Development of pediatric surgical decision-making guidelines for COVID-19 in a New York City children's hospital

During the COVID-19 pandemic, experience-based guidelines are needed in the pediatric population in order to deliver high quality care in a new way that keeps patients and healthcare workers safe and maximizes hospital resource utilization. The COVID-19 pandemic has created an unprecedented strain o...

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Bibliographic Details
Published in:Journal of pediatric surgery 2020-08, Vol.55 (8), p.1427-1430
Main Authors: DeFazio, Jennifer R., Kahan, Anastasia, Fallon, Erica M., Griggs, Cornelia, Kabagambe, Sandra, Zitsman, Jeffrey, Middlesworth, William, Stylianos, Steven, Duron, Vincent
Format: Article
Language:English
Subjects:
Betacoronavirus
Child
Coronavirus
Coronavirus Infections - epidemiology
COVID-19
Decision Making
ECMO
Guidelines as Topic
Hospitals, Pediatric - statistics & numerical data
Humans
Laparoscopy
New York City - epidemiology
Oncology
Pandemics
Pneumonia, Viral - epidemiology
SARS-CoV-2
Surgical Procedures, Operative - standards
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Summary:During the COVID-19 pandemic, experience-based guidelines are needed in the pediatric population in order to deliver high quality care in a new way that keeps patients and healthcare workers safe and maximizes hospital resource utilization. The COVID-19 pandemic has created an unprecedented strain on national health care resources, particularly in New York City, the epicenter of the outbreak in the United States. Prudent allocation of surgical resources during the pandemic quickly became essential, and there is an unprecedented need to weigh the risks of operating versus delaying intervention in our pediatric patients. Here we describe our experience in surgical decision-making in the pediatric surgical population at Morgan Stanley Children’s Hospital of New York-Presbyterian (MSCHONY), which has served as a major urban catchment area for COVID-19 positive pediatric patients. We describe how we have adjusted our current treatment of multiple facets of pediatric surgery including oncology, trauma, minimally invasive procedures, and extracorporeal membrane oxygenation (ECMO). Our pediatric surgery department had to creatively and expeditiously adjust our protocols, guidelines, and workforce to not only serve our pediatric population but merge ourselves with our adult hospital system during the COVID pandemic. Clinical research paper Level V
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2020.05.043