Pediatrics. 2023 Apr 1;151(4). doi: 10.1542/peds.2022-059459.
Pediatric surge planning is critical in the setting of decreasing pediatric inpatient capacity. We describe a statewide assessment of pediatric inpatient bed capacity, clinical care therapies, and subspecialty availability during standard and disaster operations in Massachusetts.
To assess pediatric (<18 years old) inpatient bed capacity during standard operations, we used Massachusetts Department of Public Health data from May 2021. To assess pediatric disaster capacity, therapies, and subspecialty availability in standard and disaster operations, we performed a state-wide survey of Massachusetts hospital emergency management directors from May to August 2021. From the survey, we calculated additional pediatric inpatient bed capacity during a disaster and clinical therapy and subspecialty availability during standard and disaster operations.
Of 64 Massachusetts acute care hospitals, 58 (91%) completed the survey. Of all licensed inpatient beds in Massachusetts (n = 11 670), 19% (n = 2159) are licensed pediatric beds. During a disaster, 171 pediatric beds could be added. During standard and disaster operations, respiratory therapies were available in 36% (n = 21) and 69% (n = 40) of hospitals, respectively, with high flow nasal cannula being most common. The only surgical subspecialist available in the majority of hospitals (>50%) during standard operations is general surgery (59%, n = 34). In a disaster, only orthopedic surgery could additionally provide services in the majority hospitals (76%; n = 44).
Massachusetts pediatric inpatient capacity is limited in a disaster scenario. Respiratory therapies could be available in more than half of hospitals in a disaster, but the majority of hospitals lack surgical subspecialists for children under any circumstance.
在儿科住院床位减少的情况下，儿科应急规划至关重要。我们描述了马萨诸塞州全州范围内对儿科住院床位容量、临床治疗疗法和专科可用性的评估，评估内容包括标准和灾害情况下的情况。
为了评估标准运营期间儿科（<18 岁）住院床位容量，我们使用了马萨诸塞州公共卫生部 2021 年 5 月的数据。为了评估标准和灾害运营期间儿科的灾害能力、治疗方法和专科可用性，我们对马萨诸塞州医院应急管理主任进行了全州范围的调查，调查时间为 2021 年 5 月至 8 月。从调查中，我们计算了在灾害期间增加的额外儿科住院床位数量，以及在标准和灾害运营期间的临床治疗和专科可用性。
在 64 家马萨诸塞州急症护理医院中，有 58 家（91%）完成了调查。在马萨诸塞州所有许可的住院床位中（n=11670），19%（n=2159）是许可的儿科床位。在灾害期间，可增加 171 张儿科床位。在标准和灾害运营期间，分别有 36%（n=21）和 69%（n=40）的医院提供呼吸治疗，其中最常见的是高流量鼻插管。在标准运营期间，大多数医院（>50%，n=34）都有普通外科的唯一外科专科医生。在灾害中，只有骨科手术可以在大多数医院（76%，n=44）提供服务。
马萨诸塞州儿科住院床位在灾害情况下有限。在灾害中，超过一半的医院可能会提供呼吸治疗，但在任何情况下，大多数医院都缺乏儿科外科专科医生。
