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The 2022-2023 Pediatric Respiratory Illness Surge: Survey of Acute and Critical Care Resource Use
Lilia P Christner1, Erin F Carlton1,2,3, Stephen Gorga1,2
1University of Michigan Medical School, Ann Arbor, MI, USA.
Insights
Pediatric hospitals faced significant strain during a 2022-2023 respiratory illness surge, leading to patient diversions and full critical care capacity. Enhanced preparedness is crucial for future public health emergencies.
Area of Science:
- Pediatric critical care medicine
- Public health preparedness
- Hospital resource management
Background:
- A significant surge in pediatric respiratory illnesses occurred in the US during late 2022 and early 2023.
- This surge placed considerable pressure on hospital acute and critical care resources.
Purpose of the Study:
- To evaluate the availability and utilization of hospital acute and critical care resources during a pediatric respiratory illness surge.
- To determine the extent of pediatric hospital resource use during this public health event.
Main Methods:
- An online survey was distributed to pediatric critical care professionals and organizations between January and February 2023.
- Data from 35 hospitals with pediatric intensive care units (PICUs) were summarized using median values and interquartile ranges.
Main Results:
- A significant increase in critical care resource use was observed, with 74% of hospitals diverting patients from emergency departments.
- One in five hospitals relocated mechanically ventilated patients from PICUs to other areas.
- PICU faculty, nurses, and respiratory therapists operated at 100% capacity.
Conclusions:
- The pediatric respiratory illness surge led to substantial hospital resource utilization and patient diversions.
- There is a critical need for innovation in pediatric public health emergency preparedness, particularly concerning resource capacity.
Objective:
A surge of pediatric respiratory illnesses beset the United States in late 2022 and early 2023. This study evaluated within-surge hospital acute and critical care resource availability and utilization. The study aimed to determine pediatric hospital acute and critical care resource use during a respiratory illness surge.
Methods:
Between January and February 2023, an online survey was sent to the sections of hospital medicine and critical care of the American Academy of Pediatrics, community discussion forums of the Children's Hospital Association, and PedSCCM-a pediatric critical care website. Data were summarized with median values and interquartile range.
Results:
Across 35 hospitals with pediatric intensive care units (PICU), increase in critical care resource use was significant. In the month preceding the survey, 26 (74%) hospitals diverted patients away from their emergency department (ED) to other hospitals, with 46% diverting 1-5 patients, 23% diverting 6-10 patients, and 31% diverting more than 10 patients. One in 5 hospitals reported moving patients on mechanical ventilation from the PICU to other settings, including the ED (n = 2), intermediate care unit (n = 2), cardiac ICU (n = 1), ward converted to an ICU (n = 1), and a ward (n = 1). Utilization of human critical care resources was high, with PICU faculty, nurses, and respiratory therapists working at 100% capacity.
Conclusions:
The respiratory illness surge triggered significant hospital resource use and diversion of patients away from hospitals. Pediatric public health emergency-preparedness should innovate around resource capacity.
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