Navigating Cook Children’s Health Care System

Quick Facts:

• A Fully Integrated System: Cook Children’s Health Care System is a comprehensive, not-for-profit pediatric organization encompassing two full service hospitals, physician network, home health care, surgery centers, a health plan, and a dedicated health foundation.
• Cook Children's: Within our network, our two full-service pediatric hospitals are officially named and referred to as Medical Centers (located in Fort Worth and Prosper).
• Urgent Care: For non-emergency medical needs that still require prompt attention, the system also operates seven Urgent Care Centers across the region.

An unexpected visit to the doctor can be stressful, especially when traveling. Cook Children’s Health Care System ensures that families can access health care at any time through its seven Urgent Care Centers (UCCs), or its two 24-hour emergency departments. With help from the Cook Children’s Language Services Department, families can receive care in their native language. 

Know before you go 

Whether visiting the emergency room or urgent care clinic, being prepared will help ensure care is timely and the child is back in action as quickly as possible. 

To be able to treat a child, a parent or legal guardian must be present or provide permission for treatment. If a parent or legal guardian is unavailable, a written letter of permission or immediate phone access to obtain verbal consent from the parent or legal guardian is needed. 

The adult accompanying the child should bring:

• A form of identification.
• Traveler’s insurance information (if available).
• A list of the child's medication. 

When to use the Cook Children’s Emergency Department 

With full-service medical centers in both Fort Worth and Prosper, Cook Children’s provides emergency care for children across North Texas.  

“We are always happy and prepared to help,” said Julio Castillo, M.D., medical director of emergency services at Cook Children’s Medical Center – Prosper.  

Cook Children's cares for more than 300,000 children every year through urgent care and emergency room visits, providing care in more than 200 languages.  

“We have local Spanish translators and multilanguage computerized access,” explained Dr. Castillo. 

Caregivers should take their child to the Emergency Department if their child is unconscious, not responding, a bone is sticking out, or the situation seems critical. For immediate assistance, dial 911. When a condition is sudden, life-threatening, or risks causing permanent harm, transport by ambulance is safest for the child. 

Take the child to the emergency department if your child is experiencing:  

• Severe bleeding that does not stop after 15 minutes of direct pressure
• Severe allergic reactions
• Difficulty breathing
• Bluish tint to the lips
• Coughing up or vomiting blood
• Sudden severe joint pain with swelling
• Insect stings accompanied by breathing difficulties
• Accidental swallowing of medications, chemicals or other substances
• Not being able to move or speak
• Severe or persistent vomiting or diarrhea
• Gaping wound (edges won’t come together)
• Head injury with loss of consciousness, vomiting or causing dizziness/confusion
• Visible broken bones or dislocated joints
• Fever higher than 100.4 F in infants under 8 weeks old
• Diabetes/blood sugar issues 

Urgent Care 

“For simple fever, cough, and congestion, your child can be seen in urgent care or by their pediatrician,” said Taylor Louden, M.D., medical director of emergency services at Cook Children’s Medical Center- Fort Worth. 

When a child needs same-day medical attention for non-life-threatening illnesses or injuries such as X-rays or stitches,a Cook Children's urgent care clinic can provide the necessary care.

“Cook Children’s Urgent Care Centers are available to see patients needing routine or urgent care while visiting our city for the event,” said  Kara Starnes, D.O. medical director of Urgent Care at Cook Children’s. 

Not all urgent care centers are the same. Cook Children’s Urgent Care clinics are not just kid-friendly; they are kid-only. Because childhood injuries and illnesses require specialized pediatric expertise, families must make an appointment prior to ensure a smooth, efficient visit.

When to use Cook Children’s Urgent Care 

• Ear infections/pain
• Strep/sore throats
• Cold symptoms
• Flu
• Mild dehydration
• Respiratory illnesses – including respiratory syncytial virus (RSV), bronchitis, bronchiolitis, pneumonia and asthma without severe breathing difficulty
• Sprains and possibly broken bones
• Minor cuts
• Prolonged vomiting
• Persistent diarrhea
• Infected bug bites
• Foreign body removal (marbles, beans and other interesting things)
• Urinary infection symptoms
• Pinworms, ringworm, rashes and pink eye
• Painful muscle strains
• Head injuries without loss of consciousness or vomiting 

Related Stories:  

• Cook Children’s Shares Expert Advice About Norovirus 

• Invisible Barriers in ADHD Detection for Children 

• How to Spot a Counterfeit Car Seat 

With the holidays in full swing, accidents and illness may happen at any time. It is always recommended that you try scheduling an appointment with your primary care doctor first. If that is not an option, Cook Children’s Health Care System ensures that our families can access health care at any time through a telehealth visit, an urgent care center, or an emergency department. To prepare for when you need care, know when to use Cook Children’s telemedicine, urgent care, and when to rush to the emergency department.

“For simple fever, cough, and congestion, your child can be seen in urgent care or by their pediatrician,” said Taylor Louden, M.D., medical director of emergency services at Cook Children’s Medical Center- Fort Worth. “Your wait times for simple illnesses will be much longer and visits much more expensive in the emergency department than if your child is seen in urgent care or by their pediatrician.”

He explains that doctors expect a fever to return after the Tylenol/Motrin wears off; however, for fevers lasting more than five days, or if a child appears ill, the emergency department is the appropriate place to be evaluated.  

Urgent Care

When your child needs urgent care for things like X-rays, stitches, and illnesses that are not life-threatening but need medical attention the same day, you'll find the medical care you need at a Cook Children's urgent care clinic.

Cook Children’s Urgent Care clinics are not just kid-friendly; they are kid-only.

When to use Cook Children’s Urgent Care

• Ear infections/pain
• Strep/sore throats
• Cold symptoms
• Flu
• Mild dehydration
• Respiratory illnesses – including respiratory syncytial virus (RSV), bronchitis, bronchiolitis, pneumonia and asthma without severe breathing difficulty
• Sprains and possibly broken bones
• Minor cuts
• Prolonged vomiting
• Persistent diarrhea
• Infected bug bites
• Foreign body removal (marbles, beans and other interesting things)
• Urinary infection symptoms
• Pinworms, ringworm, rashes and pink eye
• Painful muscle strains
• Head injuries without loss of consciousness or vomiting

Virtual Urgent Care

Cook Children's patients with a MyCookChildren's account can video chat with one of our medical experts for non-urgent medical conditions without visiting the doctor's office.

This service is for patients who have minor medical conditions, and not for emergencies.

• Animal and insect bites
• Burns or cuts
• Circumcision check
• Conjunctivitis (pink eye) without other symptoms
• Constipation advice
• Covid-19*
• Diaper rash
• Fever advice
• Flu-like symptoms*
• Ingrown toenail
• Lice
• Mouth ulcers, thrush
• Rashes or skin infections
• Sore throat/strep throat*
• Urinary tract infections*
• Vomiting/diarrhea
• Wound care advice

*Drive-through testing available at Cook Children's Urgent Care locations if medically necessary.

When to use the Cook Children’s Emergency Department

Cook Children’s Health Care System has two medical centers with an Emergency Department for our Fort Worth and Prosper little ones. Parents should take their child to the Emergency Department if their child is unconscious, not responding, a bone is sticking out, or the situation seems critical. Dial 911 immediately for an ambulance. When your child's condition is life-threatening or might cause permanent harm, it is safer for your child to be transported via ambulance.

• Severe bleeding that does not stop after 15 minutes of direct pressure
• Severe allergic reactions
• Difficulty breathing
• Coughing up or vomiting blood
• Sudden severe joint pain with swelling
• Insect stings accompanied by breathing difficulties
• Swallowing poison or choking
• Not being able to move or speak
• Severe or persistent vomiting or diarrhea
• Gaping wound (edges won’t come together)
• Head injury with loss of consciousness, vomiting or causing dizziness/confusion
• Visible broken bones or dislocated joints
• Fever in infants under 8 weeks old
• Diabetes/blood sugar issues

From Nov. 27 to Dec. 3, there were 533 flu A cases, a positivity rate of 33.8%. Protect yourself and your family by getting vaccinated against the flu and COVID. The flu vaccine works to prevent you from catching the flu or by reducing the severity if you do come down with the illness.

In addition to causing respiratory symptoms, the flu can also cause myositis, which results in significant muscle pain and requires admission for IV hydration and pain management. The best way to prevent influenza-associated pneumonia and influenza-induced myositis is to get your flu vaccine.

Respiratory syncytial virus (RSV) cases are declining compared to previous weeks, but remain high. We are also seeing positive cases of COVID and rhinovirus in our patients.

“There are not any current treatments for RSV,” said Laura Romano, D.O., Hospitalist at Cook Children’s Medical Center. “There is also currently not a vaccine available. We can use Synagis, a monoclonal antibody, to help prevent severe infections but that is reserved for certain patients such as our premature infants, our infants with congenital heart or lung disease, infants with compromised immune systems, or some infants with certain neurological conditions."

Cook Children’s has expedited our winter staffing plan in preparation for peak flu season. Our census is full, including beds, the Emergency Department and Urgent Care Centers. Wait times are extremely long. We ask parents and caregivers to contact their pediatrician unless their child has a moderate or severe illness or injury.

Patient Census

In the last 24 hours, 560 patients went to the Emergency Department, which is equivalent to one check in every 2 minutes. This is causing long wait times (8-10 hours) to transfer patients to the Pediatric Intensive Care Unit.

Across our seven Urgent Care Centers, we saw 654 patients on Friday, 653 patients on Saturday, 677 patients on Sunday and 528 patients in the last 24 hours.

There are steps families can take to avoid getting sick. Parents and caregivers can remind their children to continue the healthy habits learned in the pandemic, including hand hygiene, coughing into a tissue or your elbow and staying home if you or your child feel sick. Face masks add increased protection, especially in public spaces.

Last year, more people were wearing face masks and children were more likely to stay home while sick. This year, parents are sending their children to daycare and school for the first time following two years of the pandemic, Dr. Romano said. Children who haven’t been previously exposed to respiratory viruses are among the many children who are getting sick.

Positive Influenza A cases at Cook Children’s Health Care System:

Oct. 9 – Oct. 15: 47 cases

Oct. 16 – Oct. 22: 75 cases

Oct. 23 – Oct. 29: 170 cases (14.6% positivity rate)

Oct. 30- Nov. 5: 333 cases (22.6% positivity rate)

Nov. 6 - Nov. 12: 483 cases (27.5% positivity rate)

Nov. 13 - Nov. 19: 630 cases (35.4% positivity rate)

Nov. 20 - Nov. 26: 812 cases (42.3% positivity rate)

Nov. 27 - Dec. 3: 533 cases (33.8% positivity rate)

RSV cases at Cook Children’s Health Care System:

Oct. 2 – Oct 8: 210 cases (24% positivity rate)

Oct. 9 – Oct. 15: 288 cases (29% positivity rate)

Oct. 16 – Oct. 22: 246 cases (24% positivity rate)

Oct. 23 – Oct. 29: 263 cases (23% positivity rate)

Oct. 30 - Nov. 5: 337 cases (23% positivity rate)

Nov. 6 - Nov. 12: 342 cases (19% positivity rate)

Nov. 13 - Nov. 19: 267 cases (15% positivity rate)

Nov. 20 - Nov. 26: 222 cases (12% positivity rate)

Nov. 27 - Dec. 3: 174 cases(11% positivity rate)

Pediatrician Offices

Call your pediatrician first if children are experiencing mild symptoms or injuries (ear pain, sore throat, diarrhea or vomiting, rash, cough or other non-urgent health concerns). The pediatrician’s office can help you decide what steps to take.

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization.

RELATED: Doctor's Note is Not Required for Excused Absence at Fort Worth ISD

Urgent Care Centers

If your child is ill, please contact your pediatrician's office first if it is not a moderate or severe illness or injury. If you cannot get to your provider’s office or it’s after hours, go to an urgent care center. Urgent care centers manage the same problems as your regular health care provider plus services such as X-rays, stitches and splints.

Understand that kids with more severe issues will be seen first and that means long wait times for those with minor illnesses. Staff are overwhelmed and they’re encountering a lot of frustrated parents. Please be nice to the people working – they need kindness!

Emergency Department

Bring your child to the emergency room if they have trouble breathing, unusual sleepiness or confusion, poison ingestion, head injury with vomiting, serious burn or another life-threatening condition.

Seek immediate medical care if your child is experiencing:

• Persistent fever for more than two or three days. However, any temperature greater than 100.4 in an infant under two months of age is considered a medical emergency.
• Concerns for dehydration.
• In dehydrated babies, parents will see fewer wet diapers or a lack of tears. Their flat spot can also appear more sunken.
• Breathing faster than usual or can see the skin between the ribs being sucked in.
• If your child is requiring frequent use of their albuterol rescue inhaler or is having worsening asthma symptoms.
• Please understand that kids with more severe issues will be seen first and that means long wait times for those with minor illnesses. 

Preparation/Prevention

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization.

Get updated flu and COVID vaccines – these will help prevent infection and reduce the risk of hospitalization. You can call your pediatrician to schedule an appointment to receive vaccinations.

• Teach your children to cough or sneeze into their elbow.
• Use hand sanitizer.
• If you’re sick, wear a mask in public and stay home.

RELATED: 

• Prepare Now for Flu Season with Vaccine Protection
• Get Immunized for a Healthy School Year (checkupnewsroom.com)
• Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)

Cook Children’s has expedited our winter staffing plan in preparation for peak flu season. Our census is full, including beds, the Emergency Department and Urgent Care Centers. Wait times are extremely long. We ask parents and caregivers to contact their pediatrician unless their child has a moderate or severe illness or injury.

Be sure that you and your family are vaccinated against the flu and are updated on the latest COVID vaccines and booster shots. The flu vaccine works to prevent you from catching the flu – or, reduce the severity if you do come down with the illness.

“We are seeing increased cases of flu admissions, particularly influenza infections associated with pneumonias,” said Laura Romano, D.O., Hospitalist at Cook Children’s Medical Center. “In addition to causing respiratory symptoms, the flu can also cause myositis, which results in significant muscle pain and requires admission for IV hydration and pain management. The best way to prevent influenza-associated pneumonia and influenza-induced myositis is to get your flu vaccine.”

Respiratory illnesses, like flu and RSV, are typical for this time of year; RSV is a very common respiratory virus. Some children require hospitalization for RSV, but most do not. We are also seeing positive cases of COVID and rhinovirus in our patients.

There are limited treatments for RSV; most are available for premature infants, infants with other lung diseases, infants who are considered immunocompromised, or patients with a congenital heart disease.

“RSV cases continue to decline but we are still seeing children, particularly our most vulnerable patients, becoming significantly ill with symptoms,” Dr. Romano said. “Our most at-risk patients include those less than 12 weeks, any pre-term infant born at less than 34 weeks, or any baby with congenital lung disease or congenital heart disease.”

Patient Census

In the last 24 hours, 533 patients went to the Emergency Department, which is equivalent to one check in every 2 minutes. This is causing long wait times (8-10 hours) to transfer patients to the Pediatric Intensive Care Unit.

Across our seven Urgent Care Centers, there were 814 patients seen on Monday and 722 patients seen in the last 24 hours.

There are steps families can take to avoid getting sick. Parents and caregivers can remind their children to continue the healthy habits learned in the pandemic, including hand hygiene, coughing into a tissue or your elbow and staying home if you or your child feel sick. Face masks add increased protection, especially in public spaces.

Last year, more people were wearing face masks and children were more likely to stay home while sick. This year, parents are sending their children to daycare and school for the first time following two years of the pandemic, Dr. Romano said. Children who haven’t been previously exposed to respiratory viruses are among the many children who are getting sick.

RSV cases at Cook Children’s Health Care System:

Oct. 2 – Oct 8: 210 cases (24% positivity rate)

Oct. 9 – Oct. 15: 288 cases (29% positivity rate)

Oct. 16 – Oct. 22: 246 cases (24% positivity rate)

Oct. 23 – Oct. 29: 263 cases (23% positivity rate)

Oct. 30 - Nov. 5: 337 cases (23% positivity rate)

Nov. 6 - Nov. 12: 342 cases (19% positivity rate)

Nov. 13 - Nov. 19: 267 cases (15% positivity rate)

Nov. 20 - Nov. 26: 222 cases (12% positivity rate)

Positive Influenza A cases at Cook Children’s Health Care System:

Oct. 9 – Oct. 15: 47 cases

Oct. 16 – Oct. 22: 75 cases

Oct. 23 – Oct. 29: 170 cases (14.6% positivity rate)

Oct. 30- Nov. 5: 333 cases (22.6% positivity rate)

Nov. 6 - Nov. 12: 483 cases (27.5% positivity rate)

Nov. 13 - Nov. 19: 630 cases (35.4% positivity rate)

Nov. 20 - Nov. 26: 812 cases (42.3% positivity rate)

Pediatrician Offices

Call your pediatrician first if children are experiencing mild symptoms or injuries (ear pain, sore throat, diarrhea or vomiting, rash, cough or other non-urgent health concerns). The pediatrician’s office can help you decide what steps to take.

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization.

RELATED: Doctor's Note is Not Required for Excused Absence at Fort Worth ISD

Urgent Care Centers

If your child is ill, please contact your pediatrician's office first if it is not a moderate or severe illness or injury. If you cannot get to your provider’s office or it’s after hours, go to an urgent care center. Urgent care centers manage the same problems as your regular health care provider plus services such as X-rays, stitches and splints.

Understand that kids with more severe issues will be seen first and that means long wait times for those with minor illnesses. Staff are overwhelmed and they’re encountering a lot of frustrated parents. Please be nice to the people working – they need kindness!

Emergency Department

Bring your child to the emergency room if they have trouble breathing, unusual sleepiness or confusion, poison ingestion, head injury with vomiting, serious burn or another life-threatening condition.

Seek immediate medical care if your child is experiencing:

• Persistent fever for more than two or three days. However, any temperature greater than 100.4 in an infant under two months of age is considered a medical emergency.
• Concerns for dehydration.
• In dehydrated babies, parents will see fewer wet diapers or a lack of tears. Their flat spot can also appear more sunken.
• Breathing faster than usual or can see the skin between the ribs being sucked in.
• If your child is requiring frequent use of their albuterol rescue inhaler or is having worsening asthma symptoms.
• Please understand that kids with more severe issues will be seen first and that means long wait times for those with minor illnesses. 

Preparation/Prevention

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization.

Get updated flu and COVID vaccines – these will help prevent infection and reduce the risk of hospitalization. You can call your pediatrician to schedule an appointment to receive vaccinations.

• Teach your children to cough or sneeze into their elbow.
• Use hand sanitizer.
• If you’re sick, wear a mask in public and stay home.

RELATED

• Prepare Now for Flu Season with Vaccine Protection
• Get Immunized for a Healthy School Year (checkupnewsroom.com)
• Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)

The Cook Children's Health Care System census is full across the board, including beds, the Emergency Department and Urgent Care Centers. The sheer volume has made finding a bed for our patients a daily logistical puzzle.

In the last 24 hours, 487 patients went to the Emergency Department, which is equivalent to one check in every 2 minutes. This is causing long wait times (8-10 hours) for patients to be transferred to the Pediatric Intensive Care Unit and is putting unnecessary strain on the health care system.

Across our seven Urgent Care Centers, there were 763 patients on Friday, 668 patients on Saturday and 754 patients on Sunday. Cook Children’s has expedited our winter staffing plan in preparation for peak flu season.

We ask parents and caregivers to contact their pediatrician first if it’s not a moderate or severe illness or injury. Other hospitals and children's hospitals around the country are also experiencing high number of RSV and respiratory illnesses.

RSV cases at Cook Children’s Health Care System:

Oct. 2 – Oct 8: 210 cases (24% positivity rate)

Oct. 9 – Oct. 15: 288 cases (29% positivity rate)

Oct. 16 – Oct. 22: 246 cases (24% positivity rate)

Oct. 23 – Oct. 29: 263 cases (23% positivity rate)

Oct. 30 - Nov. 5: 337 cases (23% positivity rate)

Nov. 6 - Nov. 12: 342 cases (19% positivity rate)

Nov. 13 - Nov. 19: 267 cases (15% positivity rate)

Positive Influenza A cases at Cook Children’s Health Care System:

Oct. 9 – Oct. 15: 47 cases

Oct. 16 – Oct. 22: 75 cases

Oct. 23 – Oct. 29: 170 cases (14.6% positivity rate)

Oct. 30- Nov. 5: 333 cases (22.6% positivity rate)

Nov. 6 - Nov. 12: 483 cases (27.5% positivity rate)

Nov. 13 - Nov. 19: 630 cases (35.4% positivity rate)

Urgent Care Centers

If your child is ill, please contact your pediatrician's office first if it’s not a moderate or severe illness or injury. If you can’t get to your provider’s office or it’s after hours, go to an urgent care center. Urgent care centers manage the same problems as your regular health care provider plus services such as X-rays, stitches and splints.

Understand that kids with more severe issues will be seen first and that means long wait times for those with minor illness. Staff are overwhelmed and they’re encountering a lot of frustrated parents. Please be nice to the people working – they need kindness!

Emergency Department

Bring your child to the emergency room if they have trouble breathing, unusual sleepiness or confusion, poison ingestion, head injury with vomiting, serious burn or another life-threatening condition. Please understand that kids with more severe issues will be seen first and that means long wait times for those with minor illnesses. 

Pediatrician Offices

Call your pediatrician first if children are experiencing mild symptoms or injuries (ear pain, sore throat, diarrhea or vomiting, rash, cough or other non-urgent health concerns). The pediatrician’s office can help you decide what steps to take.

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization.

Preparation/Prevention

The increase in RSV and influenza began much earlier than usual this year, but we have yet to reach peak flu season. With Thanksgiving approaching, we want to help parents understand what they can do to prevent the spread of illnesses.

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization. Get updated flu and COVID vaccines – these will help prevent infection and reduce the risk of hospitalization. You can call your pediatrician to schedule an appointment to receive vaccinations.

Remind your children to continue the healthy habits learned in the pandemic, including hand hygiene, coughing into a tissue or your elbow and staying home if you or your child feel sick. 

There is a nationwide shortage of RSV tests. RSV testing doesn’t change the way in which most children are treated/managed.

RELATED: 

• Prepare Now for Flu Season with Vaccine Protection
• Get Immunized for a Healthy School Year (checkupnewsroom.com)
• Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)

Cook Children's is currently experiencing a surge in patients diagnosed with RSV, flu and other respiratory illnesses – this is impacting our ability to care for our patients in a timely manner. Other hospitals and children's hospitals around the country are also experiencing high number of RSV and respiratory illnesses.

The Cook Children's Health Care System census is full across the board, including beds, the Emergency Department and Urgent Care Centers. The sheer volume has made finding a bed for our patients a daily logistical puzzle.

In the last 24 hours, 568 patients went to the Emergency Department, which is equivalent to one check in every 2 minutes. There were 740 patients across our seven Urgent Care Center locations.

This is causing long wait times (8-10 hours) for patients to be transferred to the Pediatric Intensive Care Unit. This is putting unnecessary strain on the health care system.

Cook Children’s has expedited our winter staffing plan in preparation for peak flu season.

We ask parents and caregivers to contact their pediatrician first if it’s not a moderate or severe illness or injury. Other hospitals and children's hospitals around the country are also experiencing high number of RSV and respiratory illnesses.

RSV cases at Cook Children’s Health Care System:

• Oct. 2 – Oct 8: 
  • 210 cases (24% positivity rate)
• Oct. 9 – Oct. 15: 
  • 288 cases (29% positivity rate)
• Oct. 16 – Oct. 22: 
  • 246 cases (24% positivity rate)
• Oct. 23 – Oct. 29: 
  • 263 cases (23% positivity rate)
• Oct. 30 - Nov. 5:
  • 337 cases (23% positivity rate)

Positive Influenza A cases at Cook Children’s Health Care System:

• Oct. 9 – Oct. 15: 
  • 47 cases
• Oct. 16 – Oct. 22: 
  • 75 cases
• Oct. 23 – Oct. 29: 
  • 170 cases (positivity rate of 14.6%)
• Oct. 30- Nov. 5: 
  • 333 cases (positivity rate of 22.6%)

Urgent Care Centers

If your child is ill, please contact your pediatrician's office first if it’s not a moderate or severe illness or injury. If you can’t get to your provider’s office or it’s after hours, go to an urgent care center. Urgent care centers manage the same problems as your regular health care provider plus services such as X-rays, stitches and splints.

Understand that kids with more severe issues will be seen first and that means long wait times for those with minor illness. Staff are overwhelmed and they’re encountering a lot of frustrated parents. Please be nice to the people working – they need kindness!

Emergency Department

The influx of patients to the Emergency Department is causing long wait times (8-10 hours) to be transferred to the Pediatric Intensive Care Unit. This is putting unnecessary strain on the health care system.

Cook Children’s has expedited our winter staffing plan in preparation for peak flu season.

We ask parents and caregivers to contact their pediatrician first if it’s not a moderate or severe illness or injury.

Bring your child to the emergency room if he/she has trouble breathing, unusual sleepiness or confusion, poison ingestion, head injury with vomiting, serious burn or another life-threatening condition. Please understand that kids with more severe issues will be seen first and that means long wait times for those with minor illnesses. 

Pediatrician Offices

Call your pediatrician first if children are experiencing mild symptoms or injuries (ear pain, sore throat, diarrhea or vomiting, rash, cough or other non-urgent health concerns). The pediatrician’s office can help you decide what steps to take.

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization.

Preparation/Prevention

The increase in RSV and influenza began much earlier than usual this year, but we have yet to reach peak flu season. With Thanksgiving approaching, we want to help parents understand what they can do to prevent the spread of illnesses.

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization. Get updated flu and COVID vaccines – these will help prevent infection and reduce the risk of hospitalization. You can call your pediatrician to schedule an appointment to receive vaccinations.

Remind your children to continue the healthy habits learned in the pandemic, including hand hygiene, coughing into a tissue or your elbow and staying home if you or your child feel sick. 

There is a nationwide shortage of RSV tests. RSV testing doesn’t change the way in which most children are treated/managed.

RELATED: 

• State of the System: High Census of Patients With RSV & Respiratory Illness (checkupnewsroom.com)
• Prepare Now for Flu Season with Vaccine Protection
• Get Immunized for a Healthy School Year (checkupnewsroom.com)
• Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)

The Cook Children's Health Care System census is full across the board, including beds,  the Emergency Department and Urgent Care Centers. The sheer volume has made finding a bed for our patients a daily logistical puzzle. According to the Texas Hospital Association, pediatric hospital beds across the state are currently 88% occupied. 

Urgent Care Centers

We had 728 visits across our seven Urgent Care Center locations on Wednesday. If your child is ill, please contact your pediatrician's office first if it’s not a moderate or severe illness or injury.

If you can’t get to your provider’s office or it’s after hours, go to an urgent care center. Urgent care centers manage the same problems as your regular health care provider plus services such as X-rays, stitches and splints.

Understand that kids with more severe issues will be seen first and that means long wait times for those with minor illness.

Staff are overwhelmed and they’re encountering a lot of frustrated parents. Please be nice to the people working – they need kindness!

Emergency Department

We saw 623 patients in the ED yesterday, which is equivalent to one check in every 2 minutes. The influx of patients is causing long wait times (8-10 hours) to be transferred to the Pediatric Intensive Care Unit. This is putting unnecessary strain on the health care system.

Cook Children’s has expedited our winter staffing plan in preparation for peak flu season.

We ask parents and caregivers to contact their pediatrician first if it’s not a moderate or severe illness or injury.

Bring your child to the emergency room if he/she has trouble breathing, unusual sleepiness or confusion, poison ingestion, head injury with vomiting, serious burn or another life-threatening condition. Please understand that kids with more severe issues will be seen first and that means long wait times for those with minor illnesses. 

Pediatrician Offices

Call your pediatrician first if children are experiencing mild symptoms or injuries (ear pain, sore throat, diarrhea or vomiting, rash, cough or other non-urgent health concerns). The pediatrician’s office can help you decide what steps to take.

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization.

Preparation/Prevention

The increase in RSV and influenza began much earlier than usual this year, but we have yet to reach peak flu season. With Thanksgiving approaching, we want to help parents understand what they can do to prevent the spread of illnesses.

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization. Get updated flu and COVID vaccines – these will help prevent infection and reduce the risk of hospitalization. You can call your pediatrician to schedule an appointment to receive vaccinations.

Remind your children to continue the healthy habits learned in the pandemic, including hand hygiene, coughing into a tissue or your elbow and staying home if you or your child feel sick. 

There is a nationwide shortage of RSV tests. RSV testing doesn’t change the way in which most children are treated/managed.

RSV cases at Cook Children’s Health Care System:

• Oct. 2 – Oct 8: 210 cases
  • (24% positivity rate)
• Oct. 9 – Oct. 15: 288 cases
  • (29% positivity rate)
• Oct. 16 – Oct. 22: 246 cases
  • (24% positivity rate)
• Oct. 23 – Oct. 29: 263 cases
  • o   (23% positivity rate)

Positive Influenza A cases at Cook Children’s Health Care System:

• Oct. 9 – Oct. 15: 
  • 47 cases
• Oct. 16 – Oct. 22: 
  • 75 cases
• Oct. 23 – Oct. 29: 
  • 170 cases (positivity rate of 14.6%)

RELATED: 

• Prepare Now for Flu Season with Vaccine Protection
• Get Immunized for a Healthy School Year (checkupnewsroom.com)
• Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)

The Centers for Disease Control and Prevention (CDC) found that nearly half of all people who enter an urgent care center, or walk-in clinic, with symptoms of a cold or flu leave with a prescription for an antibiotic.

The study found that 46 percent of urgent care patients were prescribed antibiotics for conditions, compared with 24 percent at emergency rooms and 17 percent at medical offices.

Educating families and staff on antibiotic overuse has become a focus of Parul Martin, M.D., medical director of Cook Children’s Urgent Care Centers. She joins the national movement on this topic to improve antibiotic stewardship and has highlighted this topic of concern in her presentations for the Urgent Care Association (UCA).  Additionally, the Cook Children’s Urgent Care Quality Improvement and Research Council is collaborating with the UCA to improve antibiotic prescribing practices nationally.

“Cook Children’s proudly supports a culture of clinical excellence,” Dr. Martin said. “Our practice standards are very high. We follow the American Academy of Pediatrics guidelines and we follow evidence-based medicine across the board, including our primary care offices, our specialties, our Emergency Department and our Urgent Care Centers. Everyone is held to those same high standards. We are continually educating our providers about antibiotics and the treatment of viral illnesses. But we also have to continue to educate the families we treat about the proper use of antibiotics.”

Many families don’t want to leave a doctor’s office without an antibiotic. But Dr. Martin said it’s important that doctors explain to families that too much antibiotic use can be harmful to a child. Education is the key to reaching a long term solution to the current crisis.

“We’re a little more proactive on this issue than some of the other Urgent Care Centers or walk-in clinics you may take your children to if they are sick,” Dr. Martin said. “We don’t have the same pressures that they do to stay in business based on volume. If families aren’t prescribed an antibiotic they may go somewhere else. That’s a tough position to be in because if those clinics don’t satisfy the families, they aren’t going to stay in business. That’s part of what has led us to this antibiotic crisis we are in right now. As caregivers, we have to be unified and responsible about only giving this medication when it’s absolutely necessary.”

For viruses that cause illnesses such as the common cold, also known as an upper respiratory tract infection, antibiotics aren’t effective. Antibiotics don’t stop viruses. They only kill bacteria.

The CDC estimates 47 million unnecessary antibiotic prescriptions are written in doctor’s offices, emergency rooms and hospital-based clinics each year. Furthermore, they estimate up to one-third to one-half of antibiotic use in humans is either unnecessary or inappropriate.

Using antibiotics the wrong way can cause bacteria to grow into superbugs and this could mean a problem for your child.

“Antibiotics are drugs used to treat bacterial infections,” said Marc Mazade, M.D., a pediatrician who specializes in Infectious Diseases at Cook Children’s. “Over prescribing or using antibiotics the wrong way can lead to antibiotic-resistant infections. This means the next time your child is sick, the next infection could be much harder to treat when he or she really needs an antibiotic.”

If you are unsure if you or your child needs an antibiotic, ask your health care provider these 5 questions:

1. “Do I really need an antibiotic?”

2. “Can I get better without this antibiotic?”

3. “What side effects or drug interactions can I expect?”

4. “What side effects should I report to you?”

5. “How do you know what kind of infection I have? I understand that antibiotics won’t work for viral infections.”

Each year in the United States, at least 2 million people get serious infections with bacteria that are resistant to one or more of the antibiotics designed to treat those infections. At least 23,000 people die each year as a direct result of these antibiotic infections, according to the CDC.

“I think what happens sometimes is that health care providers feel pressured to give antibiotics from their patients or in a child’s case, the patient’s family,” Dr. Mazade said. “The parents feel they are doing what is right for their child, but the reality is that they may be causing long-term harm to him or her. If they overuse antibiotics, the next time children need the drug to fight off an infection, antibiotic resistance may make the antibiotic useless.”

Antibiotic resistance happens when bacteria change in a way that reduces or eliminates the ability of antibiotics to kill the bacteria.

You do not need antibiotics for:

• Colds also known as upper respiratory tract infections (URI)
• Most coughs and bronchitis
• Sore throats not caused by strep bacteria
• Runny noses, stuffy noses and nasal congestion
• Seasonal Allergies
• Most earaches
• Bug bites by themselves
• Most Diarrhea
• Most Rashes
• Uncomplicated flu infection and RSV infections

The Urgent Care Centers at Cook Children’s are seeing more kiddos day in and day out than our Emergency Department (nearly double). The Fort Worth Urgent Care alone is seeing almost as many kids per hour than the ED on any given day.

Flu testing will be driven by the incredible experience of our Urgent Care providers. They are giving flu tests as needed, and they know best what flu looks like in North Texas and have the best skillset to determine appropriate treatment and testing. Click here to learn more about why your child may not be tested for the flu at one of our Urgent Care Centers.

While I think it's important you know how bad the flu can be, I'd like to give you a few quick facts and tips to make you hopefully feel better educated about it, and feel less scared.

1. The flu happens every year. It hits hard from December through March (and other months, but those primarily). There are deaths every year. Kids, healthy people, old people, babies, and folks with chronic illness die every year. We aren't sure if the rate of death is higher this year compared to years past. It may not be. But the media is certainly paying a lot of attention to it right now. Maybe that's both a good and a bad thing.

Remember that the flu is usually a "mild" illness (I mean, you feel like you've been hit by a truck, but we call that "mild" in medicine, ha).

It hits fast and fevers can go high, which is worrisome, but with a lot of rest, fluids, pain and fever reducers, things usually get better after 3-5 days. The cough and congestion can last for 2 weeks.

2. Scared to vaccinate? Hear stories? Hate shots? Have an uncle who loves to talk up a good conspiracy theory? Know this: you can still get the flu even if you get the vaccine.

BUT: it's usually milder, if you do get it. Studies have shown that the people (and children) who get very sick (think hospital, think death) are those who are largely unvaccinated.

"This study, which looked at data from four flu seasons between 2010 and 2014, found that flu vaccination reduced the risk of flu-associated death by half (51 percent) among children with underlying high-risk medical conditions and by nearly two-thirds (65 percent) among healthy children."

Get your kids vaccinated. It's not too late.

3. You are contagious with the flu 1-2 days BEFORE you start showing symptoms. How sneaky is that?

4. You are contagious 5-7 days after you start to show symptoms. Your KIDS can be contagious up to 10 DAYS after they start to show symptoms.

5. You should keep your kids out of school for at LEAST 24 hours after their last fever. This means fever without the use of meds to keep it down. If it's financially feasible for you, I'd even try to keep your kids out at least 7 days after the first symptoms start.

6. Call us (or your pediatrician) anytime if you're worried about the flu. We can walk you through what is normal and what isn't.

7. These are the reasons to worry:

• Fast breathing or trouble breathing
• Bluish skin color
• Not drinking enough fluids
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting

Flu-like symptoms that improve but then return with fever and worse cough

Tamiflu can help make it less severe sometimes, for some people. I wrote another post about who needs it, when, and why. Click here to read it.

I know this is long, but I think the more education you get about it, the more prepared you feel, right?

And remember - WASH YOUR HANDS! The flu can live on some surfaces up to 24 hours in cold weather! Think about all those door handles you touch! The cash you get handed back from the cashier! The snot that flies from every person's sneeze can cover a 6 foot radius around them!

Wash. Those. Hands!

Hugs! Dr. Diane