Seattle Children’s Hospital is seeing “unprecedented demand” in its emergency department, creating long wait times and forcing providers to see some patients with non-life threatening illnesses in the waiting room, said Seattle Children’s Emergency Medicine medical director Tony Woodward.

After an initial lull at the start of the pandemic, Woodward said the hospital has seen a steady increase of patients to the point that patient volumes have now eclipsed their previous high in 2019.

“On a day by day basis, we’re busier than we’ve ever been,” he said.

The demand is being driven by many community pediatrician offices being strained by already full loads or staffing shortages as well as an influx of viral-related illness associated with the fall and cold weather like the flu, he said.

While most primary care physicians now see children with COVID-19 or have developed telemedicine protocols, at first kids with coronavirus were only able to go to the hospital.

Now, as school and day care have resumed and mask requirements have gone away, many children are being exposed to germs for the first time in years, he said.

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The hospital serves patients from Wyoming, Alaska, Montana and Idaho. Wildfire smoke in the region has also exacerbated respiratory illnesses, Woodward said.

The hospital has opened additional beds and increased physician staffing: It has increased the number of physician shifts from about eight or nine each day to 10 to 11, adding up to 18 additional physician hours.

Even so, sometimes more patients come in within a two-hour window than there are total beds in the emergency department, Woodward said.

In the past, providers have had to evaluate patients and plan discharges from the waiting room only during intermittent surges, Woodward said. Now, that has become a routine occurrence for patients who do not require nursing care or need something simple like an X-ray or Tylenol, he said.

“We try to use every additional square foot we have to provide care, recognizing that a waiting room with other people is not a place to have confidential conversations,” Woodward said.

Woodward emphasized that when caregivers and families genuinely believe someone needs immediate medical attention, they should go to the emergency department without hesitation.

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“We’re always available for emergencies no matter what and we prioritize waits based on need,” he said. “When patients come in and they have a dire emergency, they will get care immediately.“

Even if the wait times are long and the waiting room is crowded, Woodward recommended that caregivers do not go home without having a provider take a look at the child.

Aside from primary care, Seattle Children’s recommend visiting the hospital’s four urgent care locations for non-life-threatening illnesses and consulting the hospital’s guide on whether to go to an emergency department or urgent care for specific symptoms.

In the case of a severe asthma attack, seizure or fever in an infant, staff recommend going to the hospital’s emergency department. In the case of a minor allergic reaction, diarrhea or dehydration, urgent care is recommended.

The hospital’s urgent care does not provide ultrasounds, CT scans or MRI studies. It also does not provide primary care services like checkups for well children, referrals to other clinics, and physicals for sports or camp.