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A National US Survey of Pediatric Emergency Department Coronavirus Pandemic Preparedness
Marc A Auerbach1, Kamal Abulebda2, Anna Mary Bona3
1From the Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT.
Insights
Pediatric emergency departments rapidly adapted to the COVID-19 pandemic by changing staffing, workflows, and clinical practices. Training focused on personal protective equipment (PPE) and team dynamics, with simulation and teleconference as key methods.
Area of Science:
- Emergency Medicine
- Infectious Disease Epidemiology
- Public Health Preparedness
Background:
- The COVID-19 pandemic presented unprecedented challenges to healthcare systems.
- Pediatric emergency departments (PEDs) required rapid adaptation to manage the evolving crisis.
- Understanding preparedness efforts is crucial for future pandemic response.
Purpose of the Study:
- To describe the COVID-19 preparedness strategies implemented in US pediatric emergency departments.
- To identify changes in staffing, workflow, and clinical protocols.
- To document training modalities and learning objectives adopted by PEDs.
Main Methods:
- A prospective, multicenter survey was distributed to medical directors of PEDs.
- Hospitals were recruited through a national research network.
- The survey questionnaire was developed by experts in pediatric emergency medicine and disaster readiness.
Main Results:
- Responses were received from 25 of 35 surveyed PEDs (71% response rate).
- All PEDs reported decreased non-COVID-19 patient volume; 60% established COVID-19-dedicated units.
- Significant changes included staffing models (80% physician staffing), triage, PPE shortages (62%), and clinical protocols for airway and cardiac arrest management.
Conclusions:
- PEDs implemented comprehensive preparedness strategies, including operational and clinical practice modifications.
- Video/teleconference and simulation were favored training methods for staff.
- Further research is needed to evaluate the effectiveness of these preparedness actions for future pandemics.
Objective:
We aim to describe the current coronavirus disease 2019 (COVID-19) preparedness efforts among a diverse set of pediatric emergency departments (PEDs) within the United States.
Methods:
We conducted a prospective multicenter survey of PED medical director(s) from selected children's hospitals recruited through a long established national research network. The questionnaire was developed by physicians with expertise in pediatric emergency medicine, disaster readiness, human factors, and survey development. Thirty-five children's hospitals were identified for recruitment through an established national research network.
Results:
We report on survey responses from 25 (71%) of 35 PEDs, of which 64% were located within academic children's hospitals. All PEDs witnessed decreases in non-COVID-19 patients, 60% had COVID-19-dedicated units, and 32% changed their unit pediatric patient age to include adult patients. All PEDs implemented changes to their staffing model, with the most common change impacting their physician staffing (80%) and triaging model (76%). All PEDs conducted training for appropriate donning and doffing of personal protective equipment (PPE), and 62% reported shortages in PPE. The majority implemented changes in the airway management protocols (84%) and cardiac arrest management in COVID patients (76%). The most common training modalities were video/teleconference (84%) and simulation-based training (72%). The most common learning objectives were team dynamics (60%), and PPE and individual procedural skills (56%).
Conclusions:
This national survey provides insight into PED preparedness efforts, training innovations, and practice changes implemented during the start of COVID-19 pandemic. Pediatric emergency departments implemented broad strategies including modifications to staffing, workflow, and clinical practice while using video/teleconference and simulation as preferred training modalities. Further research is needed to advance the level of preparedness and support deep learning about which preparedness actions were effective for future pandemics.
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