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[quote=Anonymous][quote=Anonymous][quote=Anonymous]
^^The process of transfer requires finding an open bed and an accepting provider who agrees escalation of care is warranted. How were they supposed to make that case to 1) take a slot other children might need, and 2) justify to insurance to cover transfer without established medical need, and 3) justify to transport teams -- who have limited spots, and must triage transport slots -- to put him in the queue, which is always busy?

That's how this works. You can't just say, "hey, there is this irritable kid here with measles (by the way, they are all irritable), but there was no indication of inflammation in the spinal fluid, and his MRI doesn't show brain tissue or meninges affected yet, but, you know, let's put him in the PICU, eh? Let's do a transport, which comes with significant risks just on its own, for every kid with measles. That's not going to make anything worse for the kids waiting for transport with -- I don't know, head injuries or internal bleeding from motor vehicle crashes, or the neonates on the clock needing exchange transfusion to prevent kernicterus, or the four-year-old with ALL and a white count over 100,000 just waiting to go into tumor lysis syndrome, or a dozen other sicker kids. No, THIS one with the normal LP and MRI, who is walking and drinking water, yeah, he should get that slot."

On what grounds again, exactly? Make the case. Those doctors sure would have had to do so. [/quote]

“After getting a rash in the days that followed, his appetite diminished and he grew weak to the point where he could no longer stand up by himself. He began to fade in and out of consciousness.” He was screaming and not himself. [/quote]

You don't work in the ER, guaranteed. A *lot* of kids come in like this. Gastroenteritis, hand-foot-and-mouth disease, certainly with flu or COVID. They get hydrated and a proper few doses of Tylenol and/or ibuprofen, and they "look like a different kid." All the time.

Once again, from the very same article you are quoting,

[quote]“If all they're doing is antibiotics, maybe he'll be more comfortable at home, and we don't have to put him through this,” his mom said, explaining her thought process, and encouraged by the fact that Ethan appeared to have regained some strength; he could drink water by himself and walk a short distance to the bathroom.[/quote]

So you have a child with measles who is going to be uncomfortable, that's a given -- but he has a normal LP (no decrease in glucose or increase in protein, no increased white blood cells, no positive PCR) and a normal head MRI. He's sick, but he's taking in fluids and walking. He's not himself, but again -- he has measles.

[quote]Maybe he would still be in the same situation but maybe he would have had a better outcome. It doesn”t matter if kids have idiots as parents, they still are entitled to care. [/quote]

What exactly are you going to say to an intensivist to get him accepted for transfer? That he is irritable and hard to settle? They are all irritable and hard to settle. What's the rationale here that anyone with actual medical training will accept?

You have no clue what you are talking about. [/quote]

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