Distribution of airborne respiratory pathogens in pediatric emergency department waiting room

The COVID-19 pandemic has presented pediatric emergency departments with unique challenges, resulting in a heightened demand for adapted clinical pathways. In response to this need, the Montreal Children's Hospital pediatric emergency department introduced the WAVE (Waiting Room Assessment to Virtual Emergency Department) pathway, a video-based telemedicine pathway for selected non-critical patients, aiming to reduce safety issues related to emergency department overcrowding, while providing timely care to all children presenting and registering at our emergency department. The objective of the WAVE pilot phase was to evaluate the feasibility and acceptability of telemedicine in our pediatric emergency department, which was previously unfamiliar with this mode of care delivery. During the six-week, three-evening per week deployment, we conducted 18 five-hour telemedicine shifts. In total, 27 patients participated in the WAVE pathway. Results from this pilot phase met four of five a priori feasibility and acceptability criteria. Overall, participating families were satisfied with this novel care pathway and reported no disruptive technological barriers.

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Implementation of a Game-based Information System and e-Therapeutic Platform in a Pediatric Emergency Department Waiting Room: Preliminary Evidence of Benefit

Procedia Computer Science ◽

10.1016/j.procs.2015.08.351 ◽

2015 ◽

Vol 63 ◽

pp. 332-339 ◽

Cited By ~ 2

Author(s):

B.W. Taylor ◽

A. Wilcox ◽

K. Morrison ◽

M.A. Hiltz ◽

M. Campbell ◽

...

Keyword(s):

Emergency Department ◽

Information System ◽

Preliminary Evidence ◽

Pediatric Emergency ◽

Pediatric Emergency Department ◽

Waiting Room ◽

Therapeutic Platform

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Understanding the environmental factors related to the decrease in Pediatric Emergency Department referrals for acute asthma during the SARS-CoV-2 pandemic

10.22541/au.161893580.04167261/v1 ◽

2021 ◽

Author(s):

Arianna Dondi ◽

Ludovica Betti ◽

Claudio Carbone ◽

Ada Dormi ◽

Marco Paglione ◽

...

Keyword(s):

Emergency Department ◽

Air Pollution ◽

Urban Areas ◽

Acute Asthma ◽

Pediatric Emergency ◽

Anthropogenic Sources ◽

Pediatric Emergency Department ◽

Respiratory Pathogens ◽

Specific Chemical ◽

Asthma Exacerbations

Background: Asthma exacerbations, a common reason for Pediatric Emergency Department (PED) referral, can be triggered by multiple factors, including infections, air pollution and allergens. Lockdown measures and other public health interventions during the SARS-CoV-2 pandemic determined radical changes to behavioral and social habits, that were reflected by a reduction in the transmission of all respiratory pathogens and in the emissions of relevant air pollution anthropogenic sources. Objective: This study aims to describe how restrictions during SARS-CoV-2 pandemic impacted the PED referral for asthma exacerbations and their potentially associated environmental triggers in densely populated urban areas. Methods: PED referrals for acute asthma from 2015 to 2020 were compared to air pollution and pollen data. To this purpose, historical daily concentration records of PM2.5, PM10 (including specific chemical tracers), as well as NO2, C6H6, tree, grass and weed pollen were analyzed. Results: In 2020, asthma-related PED referrals decreased up to 85%, compared to the average referral rate of the previous 5 years (P<0.01). The drastic drop in PED referrals was associated with a reduction of high-priority cases by 50-60%, unlike PED referrals for overall diagnoses, showing a larger contribution for severe outcomes. A concomitant diminished contribution of traffic-related air pollution was shown. Conclusions: The lower rate of asthma exacerbations in childhood can be related to synergic interactions of the multiple effects of lockdown measures which induced lower viral infection rates and decreased exposure to outdoor allergens. The reduction of traffic-related air pollution determined a weakening of inflammatory properties of urban PM.

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Using Queue Theory and Load-Leveling Principles to Identify a Simple Metric for Resource Planning in a Pediatric Emergency Department

Global Pediatric Health ◽

10.1177/2333794x20944665 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2094466

Author(s):

Jennifer M. Loso ◽

Stephanie L. Filipp ◽

Matthew J. Gurka ◽

Michael K. Davis

Keyword(s):

Emergency Department ◽

Human Resource ◽

Resource Planning ◽

Pediatric Emergency ◽

Time Of Day ◽

Pediatric Emergency Department ◽

Waiting Room ◽

Resource Requirements ◽

Queue Theory ◽

Load Leveling

Increased waiting time in pediatric emergency departments is a well-recognized and complex problem in a resource-limited US health care system. Efforts to reduce emergency department wait times include modeling arrival rates, acuity, process flow, and human resource requirements. The aim of this study was to investigate queue theory and load-leveling principles to model arrival rates and to identify a simple metric for assisting with determination of optimal physical space and human resource requirements. We discovered that pediatric emergency department arrival rates vary based on time of day, day of the week, and month of the year in a predictable pattern and that the hourly change in pediatric emergency department waiting room census may be useful as a simple metric to identify target times for shifting resources to better match supply and demand at no additional cost.

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Respiratory Tract Pathogens in the COVID-19 era: Data from a Pediatric Emergency Department

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0041-1736216 ◽

2021 ◽

Author(s):

Leman Akcan Yildiz ◽

Bahri Unal ◽

Orkun Aydin ◽

Pembe Derin Oygar ◽

Sibel Lacinel Gurlevic ◽

...

Keyword(s):

Emergency Department ◽

Clinical Laboratory ◽

Clinical Course ◽

Pediatric Emergency ◽

Pediatric Emergency Department ◽

Respiratory Pathogens ◽

Negative Group ◽

Viral Pathogens ◽

Positive Group ◽

Respiratory Coronavirus

Abstract Objective The frequency of coinfections in pediatric Coronavirus disease 2019 (COVID-19) cases and their impact on the clinical course are not fully understood. We aimed to investigate the viral and bacterial respiratory pathogens in children admitted to the pediatric emergency department (PED), their clinical course, and the presence of coinfections during the early months of the COVID-19 pandemic. Methods Clinical, laboratory and radiological findings, viral and bacterial pathogens detected by multiplex polymerase chain reaction (PCR) tests in nasopharyngeal swabs, clinical course, and treatments of all children who were tested for severe acute respiratory coronavirus 2 (SARS-CoV-2) at the PED between March 16 and May 15, 2020, were recorded. SARS-CoV-2 PCR-positive and negative groups were compared. Results Out of 570 patients tested for SARS-CoV-2 during the study period, 43 were found positive (7.5%). Non-SARS-CoV-2 viral pathogens were more common in the SARS-CoV-2 PCR-negative group than the SARS-CoV-2 PCR-positive group (13.2%, n = 68 versus 4.7%, n = 2), but this result was not statistically significant. Leukocyte, neutrophil, lymphocyte, and platelet counts were lower in SARS-CoV-2 PCR-positive group. Bacterial panel positivity was significantly higher in the SARS-CoV-2 PCR-positive group compared with the SARS-CoV-2 PCR-negative group (52%, n = 12 versus 28%, n = 91; p < 0.05). The presence of coinfection did not alter the course of therapy in SARS-CoV-2 PCR-positive cases. Conclusion While viral coinfections were rare, bacterial panel positivity was common in children with COVID-19, but this had not influenced management decisions. The limitations of the tests should be kept in mind while interpreting the results.

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