were 92 percent filled.

“That’s considered high capacity,” said Tim Osterholm, service line administrator for outpatient and ambulatory services. “On average throughout the year, we’re usually at 68 percent capacity. You can see that’s busting at the seams.” When other hospitals have requested intensive-care beds this month, it’s been taking St. Vincent’s about 2.5 hours to assign one, about 1.5 hours more than in slower months of November and December. That does not include transport time.

Even so, Osterholm didn’t think bed supply at St. Vincent’s this year is worse than previous flu seasons.

St. Vincent’s ongoing expansion will add eight emergency beds and nine intensive-care beds, but Osterholm said those also will fill quickly at busy times of the year.

Like hospitals, Metropolitan Emergency Medical Services also has seen more business in recent weeks.

From Jan. 1 through midnight Monday, call volume at the Little Rock-based ambulance service in Little Rock and North Little Rock rose to 7,100, compared with 6,600 for the corresponding time last year, and 6,400 for the year before that, MEMS’ executive director Jon Swanson said.