Top tips for parents this winter from an emergency consultant at Temple Street

Dr Paddy Fitzpatrick says flu is now taking over this winter after respiratory syncytial virus (RSV) reached record levels

Up to 100 extra patients a day are being seen by Dublin’s three children’s hospital at present compared with a “normal” busy winter, according to Children’s Health Ireland.

The health service is dealing with a “huge number” of children with winter respiratory viruses, according to Dr Paddy Fitzpatrick, an emergency department consultant at CHI Temple Street. The hospital has been forced into surge capacity several times over the past few weeks; elective work has been cancelled; and staff have been redeployed from other areas to help the emergency department.

Although respiratory syncytial virus (RSV) had been at record levels this winter, flu was now taking over, he said.

“We can see that parents are finding it hard. We’ve had two years of very well children with the lockdowns, so it’s hard to remember what a sick child looks like. A lot of parents are experiencing this now with their two or three year olds. Many children’s immune systems are naive as they haven’t experienced these winter viruses, and they can be that bit sicker,” said Dr Fitzpatrick.

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“This is coinciding with primary care being overwhelmed, so people find it hard to get their children seen in the community. As a result, they come to us.”

Up to 90 per cent of children who attended emergency departments were discharged without requiring any further attention, a far higher proportion than in adult hospitals, said Dr Fitzpatrick.

“We’re not saying they shouldn’t be there. Parents know their children better than anyone and we are trying to empower them to manage the situation when sickness occurs.”

To help parents, Dr Fitzpatrick has compiled a “top 10 tips” list of advice to parents on dealing with a sick child.

  • First, it is important to realise that childhood illnesses are normal and common. The average child will experience about 12 infections a year in the first few years of life. The vast majority will get better within a week and won’t require medical attention or antibiotics.
  • The child flu vaccine, administered nasally, is the best way of protecting children from an illness that can make them very sick.
  • Sick children should be kept at home, in order to reduce the spread of viruses.
  • Babies under three months, and especially those under one month, are more vulnerable. During the winter viral season, try not to let too many people from outside your close circle handle and kiss them, and get people to wash their hands before doing so. Any child of this age should be seen by a doctor if they have a fever above 38 degrees, except after receiving a vaccine.
  • Try to source reputable information on your child’s health, provided by reliable institutions. Dr Fitzpatrick, who warns that social media can amplify misinformation, recommends the HSE’s undertheweather.ie or the NHS website.
  • Serious bacterial illnesses are very rare, he says but parents should “trust their gut”. Symptoms such as severe lethargy, breathing difficulties, drowsiness or a rash that won’t go away when pressed are all red flags for immediate medical attention. Watch out too for a floppy baby, one emitting a high-pitched cry that is not normal or severely pale or has blotchy blue/grey skin.
  • The most common symptoms of a sick child are fever, cough, sore throats and diarrhoea. “Fever is the body’s normal response to infection,” Dr Fitzpatrick says. “We don’t necessarily treat fever but it may make your child feel particularly miserable – if so, try using medications such as paracetamol or ibuprofen to make them more comfortable. These are also given to relieve headache, earache and sore throats. The treatment for vomiting or diarrhoea is generally hydration – in small, regular amounts.”
  • If your child has asthma, make sure an action plan for dealing with flare-ups has been updated with your GP. Take preventative medicines as directed.
  • What if you are not sure what to do? Dr Fitzpatrick advises seeking reliable advice online, or talking to an experienced parent such as a grandparent. Community pharmacists and GPs are well trained to manage childhood infections. GPs will be busy at this time but should get back to you. Emergency departments may have long wait times.
  • When to go to hospital? Symptoms such as severe breathing difficulties, severe dehydration, extreme drowsiness, a non-disappearing rash or deterioration following a previous medical visit are all signs that a child requires urgent medical attention.
Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times