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. 2021 Dec 20:17:e83.
doi: 10.1017/dmp.2021.355.

Effect of the COVID-19 Pandemic on the Pediatric Emergency Department Flow

Andrea Rivera-Sepulveda  1 , Timothy Maul  2   3 , Katherine Dong  4 , Kylee Crate  4 , Talia Helman  4 , Corinne Bria  1 , Lisa Martin  1 , Kimberly Bogers  5 , Joseph W Pearce  5 , Todd F Glass  1
Affiliations

Effect of the COVID-19 Pandemic on the Pediatric Emergency Department Flow

Andrea Rivera-Sepulveda et al. Disaster Med Public Health Prep. .

Abstract

Objective: The aim of this study was to determine how the early stages of the coronavirus disease 2019 (COVID-19) pandemic affected the use of the pediatric emergency department (PED).

Methods: Cross-sectional study of PED visits during January through April, 2016-2020. Data included: total PED visits, emergency severity index (ESI), disposition, chief complaint, age (months), time from first provider to disposition (PTD), and PED length of stay (PED-LOS). P-value <0.01 was statistically significant.

Results: In total, 67,499 visits were reported. There was a significant decrease in PED visits of 24-71% from March to April 2020. Chief complaints for fever and cough were highest in March 2020; while April 2020 had a shorter mean PED-LOS (from 158 to 123 min), an increase of admissions (from 8% to 14%), a decrease in ESI 4 (10%), and an increase in ESI 3 (8%) (P < 0.001). There was no difference in mean monthly PTD time.

Conclusions: Patient flow in the PED was negatively affected by a decrease in PED visits and increase in admission rate that may be related to higher acuity. By understanding the interaction between hospital processes on PEDs and patient factors during a pandemic, we are able to anticipate and better allocate future resources.

Keywords: COVID-19; coronavirus; flow; pediatric emergency department; use.

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Figures

Figure 1.
Figure 1.
COVID-19 tent screening organization. Screening occurs before arrival to the ED parking lot (Cabana 1). Respiratory cases with positive screens are directed to stay in their cars and undergo triage and intake assessment through the external drive-through tent. Critically ill, high-risk patients, and those with negative screens are directed to park and proceed to have the parent/guardian screened (Cabana 2) and enter through the main ED.
Figure 2.
Figure 2.
Association between daily cumulative PED census and national and state pandemic mandates by the CDC and the US government.
See this image and copyright information in PMC

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