From the Baylor College of Medicine.
Texas Children's Hospital, Houston, TX.
Pediatr Emerg Care. 2021 Mar 1;37(3):175-178. doi: 10.1097/PEC.0000000000002330.
The COVID-19 pandemic has brought new challenges to pediatric transport programs. The aims of this study were to describe the transport of pediatric patients with confirmed COVID-19 and to review the operational challenges that our transport system encountered.
A retrospective descriptive study was performed to review all COVID-19 pediatric transport performed over a 6-month period during the initial pandemic surge in 2020. Pediatric patients with a known positive SARS-CoV-2 polymerase chain reaction test at the time of transport were included. Patients' hospital records, including their transport record, were reviewed for demographics, diagnoses, transport interventions and complications, and admission disposition. Descriptive statistics were used to describe the patient cohort.
Of the 883 transports performed between April and October 2020, 146 (16%) tested positive for COVID-19 during the initial surge in our geographical area. Patient acuity was diverse with 40% of children having a chronic complex medical condition. More than 25% of children required aerosol-generating procedures during transport. The most common medical diagnosis was respiratory compromise, and the most common surgical diagnosis was appendicitis. No adverse events occurred during transports, and no transport team members contracted COVID-19 because of workplace exposure. Transport program operational challenges ranged from rapidly changing system logistics/policies to educational and utilization of proper personal protective equipment.
Children with COVID-19 can be transported safely with adaption of transport program procedures. Change management and team stress should be anticipated and can be addressed with repeated education and messaging.
COVID-19 大流行给儿科转运项目带来了新的挑战。本研究旨在描述 COVID-19 患儿的转运情况,并回顾我们的转运系统所面临的操作挑战。
对 2020 年 COVID-19 大流行初期 6 个月期间进行的所有 COVID-19 儿科转运进行回顾性描述性研究。将在转运时已知 SARS-CoV-2 聚合酶链反应检测呈阳性的儿科患者纳入研究。对患者的病历,包括转运记录,进行回顾,以了解患者的人口统计学、诊断、转运干预和并发症以及住院处置情况。使用描述性统计方法描述患者队列。
在 2020 年 4 月至 10 月期间进行的 883 次转运中,在我们所在地区的 COVID-19 初始激增期间,有 146 例(16%)检测呈 COVID-19 阳性。患者的病情轻重不一,其中 40%的儿童患有慢性复杂的医疗状况。超过 25%的儿童在转运过程中需要进行产生气溶胶的操作。最常见的医疗诊断是呼吸功能障碍,最常见的手术诊断是阑尾炎。转运过程中未发生不良事件,也没有转运团队成员因工作场所暴露而感染 COVID-19。转运项目的操作挑战范围从系统物流/政策的快速变化到适当的个人防护设备的教育和使用。
可以通过调整转运程序来安全转运 COVID-19 患儿。应预计到变革管理和团队压力,并通过反复的教育和信息传达来解决这些问题。