Pediatric emergency department volumes and throughput during the COVID-19 pandemic

Even, Laura; Lipshaw, Matthew J.; Wilson, Patricia S.; Dean, Preston; Kerrey, Benjamin T.; Vukovic, Adam A.

doi:10.1016/j.ajem.2020.09.074

Cited by 24 publications

(53 citation statements)

References 16 publications

(16 reference statements)

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“…Efforts to mitigate disease transmission, such as social-distancing measures, state lockdowns and school and recreational space closures also altered the pediatric medical landscape [ 11 , 12 ]. All aspects of pediatric medical care experienced a decrease in volume worldwide [ 13 ], including a significant reduction in PED visits [ [14] , [15] , [16] , [17] , [18] ]. At the same time, an increase in patient acuity was reported, [ 4 , 15 , [17] , [18] , [19] ].…”

Section: Introductionmentioning

confidence: 99%

“…All aspects of pediatric medical care experienced a decrease in volume worldwide [ 13 ], including a significant reduction in PED visits [ [14] , [15] , [16] , [17] , [18] ]. At the same time, an increase in patient acuity was reported, [ 4 , 15 , [17] , [18] , [19] ]. While some studies have attributed this to a possible delay in seeking care due to intentional avoidance of health care facilities during the pandemic [ 16 , 19 ], Dean et al found a large absolute decrease in PED critical care patients during the pandemic period, despite representing a high proportion of overall visits [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…To date, most data reported has focused on PED trends before and during the pandemic peak [ 14 , 15 , 18 , 26 ] and a recent study looking beyond the height of the pandemic was limited to critically ill children [ 27 ]. Unique to our study, are the reported initial effects of a state phased re-opening on all PED trends in a known COVID-19 epicenter.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The ongoing impact of COVID-19 on asthma and pediatric emergency health-seeking behavior in the Bronx, an epicenter

Levene

Fein

Silver

et al. 2021

The American Journal of Emergency Medicine

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Background: The Bronx has the highest prevalence of asthma in the United States (US), and was also an early COVID-19 epicenter, making it a unique study location. Worldwide reports describe significant declines in pediatric emergency department (PED) visits during COVID-19. The ongoing impact of COVID-19 on all PED presentations, including asthma, at an early epicenter has not been studied beyond the pandemic peak and into the early phases of state re-opening. Objectives: To compare PED health-seeking behaviors and clinical characteristics during the 2020 pandemic and subsequent initial New York State (NYS) phased re-opening to the same period in 2019. Methods: Retrospective chart review of children <21 years utilizing the PED at a high-volume quaternary children's hospital in The Bronx, NY from March 15th 2020 -July 6th 2020 (pandemic cohort) and the same interval in 2019 (comparison cohort). Visits were assigned to pre-determined diagnostic categories. Demographic and clinical data were compared. Results: 19,981 visits were included. Visits declined by 66% during 2020. Proportions of asthma visits (2% vs. 7%, p < 0.0001) and minor medical problems (61% vs. 67%, p < 0.0001) had significant declines in the pandemic cohort, while major medical problems (13% vs. 8%, p < 0.0001), appendicitis (1% vs. 0.4%, p < 0.0001) and other surgical complaints (1% vs. 0.5%, p < 0.0001) had proportional increases in the pandemic cohort. No significant proportional changes were noted among psychosocial and trauma groups between the two cohorts. Conclusion:The pandemic cohort experienced a substantial decrease in PED volume, but an increase in acuity and admission rates, which was sustained through the NYS phase-II re-opening. Despite being located in an asthma hub, the incidence of asthma-related PED visits declined appreciably in the pandemic cohort. Future studies examining the effects of indoor allergens in isolation on pediatric asthma are warranted.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The ongoing impact of COVID-19 on asthma and pediatric emergency health-seeking behavior in the Bronx, an epicenter

Levene

Fein

Silver

et al. 2021

The American Journal of Emergency Medicine

View full text Add to dashboard Cite

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“…SARS-CoV-2 diffusion and the resulting containment measures, have deeply modified national health services with a profound impact on emergency department (ED) activities [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

“…Care network disruptions could generate outsized adverse consequences for CMC who are potentially at higher risk of severe illness from not accessing health care than their healthy peers [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] .…”

Section: Introductionmentioning

confidence: 99%

The impact of COVID-19 lockdown on children with medical complexity in pediatric emergency department

Brisca

Vagelli

Tagliarini

et al. 2021

The American Journal of Emergency Medicine

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See one, see one, teach one – Decisions on allocating intubation opportunities in pediatric emergency medicine

Miller

Dechnik

Miller

et al. 2022

AEM Education and Training

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Background: Decisions about who should perform tracheal intubation in academic settings must balance the needs of trainees to develop competency in pediatric intubation with patient safety. Airway protocols during the COVID-19 pandemic may have reduced opportunities for trainees, representing an opportunity to examine the impact of shifting laryngoscopy responsibilities away from trainees. Methods: This observational study combined data from 11 pediatric emergency departments in North America participating in either the National Emergency Airway Registry for Children (NEAR4KIDS) or a national pediatric emergency medicine airway education collaborative. Sites provided information on airway protocols, patient and procedural characteristics, and clinical outcomes. For the pre-pandemic (January 2017 to March 2020) and pandemic (March 2020 to March 2021) periods, we compared tracheal intubation opportunities by laryngoscopist level of training and specialty. We also compared first-attempt success and adverse airway outcomes between the two periods.

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Pediatric emergency department volumes and throughput during the COVID-19 pandemic

Cited by 24 publications

References 16 publications

The ongoing impact of COVID-19 on asthma and pediatric emergency health-seeking behavior in the Bronx, an epicenter

The ongoing impact of COVID-19 on asthma and pediatric emergency health-seeking behavior in the Bronx, an epicenter

The impact of COVID-19 lockdown on children with medical complexity in pediatric emergency department

See one, see one, teach one – Decisions on allocating intubation opportunities in pediatric emergency medicine

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