Anyone seeing a weird pattern in their ICU

[matt2401, MSN, RN]

I have been seeing ALOT of fairly health patients coming in with URI s/s then crashing HARD and ending up on a vent/oscillator, multi-pressors then dying (usually within 24 hours of admission but sometimes just languishing). They aren't technically fitting ILI symptoms and we are being aggressive about influenza swabs, but they are finding as low as 10% sensitivity for the rapid test to pick up on swine-origin H1N1 flu (the latest, correct term of the week). The PCR confirmation tests from the health department take so long to get back, its almost useless. I have been talking with other nurses in my area and they are seeing the same thing at other hospitals. Local event? Happening other places?

I have a really bad feeling about this fall....hope I am wrong

[dorimar, BSN, RN]

What is your locality? As of yet, we have not seen this. Right now, hospital census is down for our entire county. I still do not understand why ICU census would drop, even in hard times. People do not choose to be critically ill. I would even expect critical illness to increase when people are not paying for preventative care....

However, to get back on you topic. I hear tell from those in HR for hospitals, that many feel we will be hit hard by swine flu this year. I have been told that ICU's filled with it in other parts of the world in their flu seasons (Australia, etc ). However, this is hearsay.

[geekgolightly, BSN, RN]

Worldwide.

What is your location?

https://allnurses.com/pandemic-flu-forum/no-prior-existing-400466.html

[pebbles, BSN, RN]

That is very similar to the H1N1 flu patients we've had in our ICU's here. Our doctors have publicly commented that the nasal swabs that are done to test for H1N1 don't seem to be sensitive enough and have a higher chance for error due to not swabbing deep enough, that type of thing. They have started sending secondary samples of the patient's respiratory secretions for testing.

[chani]

In NSW & Victoria Australia we have had large numbers of both H1N1 and influenza A as well as non-specific flu-like patients admitted, who then crash & burn within 24 hrs. Both states are over the worst (Victoria was the first state in Australia with H1N1 patients) now however it stretched our public system to the limit with vents, oscillators & ECMO resources maxed out for several weeks. Patients covered the usual suspects however there were a number of young ante/post partum women who were severely ill and several who died unfortunately. Our national ICU medical body (ANZICS) is collecting stats on all patients so hopefully we will be able to get a better epidemiological picture. I suspect this is happening elsewhere. In addition there were also a number of issues with false positives, negatives and 'what the' diagnosis.

Infection control departments were also continually vexed by the cavalier attitude of emergency department personnel.

[criticalHP, MSN, RN]

Not seeing anything like that in my area, although we are expecting to be hit hard with H1N1-we are a tourist destination.