Plans are being made to fast-track patients in emergency rooms who don't have life-threatening injuries, freeing up beds for those who really need them.

FLU SEASON

• Hospitals prepare for flu deluge • Clinics offering flu shots • Vaccine supply will be allocated • Flu 2004 section

If necessary, full-time staff will be asked to work overtime, and temporary nurses might be hired.

This week, Bethesda North and Good Samaritan hospitals began asking patients with respiratory illnesses to wear masks until being evaluated. Nurses also began cleaning hospital telephones on a regular basis.

"These are little things, and they may sound a bit odd, but we feel that it will help stop the spread of germs," said Joe Kelley, spokesman for TriHealth, the system that owns the two hospitals.

Flu season typically runs from November to February.

Alarmed at the possible impact of this year's flu vaccine shortage, the American College of Emergency Physicians issued a warning Monday, predicting that ERs will be slammed with flu cases that will overwhelm an already fragile system, forcing sick and elderly patients to lie on gurneys for hours and squeezing out others in need.

Hospital officials in the region say such a dire prediction is a bit strong, but they do share the general concern.

"The problem is we can never predict how bad a flu season is going to be," said Colleen O'Toole, vice president of the Greater Cincinnati Health Council.

On average, there are 200,000 flu-related hospitalizations and 36,000 deaths in the United States each year.

Even mild flu seasons can tax the hospital system.

Last year's flu season wasn't harsh, but it came in early November and was initially intense. Some hospital ERs became overcrowded, forcing them to go on diversion, meaning that life squads were asked to take non-critical cases to other hospitals.

Some hospitals last year issued visiting restrictions. No children under the age of 14 were allowed to visit, and adult visitors with flu-like symptoms - such as fever or cough - were not allowed.

Area hospitals might be in a better position because of recent developments, O'Toole said. For example:

• The vacancy rate for nurses is down. As of June 30, about 9 percent of hospital nursing jobs were unfilled. That's much better than 19 percent as of year-end 2003.

• Expansion projects have added beds. Jewish Hospital added nine emergency room beds this fall. Bethesda North plans to add 14 to 16 ER beds by early December to its current 33. And St. Elizabeth Medical Center in Edgewood is also expanding its ER from 34 to 49 beds by the end of December.

E-mail mleingang@enquirer.com