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Challenges Created by the COVID-19 Pandemic: Pediatric Emergency Medicine and Disaster Management Perspectives

Published online by Cambridge University Press:  09 June 2022

Thomas E. Tanner Open the ORCID record for Thomas E. Tanner [Opens in a new window] ,
Nichole R. Davis ,
Brent D. Kaziny ,
Erin E. Endom  and
Esther M. Sampayo
Thomas E. Tanner*
Affiliation:
Baylor College of Medicine, Houston, TX, USA
Nichole R. Davis
Affiliation:
Baylor College of Medicine, Houston, TX, USA
Brent D. Kaziny
Affiliation:
Baylor College of Medicine, Houston, TX, USA
Erin E. Endom
Affiliation:
Baylor College of Medicine, Houston, TX, USA
Esther M. Sampayo
Affiliation:
Baylor College of Medicine, Houston, TX, USA
*
Corresponding author: Thomas E. Tanner, Email: Thomas.Tanner@bcm.edu.
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Abstract

Objective:

The coronavirus disease (COVID-19) pandemic has presented unique challenges to pediatric emergency medicine (PEM) departments. The purpose of this study was to identify these challenges and ascertain how centers overcame barriers in creating solutions to continue to provide high-quality care and keep their workforce safe during the early pandemic.

Methods:

This is a qualitative study based on semi-structured interviews with physicians in leadership positions who have disaster or emergency management experience. Participants were identified through purposive sampling. Interviews were recorded and transcribed electronically. Themes and codes were extracted from the transcripts by 2 independent coders. Constant comparison analysis was performed until thematic saturation was achieved. Member-checking was completed to ensure trustworthiness.

Results:

Fourteen PEM-trained physicians participated in this study. Communication, leadership and planning, clinical practice, and personal adaptations were the principal themes identified. Recommendations elicited include improving communication strategies; increasing emergency department (ED) representation within hospital-wide incident command; preparing for a surge and accepting adult patients; personal protective equipment supply and usage; developing testing strategies; and adaptations individuals made to their practice to keep themselves and their families safe.

Conclusions:

By sharing COVID-19 experiences and offering solutions to commonly encountered problems, pediatric EDs may be better prepared for future pandemics.

Keywords

COVID-19disaster managementpediatric emergency medicinequalitative
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e227
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

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References

World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19-11 March 2020. Geneva, Switzerland: WHO; 2020.Google Scholar
Sohrabi, C, Alsafi, Z, O’Neill, N, et al. World Health Organization declares global emergency: a review of the 2019 novel coronavirus (COVID-19). Int J Surg. 2020;76:71-76. doi: 10.1016/j.ijsu.2020.02.034 CrossRefGoogle ScholarPubMed
Dong, E, Du, H, Gardner, L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020;20(5):533-534. doi: 10.1016/S1473-3099(20)30120-1 CrossRefGoogle ScholarPubMed
Schwartz, J, King, CC, Yen, MY. Protecting health care workers during the COVID-19 coronavirus outbreak—lessons from Taiwan’s SARS response. Clin Infect Dis. 2020;71(15):858-860. doi: 10.1093/cid/ciaa255 CrossRefGoogle Scholar
Zhang, Z, Liu, S, Xiang, M, et al. Protecting healthcare personnel from 2019-nCoV infection risks: lessons and suggestions. Front Med. 2020; 14(2):229-231. doi: 10.1007/s11684-020-0765-x CrossRefGoogle ScholarPubMed
Zhang, K, Liu, WL, Locatis, C, Ackerman, M. Mobile videoconferencing apps for telemedicine. Telemed J E Health. 2016;22(1):56-62. doi: 10.1089/tmj.2015.0027 CrossRefGoogle ScholarPubMed
Isba, R, Edge, R, Auerbach, M, et al. COVID-19: transatlantic declines in pediatric emergency admissions. Pediatr Emerg Care . 2020 36(11):551-553. doi: 10.1097/PEC.0000000000002260 CrossRefGoogle ScholarPubMed
Dopfer, C, Wetzke, M, Zychlinsky Scharff, A, et al. COVID-19 related reduction in pediatric emergency healthcare utilization—a concerning trend. BMC Pediatr. 2020;20(1):427. doi: 10.1186/s12887-020-02303-6 CrossRefGoogle ScholarPubMed
Walker, DM, Tolentino, VR. COVID-19: the impact on pediatric emergency care. Pediatr Emerg Med Pract. 2020;17(Suppl 6-1):1-27.Google ScholarPubMed
Harris, PA, Taylor, R, Thielke, R, et al. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377-381. doi: 10.1016/j.jbi.2008.08.010 CrossRefGoogle ScholarPubMed
Ayub, EM, Sampayo, EM, Shah, MI, Doughty, CB. Prehospital providers’ perceptions on providing patient and family centered care. Prehosp Emerg Care. 2017;21(2):233-241. doi: 10.1080/10903127.2016.1241326 CrossRefGoogle ScholarPubMed
Zhou, P, Yang, XL, Wang, XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-273. doi: 10.1038/s41586-020-2012-7 CrossRefGoogle ScholarPubMed
Venkat, A, Asher, SL, Wolf, L, et al. Ethical issues in the response to Ebola virus disease in United States emergency departments: a position paper of the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine. Acad Emerg Med. 2015;22(5):605-615. doi: 10.1111/acem.12642 CrossRefGoogle ScholarPubMed
Markwell, A, Mitchell, R, Wright, AL, Brown, AF. Clinical and ethical challenges for emergency departments during communicable disease outbreaks: can lessons from Ebola virus disease be applied to the COVID-19 pandemic? Emerg Med Australas. 2020;32(3):520-524. doi: 10.1111/1742-6723.13514 CrossRefGoogle ScholarPubMed
Team, CC-R. Coronavirus disease 2019 in children—United States, February 12-April 2, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(14):422-426. doi: 10.15585/mmwr.mm6914e4 Google Scholar
Sisk, B, Cull, W, Harris, JM, et al. National trends of cases of COVID-19 in children based on US State Health Department data. Pediatrics. 2020;146(6):e2020027425. doi: 10.1542/peds.2020-027425 CrossRefGoogle ScholarPubMed
DeLaroche, AM, Rodean, J, Aronson, PL, et al. Pediatric emergency department visits at US children’s hospitals during the COVID-19 pandemic. Pediatrics. 2021;147(4):e2020039628. doi: 10.1542/peds.2020-039628.CrossRefGoogle Scholar
Shanafelt, T, Ripp, J, Trockel, M. Understanding and addressing sources of anxiety among health care professionals during the COVID-19 pandemic. JAMA. 2020;323(21):2133-2134. doi: 10.1001/jama.2020.5893 CrossRefGoogle ScholarPubMed
Cull, B, Harris, M. Children and COVID-19: state data report. American Academy of Pediatrics. Published August, 12, 2021. Accessed August 16, 2021. https://downloads.aap.org/AAP/PDF/AAP%20and%20CHA%20-%20Children%20and%20COVID-19%20State%20Data%20Report%208.12%20FINAL.pdf Google Scholar
Auerbach, MA, Abulebda, K, Bona, AM, et al. A national US survey of pediatric emergency department coronavirus pandemic preparedness. Pediatr Emerg Care. 2021;37(1):48-53. doi: 10.1097/PEC.0000000000002307 CrossRefGoogle ScholarPubMed
Jain, S, Fahlgren, R, Giovanni, J, Dowd, MD. Pediatric emergency department challenges and response to COVID-19. Pediatr Ann. 2021;50(4):e172-e177. doi: 10.3928/19382359-20210318-01 CrossRefGoogle ScholarPubMed
Meier, KA, Jerardi, KE, Statile, AM, Shah, SS. Pediatric hospital medicine management, staffing, and well-being in the face of COVID-19. J Hosp Med. 2020;15(5):308-310. doi: 10.12788/jhm.3435 CrossRefGoogle ScholarPubMed
Hartford, EA, Keilman, A, Yoshida, H, et al. Pediatric emergency department responses to COVID-19: transitioning from surge preparation to regional support. Disaster Med Public Health Prep. 2021;15(1):e22-e28. doi: 10.1017/dmp.2020.197 CrossRefGoogle ScholarPubMed
Diskin, C, Orkin, J, Agarwal, T, et al. The secondary consequences of the COVID-19 pandemic in hospital pediatrics. Hosp Pediatr. 2021;11(2):208-212. doi: 10.1542/hpeds.2020-002477 CrossRefGoogle ScholarPubMed
Turer, RW, Jones, I, Rosenbloom, ST, et al. Electronic personal protective equipment: a strategy to protect emergency department providers in the age of COVID-19. J Am Med Inform Assoc. 2020;27(6):967-971. doi: 10.1093/jamia/ocaa048 CrossRefGoogle ScholarPubMed
Beno, S, Ross, C, Principi, T. Coronavirus disease 2019 in the pediatric emergency department: unique considerations in preparation and response. Curr Opin Pediatr. 2021;33(3):269-274. doi: 10.1097/MOP.0000000000001010 CrossRefGoogle ScholarPubMed
Dharamsi, A, Hayman, K, Yi, S, et al. Enhancing departmental preparedness for COVID-19 using rapid-cycle in-situ simulation. J Hosp Infect. 2020;105(4):604-607. doi: 10.1016/j.jhin.2020.06.020 CrossRefGoogle ScholarPubMed
Committee on Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations; Institute of Medicine. Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response. Washington (DC): National Academies Press (US); 2012. PMID: 24830057.Google Scholar
Bressan, S, Buonsenso, D, Farrugia, R, et al. Preparedness and response to pediatric COVID-19 in European emergency departments: a survey of the REPEM and PERUKI networks. Ann Emerg Med. 2020;76(6):788-800. doi: 10.1016/j.annemergmed.2020.05.018 CrossRefGoogle ScholarPubMed
Walker, DM, Tolentino, VR. COVID-19: the effects on the practice of pediatric emergency medicine. Pediatr Emerg Med Pract. 2020;17(Suppl 6-3):1-15.Google ScholarPubMed
Hu, NY, Castillo, J, Flores-Sanchez, P, et al. Perspectives on pediatric redeployment during COVID-19 from an emergency department in New York City. Pediatr Emerg Care. 2020;36(9):e541-e542. doi: 10.1097/PEC.0000000000002206 CrossRefGoogle ScholarPubMed
Levine, DA, Fraymovich, S, Platt, SL. Where have all the children gone? Pediatric perspectives on COVID-19 in New York City. Ann Emerg Med. 2020;76(1):109-110. doi: 10.1016/j.annemergmed.2020.04.035 CrossRefGoogle ScholarPubMed
Morgan, RW, Kienzle, M, Sen, AI, et al. Pediatric resuscitation practices during the coronavirus disease 2019 pandemic. Pediatr Crit Care Med. 2020;21(9):e651-e660. doi: 10.1097/PCC.0000000000002512 CrossRefGoogle ScholarPubMed
Tan, RMR, Ong, GY, Chong, SL, et al. Dynamic adaptation to COVID-19 in a Singapore paediatric emergency department. Emerg Med J. 2020;37(5):252-254. doi: 10.1136/emermed-2020-209634 Google Scholar
Parri, N, Lenge, M, Cantoni, B, et al. COVID-19 in 17 Italian pediatric emergency departments. Pediatrics . 2020;146(6):e20201235. doi: 10.1542/peds.2020-1235 CrossRefGoogle ScholarPubMed
Ludvigsson, JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 2020;109(6):1088-1095. doi: 10.1111/apa.15270 CrossRefGoogle Scholar
Yasuhara, J, Kuno, T, Takagi, H, Sumitomo, N. Clinical characteristics of COVID-19 in children: a systematic review. Pediatr Pulmonol. 2020;55(10):2565-2575. doi: 10.1002/ppul.24991 CrossRefGoogle ScholarPubMed
He, K, Stolarski, A, Whang, E, Kristo, G. Addressing general surgery residents’ concerns in the early phase of the COVID-19 pandemic. J Surg Educ. 2020;77(4):735-738. doi: 10.1016/j.jsurg.2020.04.003 CrossRefGoogle Scholar
Siddle, J, Tolleson-Rinehart, S, Brice, J. Survey of emergency department staff on disaster preparedness and training for Ebola virus disease. Am J Disaster Med. 2016;11(1):5-18. doi: 10.5055/ajdm.2016.0220 CrossRefGoogle ScholarPubMed