Pandemic Planning, Response, and Recovery for Pediatricians: A Focus on Health Equity and Social Determinants of Health.

This article summarizes how pediatricians may be uniquely positioned to mitigate the long-term trajectory of COVID-19 on the health and wellness of pediatric patients especially with regard to screening for social determinants of health that are recognized drivers of disparate health outcomes. Health inequities, that is, disproportionately deleterious health outcomes that affect marginalized populations, have been a major source of vulnerability in past public health emergencies and natural disasters. Recommendations are provided for pediatricians to collaborate with disaster planning networks and lead strategies for public health communication and community engagement in pediatric pandemic and disaster planning, response, and recovery efforts.

Prevalence of Low-Acuity Pediatric Emergency Medical Services Transports to a Pediatric Emergency Department in an Urban Area.

Objectives: Many patients transported by Emergency Medical Services (EMS) do not have emergent resource needs. Estimates for the proportion of pediatric EMS calls for low-acuity complaints, and thus potential candidates for alternative dispositions, vary widely and are often based on physician judgment. A more accurate reference standard should include patient assessments, interventions, and dispositions.

Pediatric Primary Care Provider Perspectives on Including Children in Alternative Emergency Medical Services Disposition Programs.

Introduction: Many emergency medical services (EMS) agencies have implemented alternative disposition programs for low-acuity complaints, including transportation to clinics. Our objectives were to describe pediatric primary care providers' views on alternative EMS disposition programs.

Method: We conducted virtual focus groups with pediatric primary care providers.

Caregiver Perspectives on Including Children in Alternative Emergency Medical Services Disposition Programs: A Qualitative Study.

Objectives: Almost half of pediatric EMS calls may be for low-acuity problems. Many EMS agencies have implemented alternative disposition programs for low-acuity patients, including transportation to clinics, substituting taxis for ambulances, and treatment in place without transport to an emergency department. Including children in such programs poses specific challenges, with one concern being potential caregiver opposition.

Clinician and Caregiver Determinations of Acuity for Children Transported by Emergency Medical Services: A Prospective Observational Study.

Study Objective: Many Emergency Medical Services (EMS) agencies have developed alternative disposition processes for patients with nonemergency problems, but there is a lack of evidence demonstrating EMS clinicians can accurately determine acuity in pediatric patients. Our study objective was to determine EMS and other stakeholders' ability to identify low acuity pediatric EMS patients.

Methods: We conducted a prospective, observational study of children transported to a pediatric emergency department (ED) by EMS.

Rapid Development and Testing of a COVID-19 Vaccine Curriculum for Pediatricians.

Background And Objectives: As the coronavirus disease 2019 (COVID-19) pandemic evolves and vaccines become available to children, pediatricians must navigate vaccination discussions in the setting of rapidly changing vaccine recommendations and approvals. We developed and evaluated an educational curriculum for pediatricians to improve their knowledge about COVID-19 vaccines and confidence in communicating with patients and families about COVID-19 vaccines.

Methods: Five institutions collaborated to develop an online educational curriculum.

Caregiver Perceptions Regarding Alternative Emergency Medical Services Dispositions for Children: A Cross-Sectional Survey Analysis.

Introduction: Emergency medical services (EMS) systems have developed alternative disposition processes for patients (including leaving the patient at the scene, using taxis, and transporting to clinics) vs taking patients directly to an emergency department (ED). Studies show that patients favorably support these alternative options but have not included the perspectives of caregivers of children. Our objective was to describe caregivers' views about these alternative disposition processes and analyze whether caregiver support is associated with sociodemographic factors.

Emergency Medical Services Clinicians' Perspectives on Pediatric Non-Transport.

Objectives: Emergency medical services clinicians do not transport one-third of all children assessed, even without official pediatric non-transport protocols. Little is known about how EMS clinicians and caregivers decide not to transport a child. Our objectives were to describe how EMS clinicians currently decide whether or not to transport a child and identify barriers to and enablers of successfully implementing an EMS clinician-initiated pediatric non-transport protocol.

Coronavirus Disease 2019 in the Emergency Department: Establishing an Interprofessional Incident Command System.

Coronavirus disease 2019 was declared a national emergency in the United States on March 13, 2020, at which time the Children's National Hospital Emergency Department in Washington, DC, mobilized to develop and implement a unit-based Incident Command System. Anticipating that the unique and challenging nature of this pandemic might require a large interprofessional team, emergency nurses, emergency physicians, and emergency physician assistants were placed in traditional Incident Command System roles to provide an organizational framework for the ED response. This framework served multiple purposes but most importantly it helped to efficiently streamline and coordinate communications within the emergency department, with hospital leadership and with other hospital departments.

Characteristics and Clinical Outcomes of Children and Adolescents Aged <18 Years Hospitalized with COVID-19 - Six Hospitals, United States, July-August 2021.

During June 2021, the highly transmissible B.1.617.

An Assessment of Pediatric Resident Disaster Preparedness for the Neonatal Intensive Care Unit.

Objective: To assess the level of neonatal intensive care unit (NICU) disaster preparedness among pediatric residents.

Methods: A mixed-methods study including qualitative interviews and quantitative surveys was used. Interviews guided survey development.

National Characteristics of Non-Transported Children by Emergency Medical Services in the United States.

Most 911 calls result in ambulance transport to an emergency department. In some cases, transport is refused or deemed unnecessary. The frequency of pediatric non-transport is unknown.

Creating a Pediatric Prehospital Destination Decision Tool Using a Modified Delphi Method.

Decisions for patient transport by emergency medical services (EMS) are individualized; while established guidelines help direct adult patients to specialty hospitals, no such pediatric equivalents are in wide use. When children are transported to a hospital that cannot provide definitive care, care is delayed and may cause adverse events. Therefore, we created a novel evidence-based decision tool to support EMS destination choice.

Disaster Training Following COVID-19 for Pediatric Medical Residents: Demand and Format.

Objectives: Assess the knowledge, confidence, and attitudes of residents toward disaster medicine education in the coronavirus disease 2019 (COVID-19) era.

Methods: Survey distributed to pediatric residents at a tertiary care center, assessing confidence in disaster medicine knowledge and skills, and preferred educational methods. Based on residents' responses, virtual and in-person educational session implemented with a postsurvey to analyze effectiveness of education.

Estimated SARS-CoV-2 Seroprevalence in Healthy Children and Those with Chronic Illnesses in the Washington Metropolitan Area as of October 2020.

The estimated severe acute respiratory syndrome coronavirus 2 seroprevalence in children was found to be 9.46% for the Washington Metropolitan area. Hispanic/Latinx individuals were found to have higher odds of seropositivity.

Children's Hospital Ambulatory Response to the 2019 Novel Coronavirus Disease (COVID-19) Pandemic.

The 2019 novel coronavirus disease (COVID-19) pandemic produced an abrupt and near shutdown of nonemergent patient care. Children's National Hospital (CNH) mounted a multidisciplinary, coordinated ambulatory response that included supply chain management, human resources, risk management, infection control, and information technology. To ensure patient access, CNH expanded telemedicine and instituted operational innovations for outpatient procedures.

Implementing Paper Documentation During an Influenza Surge in a Pediatric Emergency Department.

Objective: We hypothesized that a paper documentation and discharge bundle can expedite patient care during an influenza-related surge.

Methods: Retrospective cohort study of low-acuity patients younger than 21 years surging into a pediatric emergency department between January and March 2018 with influenza-like illness. Patient visits documented using a paper bundle were compared with those documented in the electronic medical record on the same date of visit.

Results of Testing Children for Severe Acute Respiratory Syndrome Coronavirus-2 Through a Community-based Testing Site.

Objective: To describe the demographics, clinical features, and test results of children referred from their primary provider for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in the community setting.

Study Design: Retrospective cross-sectional study of children ≤22 years of age who were tested for SARS-CoV-2 at a community-based specimen collection site in Washington, DC, affiliated with a large children's hospital between March 21 and May 16, 2020.

Results: Of the 1445 patients tested at the specimen collection site for SARS-CoV-2 virus, 408 (28.

COVID-19 Result Follow-Up Process in the Pediatric Emergency Department Setting.

The novel coronavirus disease 2019 (COVID-19) pandemic upended the world. As emergency departments and hospitals across the nation and world braced themselves for the surge of this new disease, the emergency department (ED) at Children's National Hospital (CNH) quickly created a process to address surges in patient visits and follow-ups for coronavirus testing. Within 2 wk of the first reported pediatric patient diagnosed with COVID-19 in the Washington, DC, metropolitan area, CNH ED implemented a new comprehensive follow-up process.

Racial and/or Ethnic and Socioeconomic Disparities of SARS-CoV-2 Infection Among Children.

Objectives: To evaluate racial and/or ethnic and socioeconomic differences in rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among children.

Methods: We performed a cross-sectional study of children tested for SARS-CoV-2 at an exclusively pediatric drive-through and walk-up SARS-CoV-2 testing site from March 21, 2020, to April 28, 2020. We performed bivariable and multivariable logistic regression to measure the association of patient race and/or ethnicity and estimated median family income (based on census block group estimates) with (1) SARS-CoV-2 infection and (2) reported exposure to SARS-CoV-2.