Innovation at a Children’s Hospital: Personal Protective Equipment Efforts During the Pandemic

2021 ◽  
pp. 155335062199998
Author(s):  
Justin Opfermann ◽  
Anuradha Dayal ◽  
Alyssa Abo ◽  
Emily Thatcher ◽  
Tyler Salvador ◽  
...  
Keyword(s):  
Emergency Department ◽  
Supply Chain ◽  
Personal Protective Equipment ◽  
Working Group ◽  
Multidisciplinary Approach ◽  
Protective Equipment ◽  
Scarce Resources ◽  
Children's Hospital ◽  
Future Needs ◽  
Children’S Hospital

The COVID-19 pandemic has affected life for everyone, and hospitals, in particular have been hard hit. In this study, we describe our efforts to develop personal protective equipment at a children’s hospital early in the pandemic. We convened an innovation working group to organize our efforts and respond to the rapidly changing situation. We describe our work in four areas: (1) plexiglass shields for the emergency department, (2) face shields for clinical providers, (3) breath shields for ophthalmology, and (4) flip-up safety glasses for nurses. The hospital’s supply chain is now caught up with addressing many pandemic-related shortages. Nevertheless, through our multidisciplinary approach to reacting to the pandemic’s urgent needs, we demonstrated agility to bring stakeholders together to maximize the use of scarce resources and build resiliency. We believe this method can be rapidly replicated as future needs arise.

scholarly journals Ultraviolet Germicidal Irradiation (UVGI) for Facemask Personal Protective Equipment (PPE): Protocol for a Systematic Review

2020 ◽  
Author(s):  
Dayre McNally ◽  
Katie O'Hearn ◽  
Margaret Sampson ◽  
Lindsey Sikora
Keyword(s):  
Systematic Review ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Children's Hospital ◽  
Ultraviolet Germicidal Irradiation ◽  
Surgical Masks ◽  
Children’S Hospital ◽  
Eastern Ontario

During the COVID-19 pandemic, a shortage of PPR (namely surgical masks, N95 masks, and gowns) has been experienced by some hospitals and could be expected in others due to a rapid increase need. One method of addressing the issue of PPE shortage is to decontaminate and re-use PPE. There are anecdotal reports and published literature evaluating the potential of Ultraviolet Germicidal Irradiation (UVGI) as effective method for PPE decontamination, without negatively impacting function. To date this literature has not been comprehensively synthesized and the purpose of this review is to systematically review the existing literature on UVGI for facemask PPE. This information will be used to develop a decontamination protocol for the Children’s Hospital of Eastern Ontario and shared with other hospitals in Ontario, Canada, and internationally.

scholarly journals Microwave- and Heat-Based Decontamination for Facemask Personal Protective Equipment (PPE): Protocol for a Systematic Review

2020 ◽  
Author(s):  
Dayre McNally ◽  
Katie O'Hearn ◽  
Shira Gertsman ◽  
Margaret Sampson ◽  
Lindsey Sikora ◽  
...  
Keyword(s):  
Systematic Review ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Structural Integrity ◽  
Protective Equipment ◽  
Children's Hospital ◽  
Surgical Masks ◽  
Children’S Hospital ◽  
Eastern Ontario

During the COVID-19 pandemic, a shortage of PPE (namely surgical masks, N95 masks, and gowns) has been experienced by some hospitals and could be expected in others due to a rapidly increased need. One method of addressing the issue of PPE shortage is to decontaminate and re-use PPE. The CDC specifically recommends N95 filtering facepiece respirators (FFRs) for healthcare workers who are interacting with patients with COVID-19.There are anecdotal reports and published literature evaluating the potential of microwave and heat methods as an effective method for FFR decontamination for reuse, with mixed reports of impact on structural integrity. To date this literature has not been comprehensively synthesized and the purpose of this review is to systematically review the existing literature on microwave and heat-based decontamination of facemask PPE.This information will be used to contribute to PPE decontamination protocols at the Children’s Hospital of Eastern Ontario and shared with other hospitals in Ontario, Canada, and internationally.

scholarly journals Impact of the COVID-19 pandemic on the Emergency Department of a tertiary children’s hospital

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Umberto Raucci ◽  
Anna Maria Musolino ◽  
Domenico Di Lallo ◽  
Simone Piga ◽  
Maria Antonietta Barbieri ◽  
...  
Keyword(s):  
Emergency Department ◽  
School Closure ◽  
Process Step ◽  
Lazio Region ◽  
Children's Hospital ◽  
Number Of Children ◽  
Children’S Hospital ◽  
Ed Visits ◽  
Relative Decline ◽  
Tract Infections

Abstract Background Italy was the first country in Europe affected by COVID-19: the emergency started on February 20, 2020, culminating with national lockdown on March 11, which terminated on May 4, 2020. We describe how the pandemic affected Emergency Department (ED) accesses in a tertiary children’s hospital, composed by two different pediatric centers, one located in Rome’s city center and the second, Palidoro (regional COVID-19 center), in its surrounding metropolitan area, both in the Lazio region, analyzing the profile of admitted patients during the pandemic period in terms of their general characteristics (at presentation in the ED’s) and urgent hospitalizations compared to prepandemic period. Methods The study compare the period between the 21st of February and the 30th of April 2020, covering the three phases of the national responses (this period will be referred to as the pandemic period) with the same period of 2019 (prepandemic period). The study analyzes the number of ED visits and urgent hospitalizations and their distribution according to selected characteristics. Results The reduction of ED visits was 56 and 62%, respectively in Rome and Palidoro centers. The higher relative decline was encountered for Diseases of Respiratory System, and for Diseases of the Nervous System and Sense Organs. A doubling of the relative frequency of hospitalizations was observed, going from 14.2 to 24.4% in Rome and from 6.4 to 10.3% in Palidoro. In terms of absolute daily numbers the decrease of urgent hospitalizations was less sharp than ED visits. For pathologies such as peritonitis, tumors or other possible life-treathening conditions we did not observe a significative increase due to delayed access. Conclusions In the pandemic period there was a general reduction in the number of children referred to ED, such reduction was greater in low-acuity levels. The reduction for respiratory tract infections and other communicable diseases during school closure and the national lockdown must make us reflect on the possible impact that these conditions may have on the health system, in particular the ED, at the reopening of schools. The major problem remains the fear for possible diagnostic delays in life-threatening or crippling diseases; our study doesn’t demonstrate an increase in number or significant delay in some serious conditions such as tumors, peritonitis, diabetic ketoacidosis, ileo-colic intussusception and testis/ovary torsion. A continuous, deep re-organizational process step by step of the ED is nececessary in the present and upcoming pandemic situation.

scholarly journals Measles Exposure Investigation in a Children’s Hospital Emergency Department— Denver Metropolitan Area, Colorado, 2019

2020 ◽  
Vol 41 (S1) ◽  
pp. s18-s19
Author(s):  
Ashley Richter
Keyword(s):  
Emergency Department ◽  
International Travel ◽  
Childhood Vaccination ◽  
Prevention Measures ◽  
Mmr Vaccine ◽  
Children's Hospital ◽  
Control Intervention ◽  
Children’S Hospital ◽  
Lost To Follow Up

Background: On December 14, 3 unvaccinated siblings with recent international travel presented to Children’s Hospital Colorado emergency department (CHCO-ED) with fever, rash, conjunctivitis, coryza, and cough. Measles was immediately suspected; respiratory masks were placed on the patients before they entered an airborne isolation room, and public health officials (PH) were promptly notified. Notably, on December 12, 1 ill sibling presented to CHCO-ED with fever only. We conducted an investigation to confirm measles, to determine susceptibility of potentially exposed ED contacts and healthcare workers (HCWs), and to implement infection prevention measures to prevent secondary cases. Methods: Measles was confirmed using polymerase chain reaction testing. Through medical record review and CHCO-ED unit-leader interviews, we identified patients and HCWs in overlapping ED areas with the first sibling, until 2 hours after discharge. Measles susceptibility was assessed through interviews with adults accompanying pediatric patients and HCW immunity record reviews. Potentially exposed persons were classified as immune (≥1 documented measles-mumps-rubella (MMR) vaccination or serologic evidence of immunity), unconfirmed immune (self-reported MMR or childhood vaccination without documentation), or susceptible (no MMR vaccine history or age <12 months). Susceptibility status directed disease control intervention, and contact follow-up was 21 days. Results: On December 14, all 3 siblings (ages 8–11 years) had laboratory-confirmed measles and were hospitalized. CHCO’s rapid isolation of the 3 cases within 5 minutes after presentation to the ED eliminated the need for exposure assessment on the day of hospitalization. However on December 12, the 1 ill sibling potentially exposed 258 ED contacts (90 patients, 168 accompanying adults) and 22 HCWs. The PH department identified 158 immune contacts (61%), 75 unconfirmed immune contacts (29%), and 19 susceptible contacts (8%); 6 contacts (2%) were lost to follow-up. Overall, 15 susceptible contacts received immune globulin (IG) postexposure prophylaxis and 4 contacts were placed on 21-day quarantine. Unconfirmed immune contacts self-monitored for measles symptoms and were contacted weekly by PH for 21 days. Moreover, 20 immune HCWs monitored symptoms daily; 2 susceptible HCWs were placed on 21-day quarantine. No secondary cases were identified. Conclusions: Rapid measles identification and isolation, high levels (90%) of immunity among contacts, prompt administration of IG, and effective collaboration between PH and CHCO prevented transmission.Funding: NoneDisclosures: None

Older adolescent presentations to a children's hospital emergency department

2016 ◽  
Vol 28 (4) ◽  
pp. 419-424 ◽  
Author(s):  
Shweta Batra ◽  
Elaine Yu Ching Ng ◽  
Feng Foo ◽  
Omar Noori ◽  
Mary McCaskill ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hospital Emergency Department ◽  
Hospital Emergency ◽  
Children's Hospital ◽  
Children’S Hospital

Management of personal protective equipment during the COVID-19 pandemic in England and the state of New York: A comparative case study

2020 ◽  
Vol 18 (7) ◽  
pp. 71-89
Author(s):  
Amy Barber, BSc ◽  
Annaëlle Vinzent, BS ◽  
Imani Williams, BA
Keyword(s):  
New York ◽  
Supply Chain ◽  
Health Systems ◽  
Personal Protective Equipment ◽  
New York State ◽  
The United States ◽  
Mitigation Strategies ◽  
Comparative Case Study ◽  
Protective Equipment

Background: The COVID-19 crisis placed extraordinary demands on the supply of personal protective equipment (PPE) at the beginning of 2020. These were coupled with shocks to the supply chain resulting from the disease. Many typically well-resourced health systems faced subsequent shortages of equipment and had to implement new strategies to manage their stocks. Stockpiles of protective equipment were held in both the United States and United Kingdom intended to prevent shortages. Method: Cross-comparative case study approach by applying Pettigrew and Whipp’s framework for change management. Setting: The health systems of England and New York state from January 2020 to the end of April 2020. Results: Both cases reacted slowly to their outbreaks and faced problems with supplying enough PPE to their health systems. Their stockpiles were not enough to prevent shortages, with many distribution problems resulting from inadequate governance mechanisms. No sustainable responses to supply disruptions were implemented during the study period in either case. Health systems planned interventions along each part of the supply chain from production and importing, to usage guidelines. Conclusion: Global supply chains are vulnerable to disruptions caused by international crises, and existing mitigation strategies have not been wholly successful. The existence of stockpiles is insufficient to preventing shortages of necessary equipment in clinical settings. Both the governance and quality of stockpiles, as well as distribution channels are important for preventing shortages. At the time of writing, it is not possible to judge the strength of strategies adopted in these cases.

scholarly journals Glucose-6-Phosphate Dehydrogenase Deficiency among Children Attending the Emergency Department of Yankin Children’s Hospital, Yangon

2019 ◽  
Vol 31 (2) ◽  
pp. 143-147
Keyword(s):  
Emergency Department ◽  
G6pd Deficiency ◽  
Who Classification ◽  
G6pd Activity ◽  
World Health ◽  
In Vitro Test ◽  
Children's Hospital ◽  
Severe Deficiency ◽  
Test Kit ◽  
Children’S Hospital

Yankin Children’s Hospital is one of the tertiary children hospitals in Myanmar, where some oxidative medications are commonly used in the management of illnesses. Paediatrician’s awareness of G6PD status in this population is very important for effective management and prevention of complications in G6PD deficient children. This preliminary study aims to determine the prevalence of G6PD deficiency according to WHO classification among children seeking medical care at Emergency Department of Yankin Children’s Hospital (YKCH). It was a cross-sectional descriptive study on 124 children, aged 1 month to 13 years. G6PD enzyme activity was determined by spectrophotometric assay within 24 hours of sample collection. Randox G6PD quantitative in vitro test kit (Randox Laboratories, Crumlin, UK) was used and G6PD activity was calculated as unit per gram (U/g) of haemoglobin (Hb). For classification of G6PD deficiency, 10% and 60% level of normal enzyme activities were calculated according to the suggestion by World Health Organization (WHO); G6PD activity <10% was defined as severe deficiency and 10-60% was defined as moderate deficiency. According to WHO classification, 18.5% (23/124) of children in this study was classified as G6PD deficient, with 3.2% severe deficiency and 15.3% moderate deficiency. The prevalence of G6PD deficiency in Myanmar children is higher than the previous reported prevalence if quantitative spectrophotometric method is used for diagnosis, detecting more individuals with moderate deficiency. The high prevalence of G6PD deficiency in this study warrants for the need to do neonatal screening to avoid the potentially fatal complications of this disease.

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