scholarly journals The Impact of COVID-19 on a Tertiary Care Pediatric Emergency Department

2020 ◽  
Author(s):  
Ilaria Liguoro ◽  
Chiara Pilotto ◽  
Michela Vergine ◽  
Anna Pusiol ◽  
Enrico Vidal ◽  
...  
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Pediatric Emergency ◽  
Relative Increase ◽  
Pediatric Care ◽  
Pediatric Emergency Department ◽  
Care Access ◽  
Ed Visits ◽  
Novel Coronavirus ◽  
The Impact

Abstract Restricting measures required to face the recent outbreak of a novel Coronavirus (CoV-2) may also impact on patterns of healthcare utilization. Our aim was to provide an insight into the changing use of a pediatric Emergency Department (ED) during the CoV-2 pandemic.Medical records of children seen in our Pediatric ED during March and April 2020 were retrospectively reviewed. Comparisons with the same time intervals in 2018 and 2019 and with other seasonal control periods (January-February 2019 and 2020, and July-August 2018-2019) were performed. The total number of ED visits declined of 73% from 2019 to 2020 (3051 vs 818). Significant variations were observed in the distribution of children among triage categories: the proportion of cases scored as green-code showed a 0.59-fold decrease in comparison to 2019 (95%CI 0.5-0.69), while a relative increase in the proportion of yellow codes was observed (OR 1.46, 95%CI 1.2-1.78). Conclusion: Quarantine measures significantly impacted on the total number and reasons for visits in our Pediatric ED. This substantial decrease in pediatric care access may be either due to lower rates of acute infections because of social distancing, and to reticence on the part of parents and caregivers to risk exposure to SARS-CoV-2 in a health-care setting.

scholarly journals The impact of COVID-19 on a tertiary care pediatric emergency department

2021 ◽  
Author(s):  
Ilaria Liguoro ◽  
Chiara Pilotto ◽  
Michela Vergine ◽  
Anna Pusiol ◽  
Enrico Vidal ◽  
...  
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
The Impact

scholarly journals The impact of lockdown on pediatric ED visits and hospital admissions during the COVID19 pandemic: a multicenter analysis and review of the literature

2021 ◽  
Author(s):  
Matthijs D. Kruizinga ◽  
Daphne Peeters ◽  
Mirjam van Veen ◽  
Marlies van Houten ◽  
Jantien Wieringa ◽  
...  
Keyword(s):  
The Netherlands ◽  
Hospital Admissions ◽  
Clinical Care ◽  
Pediatric Emergency ◽  
Pediatric Care ◽  
Care Utilization ◽  
Admission Data ◽  
Multicenter Analysis ◽  
Ed Visits ◽  
The Impact

AbstractThe coronavirus disease 2019 pandemic has enormous impact on society and healthcare. Countries imposed lockdowns, which were followed by a reduction in care utilization. The aims of this study were to quantify the effects of lockdown on pediatric care in the Netherlands, to elucidate the cause of the observed reduction in pediatric emergency department (ED) visits and hospital admissions, and to summarize the literature regarding the effects of lockdown on pediatric care worldwide. ED visits and hospital admission data of 8 general hospitals in the Netherlands between January 2016 and June 2020 were summarized per diagnosis group (communicable infections, noncommunicable infections, (probable) infection-related, and noninfectious). The effects of lockdown were quantified with a linear mixed effects model. A literature review regarding the effect of lockdowns on pediatric clinical care was performed. In total, 126,198 ED visits and 47,648 admissions were registered in the study period. The estimated reduction in general pediatric care was 59% and 56% for ED visits and admissions, respectively. The largest reduction was observed for communicable infections (ED visits: 76%; admissions: 77%), whereas the reduction in noninfectious diagnoses was smaller (ED visits 36%; admissions: 37%). Similar reductions were reported worldwide, with decreases of 30–89% for ED visits and 19–73% for admissions.Conclusion: Pediatric ED utilization and hospitalization during lockdown were decreased in the Netherlands and other countries, which can largely be attributed to a decrease in communicable infectious diseases. Care utilization for other conditions was decreased as well, which may indicate that care avoidance during a pandemic is significant. What is Known:• The COVID-19 pandemic had enormous impact on society.• Countries imposed lockdowns to curb transmission rates, which were followed by a reduction in care utilization worldwide. What is New:• The Dutch lockdown caused a significant decrease in pediatric ED utilization and hospitalization, especially in ED visits and hospital admissions because of infections that were not caused by SARS-CoV-2.• Care utilization for noninfectious diagnoses was decreased as well, which may indicate that pediatric care avoidance during a pandemic is significant.

Foreign Body Ingestions in Children: Risk of Complication Varies With Site of Initial Health Care Contact

PEDIATRICS ◽  
1993 ◽  
Vol 91 (1) ◽  
pp. 121-127 ◽  
Author(s):  
Ronald I. Paul ◽  
Katherine Kaufer Christoffel ◽  
Helen J. Binns ◽  
David M. Jaffe ◽  
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Tertiary Care ◽  
Standard Of Care ◽  
Pediatric Emergency ◽  
Adverse Outcomes ◽  
Pediatric Emergency Department ◽  
Parent Supervision ◽  
Tertiary Care Hospitals ◽  
Patient Enrollment

Current recommendations for the management of pediatric foreign body ingestions are based on studies of patients cared for at tertiary care hospitals; they call for aggressive evaluation because of a high incidence of complications. Two hundred forty-four children with suspected foreign body ingestions were prospectively followed to analyze adverse outcomes, ie, procedures, complications, and hospitalizations. Patient enrollment into the study was from three sources: (1) patients who referred themselves to a tertiary pediatric emergency department, (2) patients referred to the same tertiary pediatric emergency department after an initial evaluation by another hospital or physician, and (3) Patients who reported their foreign body ingestions to a private pediatric practitioner participating in the study. Most children were well toddlers in normal circumstances, under parent supervision at the time of ingestion. Coins were the most common item ingested (46%). Procedures were done in 53 (24%) of 221 patients and complications occurred in 48 (22%) of 221. Complications were higher in patients referred to the emergency department (63%) than in emergency department self-referred patients (13%) or private practice patients (7%) (x2, P < .01). These findings demonstrate the risk of drawing conclusions regarding a universal standard of care from studies involving only hospital-based patients.

Trends in the diagnosis and management of anaphylaxis in a tertiary care pediatric emergency department

2018 ◽  
Vol 121 (3) ◽  
pp. 348-352 ◽  
Author(s):  
Neta Cohen ◽  
Tali Capua ◽  
Dikla Pivko ◽  
Moshe Ben-Shoshan ◽  
Shira Benor ◽  
...  
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Diagnosis And Management

scholarly journals Adjacent Primary Care May Reduce Less Urgent Pediatric Emergency Department Visits

2020 ◽  
Vol 11 ◽  
pp. 215013272092627
Author(s):  
Julia Ellbrant ◽  
Jonas Åkeson ◽  
Helena Sletten ◽  
Jenny Eckner ◽  
Pia Karlsland Åkeson
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Patient Characteristics ◽  
Pediatric Emergency ◽  
Emergency Department Visits ◽  
University Hospital ◽  
Pediatric Emergency Department ◽  
Hospital Data ◽  
Cross Sectional ◽  
Ed Visits

Aims: Pediatric emergency department (ED) overcrowding is a challenge. This study was designed to evaluate if a hospital-integrated primary care unit (HPCU) reduces less urgent visits at a pediatric ED. Methods: This retrospective cross-sectional study was carried out at a university hospital in Sweden, where the HPCU, open outside office hours, had been integrated next to the ED. Children seeking ED care during 4-week high- and low-load study periods before (2012) and after (2015) implementation of the HPCU were included. Information on patient characteristics, ED management, and length of ED stay was obtained from hospital data registers. Results: In total, 3216 and 3074 ED patient visits were recorded in 2012 and 2015, respectively. During opening hours of the HPCU, the proportions of pediatric ED visits (28% lower; P < .001), visits in the lowest triage group (36% lower; P < .001), patients presenting with fever ( P = .001) or ear pain ( P < .001), and nonadmitted ED patients ( P = .033), were significantly lower in 2015 than in 2012, whereas the proportion of infants ≤3 months was higher in 2015 ( P < .001). Conclusions: By enabling adjacent management of less urgent pediatric patients at adequate lower levels of medical care, implementation of a HPCU outside office hours may contribute to fewer and more appropriate pediatric ED visits.

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